Prevalence, risk factors, and awareness of sciatica symptoms and treatment approaches among adults in the Jazan region

Abstract

Sciatica represents a significant neurological disorder affecting global health systems. This study assessed the prevalence, risk factors, awareness of symptoms and treatment approaches for sciatica in the Jazan Region of Saudi Arabia. A cross-sectional study was conducted among 927 adults in the Jazan Region using a validated questionnaire distributed through digital platforms. The questionnaire assessed demographics, medical history, risk factors, and knowledge of sciatica symptoms and treatment. Data analysis employed descriptive statistics and chi-square tests using R software. The study revealed a sciatica prevalence of 9.9%, with significant associations observed with arthritis, obesity, and family history. Knowledge assessment showed that most participants demonstrated poor understanding of sciatica’s causes and treatments. Arthritis emerged as the strongest risk factor, with 33.3% prevalence among affected individuals. While 83% recognized the superiority of evidence-based treatments over traditional approaches, only 31.1% correctly identified herniated discs as a primary cause. Significant knowledge disparities were observed across demographic groups, with higher awareness among females, younger adults, and those with chronic conditions (all p < 0.05). The findings highlight substantial knowledge gaps regarding sciatica in the Jazan Region, despite its considerable prevalence. The study underscores the need for targeted educational initiatives, particularly focusing on high-risk groups and preventive strategies. Integration of sciatica awareness programs into primary healthcare services, alongside workplace wellness initiatives, could significantly improve public health outcomes and reduce disease burden.

Introduction

Sciatica, or lumbar radicular pain (LRP), is a significant neurological disorder affecting the sciatic nerve, the largest nerve in the human body formed by the union of nerve roots L4–S1^1–3. To understand sciatica’s impact and symptoms, it is essential to comprehend its anatomical basis. The sciatic nerve, the largest nerve in the human body, is formed by the union of nerve roots from the lower spine^2,4. The peroneal and tibial nerves emerge from the pelvis in an ensheathed single trunk as the sciatic nerve, which is formed when the fourth and fifth lumbar nerve roots and the first two sacral nerve roots unite in the lumbosacral plexus. This complex anatomical arrangement explains why sciatica can manifest from various causes and locations along the nerve pathway⁴. While sciatica can result from disturbances anywhere along the sciatic nerve’s path, the most vulnerable points are the L4–L5 and L5–S1 levels, where disk rupture and osteoarthritic changes commonly occur, and, less frequently, the L3–L4 level, where the root is typically compressed beneath the corresponding disk^5,6. The development of sciatica symptoms can occur through two primary mechanisms: deformity of the nerve root or its sensory ganglion, or through the action of inflammatory cytokines in the local area^5,7. This understanding of the nerve’s anatomy and potential points of compression or irritation helps clinicians identify the likely cause and location of the problem, leading to more targeted and effective treatments^5,8. Recent research has shown that the anatomical location of nerve compression strongly correlates with specific symptom patterns, allowing for more precise diagnosis and treatment planning^2,8.

Sciatica represents a significant global health burden, with current epidemiological data indicating that low back pain (LBP) affects 58–84% of the general population during their lifetime⁹. Current epidemiological data indicates that low back pain (LBP) affects 58–84% of the general population during their lifetime, with sciatica accounting for 5–10% of these cases^2,8. In the general population, The annual incidence of an episode of sciatica ranges from 1 to 5%, while the annual incidence of disc-related sciatica is estimated at 2.2%^3,8. Sciatica places substantial burden on healthcare systems, with approximately 7% of general practitioner consultations related to back discomfort, resulting in 4.1 million missed workdays annually². The clinical presentation typically includes pain that can develop gradually or suddenly, starting in the hip joint, radiating down the leg, and reaching the toes. This characteristic pain pattern is a hallmark of sciatica. The condition is often accompanied by a burning sensation in the lower back, paresthesia, and leg numbness, particularly when standing. Studies have shown that the severity of the pain may worsen with coughing, bending, twisting, or engaging in physical activities³. Notably, approximately 30% of patients experience severe symptoms within the first year of diagnosis, highlighting the progressive nature of the condition^2,8.

Regional studies have provided valuable insights into sciatica’s prevalence patterns and knowledge gaps. Korovessis et al.¹⁰ conducted a cross-sectional study in the Mediterranean region involving 674 adults, reporting a 6-month prevalence of 24.6% for sciatica and 39.5% for low back pain. The study identified significant associations between symptom severity and specific demographic factors, particularly among older married individuals and those with smoking history¹⁰. Younes et al.¹¹ conducted a larger cross-sectional study in Tunisia (n = 5000) revealing annual disc-related sciatica (DRS) prevalence and incidence rates of 2.21% and 1.44%, respectively². These findings align with broader epidemiological patterns observed in other regional studies^11,12, highlighting the importance of considering sociodemographic factors in sciatica risk assessment. In Saudi Arabia specifically, recent healthcare reforms have highlighted low back pain as an emerging public health challenge, with prevalence estimates ranging from 63.8 to 89%¹³, recent studies have revealed significant knowledge deficits. A 2022 nationwide study (n = 3764) found that 60.1% of respondents demonstrated poor understanding of sciatica, with most relying on specialist consultations for information³. Similarly, although 83.7% reported awareness of sciatica, only 36% correctly identified herniated discs as a primary cause¹⁴. These findings underscore the critical need for enhanced educational initiatives and preventive strategies in the region.

Knowledge gaps regarding sciatica management represent a critical challenge in healthcare delivery^3,14. International studies have consistently demonstrated limited patient understanding of spinal conditions and their management, leading to delayed care-seeking behavior and suboptimal treatment outcomes^5,8,9,15. This knowledge deficit is especially concerning given sciatica’s significant socioeconomic impact, including prolonged work absence and reduced quality of life^8,11. Although, extensive literature exists on sciatica across different populations, in other regions of Saudi Arabia, no comprehensive study has yet investigated its prevalence, risk factors, and public awareness in the Jazan Region. This area has distinctive demographic and occupational characteristics (Fishing and agriculture), which may influence both the occurrence and management of sciatica¹⁶.

The present study aims to assess the prevalence, risk factors, awareness of symptoms, and treatment approaches for sciatica in the Jazan Region of Saudi Arabia. The findings of this study are expected to guide the development of region-specific preventive strategies and enhance early recognition of this health issue. This investigation is particularly significant as it addresses a crucial gap in regional literature, being the first comprehensive assessment of sciatica knowledge and prevalence in this geographical area. Understanding these patterns could inform the development of targeted educational programs, enhance early intervention strategies, and improve healthcare resource allocation. Furthermore, findings from this study could potentially guide policy reforms in primary healthcare delivery, emphasizing preventive measures and patient education. This research also aligns with Saudi Arabia’s Vision 2030 healthcare transformation goals, particularly in strengthening preventive care and reducing the burden of chronic conditions.

Materials and methods

Study design, settings, and sampling

A cross-sectional study was conducted during February–March 2024 to evaluate sciatica prevalence and knowledge among individuals older than 18 years in the Jazan region, Saudi Arabia. This region has a population of 1.5 million according to the 2022 Saudi census¹⁷. The minimum required sample size was calculated as 384 using the formula n = Z²P(1 − P)/d², where Z = 1.96 for 95% confidence level, P = 50% for maximum sample size, and d = 5% margin of error¹⁸. Convenience sampling through digital platforms was employed. This sampling approach was particularly appropriate given that Saudi Arabia ranks among the top countries globally in social media engagement¹⁹. The study recruited 927 participants, substantially exceeding the minimum requirement. This larger sample size reduced the margin of error and enhanced the study’s statistical power, particularly important for detecting differences across demographic subgroups²⁰.

Study participants and recruitment process

The target participants were all individuals older than 18 years living in the Jazan region. The main inclusion criteria were being an individual older than 18, who were willing to participate, and having residency in the Jazan region. To preserve participant confidentiality, identifiable data such as names or ID numbers were not collected. The survey was distributed to the general population by asking people who fit our study’s inclusion criteria to fill in the questionnaire after consent. Participants were promulgated via social media platforms, including WhatsApp, Telegram, and Twitter. Each participant has one opportunity to participate in the survey, which was prepared via Google Forms.

Study instruments and measures

The study utilized a 43-item Arabic questionnaire, expanding upon the validated instrument by Hashem et al.¹². While the core knowledge assessment components were maintained from the original questionnaire—including sciatica pathophysiology, risk factors, and symptoms (15 items), and treatment approaches and prevention awareness (13 items)—we supplemented the instrument with additional sections on socio-demographic characteristics (8 items) and medical and lifestyle factors (7 items). The electronic questionnaire required explicit informed consent before participation. Knowledge assessment followed the original scoring system with 1 point for correct answers and 0 for incorrect answers (maximum score: 28 points), categorizing knowledge levels as poor (< 50%), moderate (50–75%), and good (> 75%).

Data analysis

Data extraction from the questionnaire was processed and examined using the R software (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria). Preliminary steps involved inspecting the dataset for any missing values. After this, all variables underwent descriptive analysis. The Chi-squared and Fisher’s exact tests were applied to investigate the association between background characteristics, sciatica prevalence and knowledge. These tests were used for categorical data; the Chi-square test was applied for variables with adequate sample sizes, while Fisher’s exact test was used when expected counts were small (< 5), ensuring statistical reliability and precision in identifying significant associations. A threshold p-value of < 0.05 was set as the marker for statistical significance.

Ethical considerations

Before data procurement, all requisite official authorizations were secured. All potential participants were briefed on the study’s objectives and reassured of the study’s non-harmful nature, data anonymity, and comprehensive confidentiality. Informed consent was sought from all participants. In February 2024, the Jazan University Research Ethics Committee (REC-45/07/973) granted ethical clearance.

Results

The sociodemographic characteristics and anthropometric measurements of the study participants are presented in Table 1. The study included 927 participants with a mean age of 30 ± 11 years and a mean BMI of 25 ± 6.4 kg/m². The majority of participants were female (76%, n = 706) and resided in villages (56%, n = 519). Educational attainment showed that most participants held undergraduate degrees (75%, n = 693), with postgraduates comprising 6% (n = 60). Regarding employment status, 47% (n = 435) were students, 26% (n = 238) worked in the government sector, and 5% (n = 49) in the private sector. Most participants were single (58%, n = 542), and 92% (n = 854) were non-smokers. Family monthly income varied, with 34% (n = 319) earning less than 5000 SR ($1333), 20% (n = 182) earning 5000–9999 SR ($1333–2666), 19% (n = 175) earning 10,000–14,999 SR ($2667–3999), and 27% (n = 251) earning more than 15,000 SR ($4000).

Table 1.

Sociodemographic characteristics and anthropometric measurements of study participants in Jazan Region, Saudi Arabia (N = 927).

Characteristics	Mean ± SD
Age	30 ± 11 years
Weight	63 ± 17 Kg
Height	159 ± 9.6 cm
BMI	25 ± 6.4 Kg/ m2

Characteristics	Frequency (%)
Gender
Male	221 (24%)
Female	706 (76%)
Residence
City	408 (44%)
Village	519 (56%)
Education
Secondary school or less	174 (19%)
Undergraduate	693 (75%)
Postgraduate	60 (6%)
Marital status
Single	542 (58%)
Married	352 (38%)
Widowed /divorced	33 (4%)
Job
Employed in governmental sector	238 (26%)
Employed in private sector	49 (5%)
Student	435 (47%)
Unemployed	205 (22%)
Family monthly income
Less than 5000 SR	319 (34%)
5000–9999 SR	182 (20%)
10,000–14,999 SR	175 (19%)
15,000 SR or more	251 (27%)
Smoking
Yes	73 (8%)
No	854 (92%)

Data are presented as mean ± standard deviation (SD) for continuous variables and frequency (%) for categorical variables.

BMI categories: Underweight (< 18.5 kg/m²), Normal weight (18.5–24.9 kg/m²), Overweight (25–29.9 kg/m²), Class I obese (30–34.9 kg/m²), Class II obese (35–39.9 kg/m²), Class III obese (≥ 40 kg/m²).

SR: Saudi Riyal (1 USD = 3.75 SR).

Family monthly income categories: Low income (< 5000 SR), Lower-middle income (5000–9999 SR), Upper-middle income (10000–14999 SR), High income (≥ 15000 SR).

N: Total sample size.

The prevalence and risk factor analysis revealed that 92 participants (9.9%) reported having sciatica (Table 2). Several risk factors demonstrated significant associations with sciatica occurrence. Participants with a history of low back pain following accidents or falls exhibited a significantly higher prevalence (19.6%) compared to those without such history (6.4%, p < 0.001). Family history emerged as a substantial risk factor, with 23.5% prevalence among those with affected relatives versus 4.8% in those without (p < 0.001). The strongest association was observed with arthritis, where affected individuals showed a prevalence of 33.3% compared to 6% in those without arthritis (p < 0.001). Body mass index demonstrated a clear dose-response relationship, with prevalence increasing through weight categories to reach 33.3% in Class III obesity (p < 0.001). Duration of daily car riding showed significant correlation with sciatica prevalence (p = 0.004), with those spending less than one hour showing higher prevalence (13.8%) compared to those spending more than two hours (5.8%). Among female participants (n = 706), multiple pregnancies strongly correlated with sciatica prevalence (p < 0.001), particularly in those with more than three pregnancies (53.8%). Interestingly, daily phone usage duration showed no significant association with sciatica prevalence (p = 0.356), suggesting that this modern lifestyle factor may not significantly influence sciatica development.

Table 2.

Distribution of sciatica prevalence according to risk factors and associated variables among adults in Jazan Region, Saudi Arabia (N = 927).

Characteristics	With Sciatica (n = 92) (9.9%)	No sciatica (n = 835) (90.1%)	p-value
Have you suffered low back pain after accident or fall?
Yes	49 (19.6%)	201 (80.4%)	< 0.001*
No	43 (6.4%)	634 (93.6%)
Family history of Sciatica?
Yes	60 (23.5%)	195 (76.5%)	< 0.001*
No	32 (4.8%)	640 (95.2%)
Do you have arthritis
Yes	44 (33.3%)	88 (66.7%)	< 0.001*
No	48 (6%)	747 (94%)
Daily hours of phone usage
Less than 2 h	4 (8.7%)	42 (91.3%)	0.356
2–4 h	30 (12.9%)	202 (87.1%)
4–8 h	36 (9.3%)	353 (90.7%)
More than 8 h	22 (8.5%)	238 (91.5%)
Daily hours of car riding
Less than 1 h	49 (13.8%)	305 (86.2%)	0.004*
1–2 h	31 (8.5%)	334 (91.5%)
More than 2 h	12 (5.8%)	196 (94.2%)
Number of pregnancies (n = 706)
0	20 (25.6%)	372 (59.2%)	< 0.001*
1	2 (2.6%)	38 (6.1%)
2	5 (6.4%)	42 (6.7%)
3	9 (11.5%)	38 (6.1%)
More than 3	42 (53.8%)	138 (22%)
BMI
Underweight	7 (5.5%)	121 (94.5%)	< 0.001*
Normal weight	21 (5.2%)	383 (94.8%)
Overweight	33 (12.9%)	223 (87.1%)
Class I obese	21 (21.9%)	75 (78.1%)
Class II obese	4 (16%)	21 (84%)
Class III obese	6 (33.3%)	12 (66.7%)

*Statistically significant at p < 0.05.

BMI categories: Underweight (< 18.5 kg/m²), Normal weight (18.5–24.9 kg/m²), Overweight (25–29.9 kg/m²), Class I obese (30–34.9 kg/m²), Class II obese (35–39.9 kg/m²), Class III obese (≥ 40 kg/m²).

Data presented as n (%).

Number of pregnancies analysis includes only female participants (n = 706).

Chi-square test was used to determine statistical significance.

Knowledge assessment of sciatica symptoms and treatment methods revealed significant knowledge gaps among participants (Table 3). Only 31.1% correctly identified herniated vertebral discs as the primary cause of sciatica, while 47.4% recognized its characteristic symptoms. Risk factor awareness was moderate, with 49.1% acknowledging the role of age, weight, and prolonged sitting. Treatment knowledge was notably limited, with just 29.3% identifying physiotherapy and steroid injections, and 28.4% recognizing NSAIDs and muscle relaxants as valid interventions. Several misconceptions were prevalent: 14.2% incorrectly believed movement should be avoided during episodes, only 9.3% understood sciatica’s preventable nature, and 8.1% mistakenly believed sciatica inevitably leads to movement disability. Diagnostic awareness was also limited, with 33.8% recognizing the role of spinal CT/MRI, and 23.4% understanding surgery as a last resort option. Alternative treatment awareness varied considerably: turmeric milk (12.9%), mustard oil massage (22.1%), bloodletting (14.6%), moxibustion (19.2%), acupuncture (18.6%), and cupping therapy (21.7%). Encouragingly, 51.6% acknowledged the benefits of regular exercise and proper sitting posture, and 83% correctly recognized that traditional therapy is not superior to medical interventions in treating sciatica.

Table 3.

Assessment of knowledge regarding sciatica symptoms, risk factors, and treatment methods among adults in Jazan region, Saudi Arabia (N = 927).

Characteristics	Frequency
	Yes	No
The most common cause of Sciatica is herniated vertebral disc, which often occurs with age	*290 (31.1%)	637 (68.7%)
Pain, numbness, tingling sensation extending from the lower back down to toes and weakness of leg/foot muscles are symptoms of Sciatica	*439 (47.4%)	488 (52.6%)
Age, weight, nature of work and prolonged sitting are risk factors of Sciatica	*455 (49.1%)	472 (50.9%)
Sciatica is thought to be preventable, and it may not recur	86 (9.3%)	*841 (90.7%)
Physiotherapy and steroid injections are methods to reduce/treat Sciatica	*272 (29.3%)	655 (70.7%)
NSAIDs, Muscle relaxants are methods to reduce/treat Sciatica	*263 (28.4%)	664 (71.6%)
People with Sciatica should avoid movement as it may cause more injury	132 (14.2%)	*795 (85.8%)
Having Sciatica may mean you will end up with a movement disability	75 (8.1%)	*852 (91.9%)
The severity of pain varies from mild to very severe and it intensifies when sneezing or coughing or after prolonged sitting	*301 (32.5%)	626 (67.5%)
Spinal CT/MRI Can diagnose Sciatica	*313 (33.8%)	614 (66.2%)
Surgical intervention is the last method to relieve Sciatica	*217 (23.4%)	710 (76.6%)
Drinking Turmeric and Cinnamon mixed with warm milk can reduce/treat Sciatica pain	120 (12.9%)	*807 (87.1%)
Mustard oil massage can reduce/treat Sciatica pain	205 (22.1%)	*722 (77.9%)
FASD is one of the most effective ways in reducing/treating Sciatica	135 (14.6%)	*792 (85.4%)
Moxibustion and cautery can reduce/treat Sciatica pain	178 (19.2%)	*749 (80.8%)
Acupuncture can reduce/treat Sciatica pain	172 (18.6%)	*755 (81.4%)
Cupping therapy can reduce/treat Sciatica pain	201 (21.7%)	*726 (78.3%)
Regular exercising and proper sitting can significantly contribute to back protection	*478 (51.6%)	447 (48.4%)
Traditional therapy is more effective than medical intervention in treating Sciatica	158 (17%)	*769 (83%)

Data presented as frequency (%).

*Correct answers are marked with an asterisk.

NSAIDs: Non-steroidal anti-inflammatory drugs. CT: Computed tomography. MRI: Magnetic resonance imaging. FASD: Facial area substance dependence (blood-letting therapy).

Knowledge assessment based on validated questionnaire adapted from Hashem et al.³

Percentages may not total 100% due to rounding.

N: Total sample size.

Analysis of sciatica knowledge levels across different demographic and health characteristics revealed significant variations (Table 4). Overall, only 5% of participants demonstrated good knowledge, while 15.9% showed moderate knowledge, and a concerning 79.2% exhibited poor knowledge. Female participants showed better knowledge levels (6.1% good knowledge) compared to males (1.4% good knowledge) (p = 0.018). Age-wise differences were significant (p = 0.002), with the 18–24 years age group showing the highest proportion of good knowledge (6.4%). BMI categories demonstrated significant variation in knowledge levels (p = 0.043), with Class II obese participants showing the highest proportion of good knowledge (8%). Marital status significantly influenced knowledge levels (p = 0.02), with divorced/widowed participants showing the highest proportion of good knowledge (12.1%). Employment status showed significant differences (p < 0.001), with government sector employees and students demonstrating better knowledge levels. Physically active participants showed higher knowledge levels (5.6% good knowledge) compared to inactive participants (3.9%) (p = 0.027). Notably, diabetic participants demonstrated significantly higher good knowledge levels (13%) compared to non-diabetics (4.5%) (p = 0.006).

Table 4.

Distribution of sciatica knowledge levels according to sociodemographic and health characteristics among adults in Jazan Region, Saudi Arabia (N = 927).

Characteristics	Good knowledge 46 (5%)	Moderate knowledge 147 (15.9%)	Poor knowledge 734 (79.2%)	P value
Gender
Male	3 (1.4%)	37 (16.7%)	181 (81.9%)	0.018*
Female	34 (6.1%)	110 (15.6%)	553 (78.3%)
Age
18–24 years	32 (6.4%)	60 (11.9%)	411 (81.7%)	0.002*
25–29 years	1 (1.1%)	15 (16.9%)	73 (82%)
30–39 years	3 (2.7%)	17 (15.2%)	92 (82.1%)
40–49 years	6 (3.9%)	38 (25%)	108 (71.1%)
50 years and above	4 (5.6%)	17 (23.9%)	50 (70.4%)
BMI
Underweight	5 (3.9%)	13 (10.2%)	110 (85.9%)	0.043*
Normal weight	23 (5.7%)	53 (13.1%)	328 (81.2%)
Overweight	11 (4.3%)	48 (18.8%)	197 (77%)
Class I obese	4 (4.2%)	21 (21.9%)	71 (74%)
Class II obese	2 (8%)	5 (20%)	18 (72%)
Class III obese	1 (5.6%)	7 (38.9%)	10 (55.6%)
Marital status
Single	28 (5.2%)	72 (13.3%)	442 (81.5%)	0.02*
Married	14 (4%)	67 (19%)	271 (77%)
Divorced/Widowed	4 (12.1%)	8 (24.2%)	21 (63.6%)
Job
Employed in governmental sector	12 (5%)	51 (21.4%)	175 (73.5%)	< 0.001*
Employed in private sector	0 (0%)	9 (18.4%)	40 (81.6%)
Student	32 (7.4%)	58 (13.3%)	345 (79.3%)
Unemployed	2 (1%)	29 (14.1%)	174 (84.9%)
Physical activity
Active	33 (5.6%)	106 (17.9%)	452 (76.5%)	0.027*
Not active	13 (3.9%)	41 (12.2%)	282 (83.9%)
Diabetic?
Yes	7 (13%)	12 (22.2%)	35 (64.8%)	0.006*
No	39 (4.5%)	135 (15.5%)	699 (80.1%)

Data presented as n (%).

*Statistically significant at p < 0.05.

Knowledge levels categorized as: good knowledge (≥ 75% correct responses), moderate knowledge (50–74% correct responses), poor knowledge (< 50% correct responses).

BMI categories: underweight (< 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), Class I obese (30–34.9 kg/m²), Class II obese (35–39.9 kg/m²), Class III obese (≥ 40 kg/m²).

Physical activity: active (≥ 150 min of moderate-intensity or ≥ 75 min of vigorous-intensity physical activity per week).

Chi-square and fisher’s exact tests were used to determine statistical significance.

Percentages may not total 100% due to rounding.

Discussion

This study revealed a sciatica prevalence of 9.9% among adults in the Jazan region, comparable to global estimates of 5–10% reported in systematic reviews⁸. This prevalence rate positions our findings between those reported in Mediterranean countries (2.21–24.6%)^10,11, suggesting regional variations in disease burden that may be influenced by genetic, environmental, and healthcare access factors^21,22. Furthermore, Mediterranean populations have reported slightly higher prevalence rates, potentially reflecting cultural and lifestyle factors such as higher smoking prevalence, sedentary lifestyle and the dual occupational and domestic workload commonly experienced by married working women in older age^10,23.

Particularly concerning is our finding that 79.2% of participants demonstrated poor knowledge of sciatica, significantly higher than rates reported in other Saudi regions (60.1%)³ and neighboring countries (25-64.4%)^24,25. This substantial knowledge deficit, coupled with the significant prevalence rate, highlights a critical public health challenge in the region, potentially contributing to delayed care-seeking behavior and suboptimal treatment outcomes²⁶. Understanding the relationship between disease prevalence and knowledge gaps is crucial, as it provides a foundation for examining the specific risk factors and demographic characteristics associated with both the condition and awareness levels in our population.

Our analysis identified several significant physical and medical risk factors associated with sciatica occurrence. The highest prevalence was observed among individuals with arthritis (33.3%), followed by those with a family history (23.5%), and those with a history of accidents or falls (19.6%). In this study, the term arthritis referred to self-reported joint disease, encompassing both degenerative (osteoarthritis) and inflammatory conditions, as identified through participants’ medical history. These associations align with established literature, particularly the arthritis-sciatica relationship documented by Zhu et al.⁶, who reported a significant correlation between facet joint osteoarthritis and lumbar disc herniation (OR = 2.74, 95% CI 1.56–4.82). The relationship between BMI and sciatica was particularly noteworthy, with Class III obesity showing a prevalence of 33.3%, supporting the findings of Shiri et al.²⁷, who demonstrated through a meta-analysis that obesity (BMI ≥ 30) was significantly associated with increased risk of lumbar radicular pain (OR = 1.40, 95% CI 1.27, 1.55). Notably, we found that prolonged car rides (p = 0.004) and multiple pregnancies (p < 0.001) were significant contributors, consistent with Gallais et al.‘s findings²⁸ on occupational exposures and Euro’s²⁹ work on non-spinal causes of sciatica. These risk factor associations have important clinical implications, suggesting that preventive strategies should focus on weight management, ergonomic interventions, and careful monitoring of high-risk groups, particularly those with multiple risk factors. The identification of these modifiable risk factors provides a foundation for examining knowledge levels and treatment approaches in our population.

Knowledge assessment revealed significant gaps across multiple domains of sciatica understanding. Core disease knowledge was limited, with only 31.1% correctly identifying herniated vertebral discs as the primary cause, considerably lower than findings from similar regional studies (39.6–45%)^3,12,14. Symptom recognition showed moderate awareness (47.4%), showed a concerning 15% deficit compared to the national benchmark of 62.1%¹³. Risk factor awareness demonstrated notable variation, with 49.1% recognizing traditional risk factors, closely matching the national average of 49–51%^3,24. Our study revealed significantly lower treatment awareness compared to national data, particularly in: physiotherapy/steroid injections (29.3% vs. 35.8% national average) and pharmacological interventions (28.4% vs. 43.6% in comparable regions)^3,12. Movement-related misconceptions were notably less prevalent in our population (14.2% vs. 25.2% national average)^3,12, though understanding of preventability was concerning at 9.3%, half the national rate of 18.2%³. Diagnostic awareness showed regional consistency, with our finding of 33.8% aligning with national rates (32.9–35.8%)^3,12. However, despite this consistency, the overall level of awareness remained relatively low, indicating that public understanding of sciatica remains insufficient across both regional and national populations. Cultural beliefs and practices in Saudi Arabia may play a key role in treatment-seeking behaviour and perceptions of sciatica. Research in the Al-Qassim region found that many individuals regarded traditional therapies (cupping, massage and acupuncture) as beneficial for sciatica, despite limited awareness of anatomical causes and contemporary treatment options such as spinal imaging³⁰. Furthermore, spiritual beliefs around illness and healing (such as attributing pain to fate or divine test) may reduce the perceived urgency of seeking clinical care³¹. Interestingly the recognition (83%) that evidence-based treatments supersede traditional therapies, exceeding previous regional studies by 10–15%^3,12. This higher level of awareness may be attributed to recent national health reforms and increased public access to medical information.

Demographic analysis revealed distinct patterns in sciatica knowledge distribution. Gender differences were pronounced, with females showing significantly higher knowledge levels (6.1% good knowledge vs. 1.4% in males, p = 0.018), contrasting with previous findings of minimal gender variation³. Age-related patterns were noteworthy, with younger adults (18–24 years) demonstrating the highest proportion of good knowledge (6.4%, p = 0.002), particularly among university students (7.4%, p < 0.001). Socioeconomic factors showed unexpected associations: divorced/widowed individuals demonstrated the highest knowledge levels (12.1%, p = 0.02), while government sector employees outperformed private sector workers (5.0% vs. 0%, p < 0.001). Health-related characteristics revealed compelling patterns: diabetic participants showed significantly higher knowledge levels (13% vs. 4.5% in non-diabetics, p = 0.006), possibly reflecting increased healthcare engagement. Similarly, physically active individuals demonstrated better understanding (5.6% vs. 3.9% in inactive participants, p = 0.027), supporting previous findings¹². BMI classification showed a complex relationship with knowledge levels, with Class II obese participants demonstrating unexpectedly high knowledge (8%, p = 0.043), suggesting potential disease-driven health literacy. These demographic patterns suggest the need for targeted interventions focusing on males, private sector employees, and physically inactive individuals, while leveraging the existing knowledge base among healthcare-engaged populations.

Future sciatica-prevention initiatives should be strategically aligned with the overarching goals of Saudi Vision 2030, which emphasize reducing the burden of lifestyle-related and chronic musculoskeletal disorders, enhancing population well-being, and improving healthcare-system efficiency. As highlighted by Al-Anezi³², achieving these goals will require sustainable financing frameworks and robust public–private partnerships to strengthen healthcare transformation efforts in Saudi Arabia. Therefore, forthcoming policies should focus on developing value-based funding models that support long-term investments in community awareness programs, workplace health initiatives and partnerships.

Limitations and strength

This study represents the first comprehensive assessment of sciatica in Jazan, with notable strengths including: a robust sample size exceeding statistical requirement, validated measurement tools adapted, and comprehensive urban-rural population coverage. The study uniquely explored previously unexamined associations between chronic conditions and sciatica knowledge, establishing baseline data for future regional studies. However, several limitations warrant consideration: the cross-sectional design precluded causal inference. A key limitation of this study is that the data were based on participants’ self-reported responses, which may be subject to recall bias. The reliance on digital platforms for data collection, may have introduced selection bias by underrepresenting older adults, individuals with limited digital literacy, or those without regular internet access. Consequently, the findings may not fully capture the perspectives of these subpopulations, potentially affecting the generalizability of the results to the wider community. The convenience sampling through social media may have skewed participation toward younger, educated respondents (75% of undergraduates). Another limitation of this study is the absence of logistic regression analysis to estimate odds ratios for the influence of multiple risk factors on sciatica. This decision was based on the cross-sectional design and limited sample size, which did not permit reliable multivariate modeling without violating statistical assumptions. The cross-sectional nature of the study limits the ability to determine temporal or causal relationships between risk factors and disease occurrence. Despite these constraints, our findings provide valuable insights for developing targeted educational interventions and future epidemiological research in similar demographic settings.

Conclusion

This study provides compelling evidence of substantial sciatica burden and knowledge gaps in the southwestern region of Saudi Arabia, highlighting pressing needs for public health intervention. The notable prevalence of sciatica, coupled with widespread knowledge deficits across various demographic groups, presents significant challenges to healthcare delivery and patient outcomes. Concerns are the identified disparities in disease understanding and treatment awareness among specific population segments, especially males, physically inactive individuals, and those with multiple risk factors such as obesity and arthritis. However, the population’s demonstrated trust in evidence-based medicine over traditional approaches provides an encouraging foundation for educational initiatives. To address these challenges, we recommend integrating comprehensive sciatica awareness programs into primary healthcare services, developing culturally sensitive educational materials, and implementing workplace wellness programs with emphasis on ergonomic interventions. Educational materials should be developed in simple, locally understood language and disseminated through community health centers, mosques, and social media platforms, ensuring accessibility for all age and literacy groups. Future initiatives should prioritize piloting community-based educational programs aimed at high-risk groups, such as individuals with obesity, arthritis, or occupations involving heavy physical labor to enhance understanding of sciatica prevention and management. These recommendations, aligned with Saudi Arabia’s Vision 2030 healthcare transformation goals, offer practical pathways to reduce sciatica-related disability burden and enhance public health outcomes. Moving forward, longitudinal research evaluating intervention effectiveness will be crucial for optimizing healthcare resource utilization and improving patient care in the region, ultimately contributing to better health outcomes for the Jazan population.

Author contributions

M.A.J. conceived and designed the study, developed the methodology, performed formal analysis, led the investigation, curated data, wrote the original draft, administered the project, and supervised junior researchers. A.Y.A. supervised the overall project, validated methodology, provided resources, and performed critical revision of the manuscript. M.A.R., A.A.B., N.H.A., and I.A.H. contributed to methodology validation, data analysis, and quality control. A.J.A., A.S., E.F.H., M.H.M., S.N.W., F.N.H., S.K.A., M.I.H., and A.E.A. conducted data collection, data entry, participant recruitment, and preliminary analysis. M.A.J. and A.Y.A. wrote the main manuscript text. M.A.J., M.A.R., and N.H.A. prepared the tables and figures. A.Y.A. handled manuscript submission and correspondence. All authors reviewed and approved the final version of the manuscript and agree to be accountable for all aspects of the work.

Funding

This research received no external funding.

Data availability

The data presented in this study are available on request from the corresponding author.

Declarations

Competing interests

The authors declare no competing interests.

Institutional review board statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Research Ethics Committee of Jazan University, Saudi Arabia (IRB Approval number REC-45/07/973, date 07 February 2024).

Informed consent

Informed consent was obtained from all subjects involved in the study.