Sciatica: causes, symptoms and physiotherapy treatment

Sciatica is pain that travels along the sciatic nerve, from the lower back or buttock down the back of the leg. It is common, and most people improve without surgery.

Common symptoms

• Pain from the buttock down the back of the thigh, sometimes to the foot
• Tingling, pins and needles or numbness in the leg or foot
• Pain that is worse when sitting for long, bending, coughing or sneezing
• Leg pain that is often worse than the back pain

What causes it?

• A bulging (slipped) disc pressing on a nerve root: the most common cause in adults under 50
• Narrowing of the spinal canal (spinal stenosis): more common after 60
• Tight buttock muscles can irritate the nerve in some people

What helps in the first weeks

• Stay as active as you can. Short, frequent walks help more than bed rest.
• Change position often. Avoid sitting for more than 30 minutes at a time.
• Find positions that ease the leg pain, such as lying on your back with your knees bent over a pillow.
• Take medicines only as advised by your doctor or pharmacist.

Three gentle exercises

Stop any exercise that makes the leg pain spread further down the leg.

How physiotherapy treats sciatica

• An assessment to find the likely source: disc, joint or muscle
• Movement and exercises that calm the nerve
• Core and hip strengthening so the pain does not keep returning
• Manual therapy, and dry needling for tight buttock muscles where suitable
• Advice on sitting, lifting, driving and sleeping

Sciatica often settles over several weeks. A typical plan at MoveMed is 8 to 10 sessions, with home exercises between visits. See sciatica treatment at MoveMed.

This article is general information, not a diagnosis. If you have pain, an assessment with a qualified physiotherapist or doctor is the best next step.