Common symptoms
- Pain from the buttock down the back or side of the leg, sometimes to the foot
- Burning, shooting or electric-shock type pain
- Pins and needles or numbness in the leg or foot
- Leg pain that is often worse than the back pain
- Pain worse with sitting, coughing or sneezing
What causes sciatica
The sciatic nerve is formed from nerve roots that leave the lower spine. The most common cause of sciatica is a herniated (slip) disc irritating one of those roots. Other causes include narrowing of the spaces where nerves exit the spine (spinal stenosis), more common after the age of 60, and less commonly other spinal conditions.
Pain in the buttock and leg is not always sciatica; hip and muscle problems can feel similar. A careful assessment tells them apart.
How we assess it
We check the pattern of your symptoms, test the strength, reflexes and sensation linked to each nerve root, and use gentle tests to see how sensitive the nerve is. We also screen carefully for the warning signs below.
How we treat it
- Positions and movements that reduce leg pain, and what to avoid for now
- Gentle nerve mobilisation (“nerve glides”) as the nerve settles
- Progressive exercise for the back, hips and legs
- Spinal decompression for suitable disc-related sciatica
- Practical advice on sitting, sleeping, driving and work
How many sessions will I need?
Sciatica often improves within 4 to 6 weeks, but it can take longer. A typical plan is 6 to 12 sessions over 4 to 8 weeks, sometimes with spinal decompression, then a home programme.
When to see a doctor first
Please see a doctor or go to an emergency department, rather than booking physiotherapy, if you have:
- Sciatica in both legs
- Numbness around the groin, buttocks or inner thighs (saddle area)
- New difficulty passing urine, or loss of bladder or bowel control: seek emergency care
- Leg or foot weakness that is getting worse, or foot drop
- Sciatica with fever, unexplained weight loss or a history of cancer
Frequently asked questions
How long does sciatica last?
Many people improve within 4 to 6 weeks, although some cases take a few months. Staying active within comfort and following a physiotherapy plan helps recovery.
Is walking good for sciatica?
For most people, yes. Short, regular walks within comfort usually help more than resting. If walking makes your leg pain worse, we can find alternatives.
What is the best sleeping position for sciatica?
Lying on your side with a pillow between your knees, or on your back with a pillow under your knees, is comfortable for many people. The best position is the one that eases your leg pain.
Can spinal decompression help sciatica?
It may help when sciatica is caused by a disc irritating a nerve, as part of a plan with exercise. We assess suitability first and only continue if it is helping.
Should I stretch my hamstrings for sciatica?
Strong hamstring stretches can irritate a sensitive sciatic nerve. Gentler nerve-glide movements are often better early on. We will show you what suits your stage.