Fill Out the Sciatica Severity Assessment Form Below to Receive Free Expert Guidance on YOUR Problem! * indicates required Your First Name * Where exactly is your pain? * Lower back onlyLower back and buttock(s)No back pain, just leg painLower back and all the way down leg(s)Lower back and partially down leg(s) Do you have pain in one or both legs? * One leg onlyBoth legsNo leg pain Do you experience pins and needles/numbness? * Yes, constantlyYes, sometimesNone How long have you suffered? * 0-4 weeks4 weeks - 3 months3-6 months6 months - 2 years2 years +Feels like a lifetime What does sciatica stop you from doing/enjoying? * What hurts most from the following? * WalkingStanding stillSittingLying down Which movement hurts most from the following? * Bending forwardLeaning backTwistingPutting on socks How badly does this affect your work? * I can still work as normalI'm still at work, but very distracted by painHaving to take regular days offI can't work at allRetired/NA How are you sleeping? * I can still sleep as normalI am woken up occasionally by pain or struggle to get comfyI am constantly woken up by the painI can't sleep at all Have you had any bladder/bowel problems? * Some episodes of loss of bladder/bowel controlGreater sense of urgency for the toiletTrouble feeling the tissue when wipingNone of the above What have you tried so far for the pain? * Has anything helped the pain? * Are your friends or family noticing your sciatica? * Yes, all the timeYes, occasionallyNot that I'm aware of Your Email Address * Consent Please confirm that you are happy to receive the results of your sciatica severity injury assessment by email: Yes, please send me my results! Please allow at least 48 hours for a specialist to analyse your results. As part of the service, you will receive occasional emails from Overcome Sciatica. You can unsubscribe at any time.