Sciatica is one of the most common reasons people walk through our doors, and over the years our team has helped hundreds of clients with it. If you have pain shooting from your lower back or buttock down the back of your leg, sometimes with pins and needles or numbness, you are not alone. The good news is that most people with sciatica get better without surgery.
What is sciatica?
Sciatica is not a diagnosis in itself. It describes pain that travels along the path of the sciatic nerve, the longest nerve in the body, which runs from your lower back through the buttock and down the leg. It happens when one of the nerve roots in the lower back becomes irritated or compressed. The most common cause is a disc bulge or disc herniation. Other causes include narrowing of the spaces the nerves travel through (stenosis), and less commonly, tight or irritated muscles deep in the buttock.
Common symptoms
- Pain in the buttock or down the back or side of the leg, often worse than any back pain
- Burning, shooting or electric-shock sensations
- Pins and needles or numbness in the leg or foot
- Weakness in the leg or foot
- Pain that is worse with sitting, bending, coughing or sneezing
Will it get better?
For most people, yes. Sciatica often improves significantly over the first six to twelve weeks. Disc material that is pressing on a nerve can shrink and be reabsorbed by the body over time. The aim of treatment is to settle your pain, keep you moving and help you return to normal life as quickly and safely as possible.
How physiotherapy helps
At IntegratePHYSIO we start with a thorough assessment to work out where the nerve is being irritated and how it is affecting your strength, sensation and reflexes. Your treatment plan may include:
- Education and reassurance about what is happening and what to expect
- Pain-relieving positions and movements you can use at home and at work
- Hands-on treatment such as joint mobilisation and soft tissue work
- Nerve mobility exercises to help the nerve glide more freely
- A graded exercise program to restore strength and confidence in your back
- Advice on sitting, sleeping, lifting and work while you recover
Staying gently active is usually better than bed rest. We will guide you on what to do, and what to avoid, at each stage.
When to seek urgent help
Rarely, a large disc can compress the nerves that control the bladder and bowel (cauda equina syndrome). This is a medical emergency. Go to an emergency department straight away if you notice:
- Numbness around the groin, genitals or inner thighs (saddle area)
- Difficulty passing urine, or loss of bladder or bowel control
- Rapidly worsening weakness in one or both legs
- Sciatica in both legs at the same time
You should also see your GP or physio promptly if your pain is not easing, if you are losing strength, or if you are unwell with fever or unexplained weight loss.
Do I need a scan?
Most people with sciatica do not need a scan to get better. Imaging is useful if symptoms are severe, getting worse, not improving with good care, or if an injection or surgery is being considered. We will tell you if we think you need one and work with your GP or specialist to arrange it.
If sciatica is stopping you from sitting, sleeping or working, book an appointment with our team. No referral is needed. You can also read more about how we treat sciatica.
Information on this page is general and does not replace individual medical or physiotherapy advice. Your clinician will explain the most appropriate options after assessing you.
