Sciatica is a very common reason people with leg pain come to see us. The pain from sciatica can be sharp, burning, tingling or aching, and it can make sitting, sleeping and even walking uncomfortable. The good news is that most people get better, and there is plenty you can do to help the process along.
What is sciatica?
Sciatica isn’t a diagnosis on its own. It’s the name for pain that travels along the path of the sciatic nerve, which runs from your lower back, through your buttock and down the back of your leg. It usually affects one side, and the pain often reaches below the knee. Some people also notice pins and needles, numbness or a feeling of weakness in the leg or foot.
Most of the time, sciatica happens when a nerve in the lower back becomes irritated or squeezed. Common causes include:
A disc bulge or herniation. The soft cushion between two spinal bones pushes out and irritates a nearby nerve.
Narrowing of the space around the nerves. This is more common as we age and can be related to arthritic changes in the spine.
Tight or irritated tissue in the buttock. Less commonly, muscles deep in the buttock can compress the nerve.
Sciatica can feel alarming, but pain along the nerve doesn’t mean serious damage has been done. Nerves can be quite sensitive when they’re irritated, and that sensitivity usually settles down over time.
What affects your risk?
Anyone can get sciatica, but some things make it more likely:
Age. It’s most common between your 30s and 50s.
Previous back pain or back injuries
Physically demanding work or long periods of sitting, especially without a break
Low activity levels or low general fitness
Smoking and carrying extra body weight, which can affect the health of the discs and tissues in your spine
What can you do about it?
For most people, the best first step is simple and doesn’t involve surgery or scans:
Education. Understanding what’s going on, why it hurts and what to expect takes away a lot of the fear. Most sciatica improves within weeks to a few months.
Pain Management. While sciatica and irritated nerves tend to heal on their own, pain management in the form of massage, dry needling, heat therapy and other exercises / techniques can make the time it takes much more bearable. Medication designed for nerve pain and anti-inflammatories may be beneficial too - we will often work with you and a GP to help you manage your pain while things heal.
Staying active. Gentle movement, such as short, regular walks, is usually better than bed rest. Rest might feel good in the moment, but too much of it can slow your recovery.
Targeted exercise. A physio can guide you towards movements that ease your symptoms and build strength and control in your back, hips and legs.
Adjusting your daily habits. Changes to how you sit, sleep and lift can calm things down while the nerve settles.
Do you need a scan?
Most people with sciatica don’t need an X-ray, CT or MRI at the start. Scans often show changes that are common in people with no pain at all, so they don’t always explain your symptoms or change the treatment. We’ll let you know if imaging is worth considering in your case.
When to get checked quickly.
Most sciatica is not dangerous, but some symptoms need urgent medical attention. Please see your GP or go to the emergency department if you have:
Difficulty controlling your bladder or bowels
Numbness around your groin, genitals or inner thighs
Weakness in your leg that is getting worse, or a foot that is dragging
Severe pain that is not easing, or pain with fever, unexplained weight loss or a recent significant injury
What about injections and surgery?
Injections and surgery are generally kept for people who haven’t improved after a good trial of the options above, or who have serious or worsening nerve symptoms. They can be the right choice for some people, and we’re not trying to talk you out of them. But for most people with sciatica, they aren’t needed.
If you do go ahead with either, rehabilitation still matters. Exercise and a gradual return to activity help you get the best result and lower the chance of the problem coming back.
How we help at Formotion Physio
Our team can work out what’s behind your leg pain and build a plan around your goals. That usually includes:
A thorough assessment. We look at how your back, hips and legs move, test your strength, sensation and nerve sensitivity, and ask about your work, sleep and daily activities. We’ll also check for any signs that need further medical attention.
Clear education. We’ll explain what’s going on and what to expect, so you can feel confident about the road ahead.
A personalised treatment and exercise plan. We’ll recommend gentle, progressive exercises to settle your symptoms and build your strength back up, along with practical tips for work, home and sleep. Where it suits, we can also move you into our small group classes for ongoing support.
Keeping it from coming back
Sciatica can return, especially if the underlying causes haven’t changed. Staying active, building strength in your back, hips and legs, and breaking up long periods of sitting all help to reduce the chance of another flare-up. We’ll help you build a plan that fits your life, so you can keep doing the things you love.
The short version
Sciatica is pain along the sciatic nerve, usually caused by irritation of a nerve in the lower back.
Most cases improve over weeks to months, often without surgery or scans.
Staying active, learning about your condition and doing the right exercises are the best first steps.
Some symptoms, such as changes in bladder or bowel control or worsening leg weakness, need urgent medical attention.
A plan for strength and movement is the best way to reduce the chance of it coming back.
If you’re dealing with leg or back pain and aren’t sure what’s causing it, get in touch with the team at Formotion Physio. We’re happy to help.