Best evidence · Patient guide
Who should I see for sciatica?
The right person depends on your symptoms and how they are changing. Many people can start with their GP or physiotherapist. Severe pain, uncertainty about the cause or symptoms that are not improving may call for specialist assessment.
Go to A&E immediately if sciatica affects both legs, you develop numbness around your genitals or bottom, new difficulty starting or controlling urine, loss of awareness or control of bowel movements, or severe or worsening weakness or numbness in both legs. These can signal serious pressure on the nerves. Do not wait for a routine appointment. Call 999 if you need an ambulance.
GP or physiotherapist: a starting point
A GP can assess symptoms, review medicines and arrange further care. A physiotherapist can help with movement and rehabilitation, and recognise when medical assessment is needed. In some areas you can refer yourself to NHS musculoskeletal services.
Arrange a GP review if pain is worsening, limiting everyday activities or not improving after a few weeks. You do not need to wait if pain is already difficult to manage. NHS advice on getting help.
Pain medicine consultant: when the next step is unclear
A specialist consultation can help when initial treatment has not helped enough, medicines are causing problems, or you have conflicting advice about what to do next.
Dr Oliver Seyfried provides specialist assessment and non-surgical pain treatment. He can help you decide whether to continue rehabilitation, consider an image-guided nerve-root injection or seek a spinal surgical opinion. Read what happens in a consultation.
Spinal surgeon: when an operation needs consideration
A surgical consultation is appropriate when an operation may offer a worthwhile benefit. You do not have to decide on surgery before seeing a surgeon. The existing guide explains when referral is indicated and what to discuss.
New or increasing weakness, including difficulty lifting the front of your foot, needs urgent medical assessment. Contact your GP or NHS 111 the same day; rapidly worsening weakness needs emergency assessment.
Choosing someone to help you
Look for relevant training and a clinician who explains the reasons for their advice, the alternatives and what happens if the first approach does not help. Someone who offers a procedure should also be willing to explain when it is unlikely to be useful.
Dr Seyfried’s professional profile sets out his qualifications and clinical practice. For private appointments, contact the secretary about referral requirements. If using insurance, check whether your insurer requires a GP referral and authorisation.
Evidence used
Evidence checked and clinically approved by Dr Oliver Seyfried · 5 September 2026