What is Sciatica?
Sciatica is not a diagnosis, but a set of symptoms caused by irritation or compression of the sciatic nerve—the longest and thickest nerve in the human body. It originates from the L4–S3 nerve roots in the lower spine and travels through the buttocks, down the back of each leg, and into the feet.
Symptoms of Sciatica May Include:
- Sharp, burning or shooting pain from the lower back down the buttock and leg.
- Numbness or tingling in the foot or toes.
- Muscle weakness in the leg or foot.
- Increased pain when sitting, bending, coughing or lifting.
Note: Sciatica typically affects only one side of the body.
What Causes Sciatica?
Sciatica is a symptom of an underlying condition. The most common causes include:
- Lumbar disc herniation (“slipped disc”) – A bulging or ruptured disc compresses a spinal nerve root.
- Degenerative disc disease – Age-related changes can narrow spaces and irritate nerves.
- Spinal stenosis – Narrowing of the spinal canal compressing nerve tissue.
- Spondylolisthesis – A vertebra slips out of place, potentially compressing the nerve.
- Piriformis syndrome – The piriformis muscle in the buttock compresses the sciatic nerve.
- Postural or muscular imbalances – Weak glutes or a tight lower back can exacerbate nerve irritation.
How Long Does Sciatica Last?
In most cases, acute sciatica improves within 4–6 weeks, especially with conservative management. However, chronic or recurrent sciatica may last longer and require a more structured rehab approach.
How Physiotherapy Helps Sciatica
Physiotherapy is a first-line, evidence-based treatment for sciatica. Rather than only addressing the symptoms, we focus on improving nerve mobility, spinal function, and muscular control.
A tailored plan at Personal-Physio might include:
Assessment
- Postural & movement screening
- Neurological tests (reflexes, sensation, muscle strength)
- Nerve tension tests (e.g. Straight Leg Raise, Slump test)
- Joint mobility & soft tissue assessment
Treatment Options:
- Pain relief techniques (manual therapy, soft tissue release)
- Neural mobilisation (nerve gliding) exercises
- Core & glute strengthening to offload pressure from the lumbar spine
- Postural and ergonomic advice for home, work and sleep
- Education on pacing and avoiding aggravating movements
- Activity modification, not elimination (we encourage staying active!)
What Does the Evidence Say?
Research supports individualised exercise and education as primary interventions for lumbar radiculopathy (sciatica) over passive treatments alone. Key findings from recent studies:
- Active rehab is more effective than bed rest or medication alone.
- Manual therapy + exercise improves outcomes in subacute/chronic sciatica.
- Surgical interventions are typically reserved for severe or non-responsive cases after 6–12 weeks of conservative care.
Sources: National Institute for Health and Care Excellence (NICE), Cochrane Review (2021), British Journal of Sports Medicine
When Should You Seek Help?
You should book a physiotherapy assessment if:
- Your symptoms persist beyond a few days
- Pain interferes with sleep, walking, or daily tasks
- You notice tingling, numbness, or muscle weakness
- Your symptoms are recurring or getting worse
Urgent referral is needed if you have:
- Bladder/bowel dysfunction
- Saddle anaesthesia (numbness in the groin)
- Severe progressive weakness → These could indicate cauda equina syndrome, a medical emergency.
How We Work at Personal-Physio
At Personal-Physio, we:
- Use a whole-person approach that combines rehab, movement therapy, and education
- Offer in-clinic appointments at UNTIL Soho, plus home visits across London
- Support your long-term recovery, not just short-term pain relief
- Provide you with exercises that make sense for your life and goals
Ready to Get Help with Sciatica?
You don’t have to manage it alone. Book your initial assessment and let’s get started on your personalised recovery plan.
