What is sciatica?
Sciatica is pain that follows the sciatic nerve, the long nerve running from your lower back through the buttock and down the back of the leg. It is a symptom, not a diagnosis in itself.
The pain can feel sharp, burning, electric or like a deep ache. You may also notice tingling, numbness or weakness in the leg or foot, usually on one side.
What causes it?
Something is irritating or squeezing a nerve root in the lower spine, or the nerve itself as it passes through the buttock.
- A slipped disc pressing on a nerve root. See slipped disc.
- Narrowing of the canal that carries the nerves. See spinal stenosis.
- Joint or muscle tightness in the lower back and deep buttock.
- A period of prolonged sitting, lifting or a sudden twist.
Sometimes more than one factor is involved, and the cause can stay unclear. That is acceptable: we treat what we find and watch how it responds.
How is it different from ordinary back pain?
In plain back pain, the ache stays in the back. In sciatica, the pain, tingling or numbness travels below the knee into the calf or foot, or at least beyond the buttock.
Leg pain that comes from a nerve is called referred pain when it spreads away from its source. Our glossary entry explains the idea.
What does a physiotherapist check?
We listen to your story, then test how you move and how the nerve behaves.
- Where the pain travels, and what makes it better or worse.
- Back and hip movement.
- Leg strength, feeling and reflexes.
- How the nerve responds to gentle stretching positions.
- Warning signs that need a doctor first.
The result decides where we start: calming, moving or strengthening.
What helps sciatica?
The World Health Organization (WHO) says painkillers should not be the first-line treatment for low back pain, and that physical therapies, psychological and social support and staying active can help [1]. Sciatica sits in the same family of problems.
- Positions that ease the leg, such as lying with knees supported.
- Short, regular walks.
- Nerve glides: gentle sliding movements that let the nerve move freely.
- Hip and core strengthening once the pain settles.
- Changes to your sitting, driving and sleeping set-up.
Our blog has practical sitting tips for sciatica and advice on back pain on long drives.
When do I need a doctor first?
Go to the emergency department if you have numbness around the groin or seat, loss of bladder or bowel control, or weakness in both legs. These need urgent attention.
See a doctor soon if one foot is dragging or getting weaker, if pain wakes you every night, or if you have fever or unexplained weight loss. We stay in touch with your doctor’s advice.
What can I do this week?
Keep moving in short, gentle bouts. Sit with your back supported and change position every half hour. Sleep on your side with a pillow between your knees, or on your back with a pillow under your knees.
Avoid long sitting on hard seats, and heavy lifting while the pain is sharp. A physiotherapist can see your set-up at home. Read about home physiotherapy; our Canning Garden centre is opening soon, and prices are quoted on WhatsApp.