How do I deal with my sciatica and back pain in France? 

If you have ever suffered from sciatica, you will probably wince at just seeing the word. 

In France, there are around 150,000 cases of sciatica (sciatique) every year, according to the Centre Hospitalier de Reims, mostly in adults aged 30 to 55, although it can affect anyone. 

What is it? 

Sciatica is named after the sciatic nerve, a large, thick nerve made up of several nerve roots located in the lower back, buttocks and thighs. When this nerve is irritated or compressed, it causes a sharp, shooting pain down the leg, often right into your feet, and can also cause tingling or numbness in your back or buttocks.

What causes it? 

Sciatica usually occurs suddenly once the sciatic nerve has been pinched or compressed. This can be caused by poor posture, heavy lifting, a shift in the spine – such as during pregnancy –  a slipped disc in the lower back, known as a hernie discale lombaire. 

Can I treat it myself? 

Ameli, the French online health service, initially suggests lying on your back with legs elevated, and relaxing the contracted muscles using heat, such as warm baths or a heat pad, taking care not to scald yourself as numbness might make you less sensitive to temperature. It recommends paracetamol and, if the pain is bearable, to continue daily activities, avoiding movements that exacerbate the problem.

When do I need to see a doctor? 

If the pain does not improve within a few days of following these recommendations, Ameli advises consulting your GP. 

You should also do so if you notice progressive weakness or numbness in your leg or foot, a loss of sensation in part of the leg, or if the sciatic pain intensifies, especially at night. 

One additional case where you need to see your GP is if you had lost weight involuntarily before the sciatica appeared, as this could be a sign of a more serious underlying condition. 

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What are the likely treatments? 

For 80% of sciatica patients, medical treatments will prove to be effective within four to six weeks. 

The first recommendation will be rest, and taking care not to carry out activities that will aggravate your sciatica.

Prescribed treatments from your GP are likely to include anti-inflammatories, painkillers or muscle relaxants and you might be prescribed physiotherapy (kiné) sessions. 

A physiotherapist can show you exercises to stretch the affected muscles, targeting particular areas using a tennis ball (or similar) to ease the pain. 

If necessary, your GP might refer you to a rheumatologist who can offer an infiltration, a local corticosteroid injection to relieve pain, but these are not fully reimbursed by the state. 

Might I need surgery? 

Of the 150,000 cases of sciatica each year in France, only 30,000 require an operation, according to the Centre Hospitalier de Reims.

If surgery is required, it is usually because your sciatica has been caused by a damaged spinal disc pressing down on the underlying nerve – commonly known as a slipped disc. 

In this case, you might need lumbar decompression surgery to treat the damaged disc, which might even be possible as an outpatient. 

You will need six weeks’ convalescence, and can normally resume physical activity after three months. 

Where can I find out more? 

Search pages about sciatique on the Ameli website (www.ameli.fr/assure). 

These include treatments, recommendations on easing the pain, and cases in which it is advisable to see a doctor.

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