If you have a sharp pain that extends from your lower back, through a buttock and down that same leg, then there’s a good chance you have sciatica.

In simple terms, sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from your lower back, through your hips and buttocks, and down each leg into the feet. Typically, sciatica affects only one side of your body, but it is possible to experience it in both legs at the same time.

Causes of sciatica

Sciatica most commonly occurs when something is compressing or irritating the nerve roots near the base of your spine. This is often due to a herniated (“slipped”) disk, overgrowth of bone (bone spur), or a problems such as spinal stenosis (narrowing of the spinal canal). It can even be that a nearby muscle is irritating the sciatic nerve.

Several factors can put you at greater risk of experiencing sciatica (13-40% of us will have it at least once during our lifetimes): age, height, weight, genetic predisposition, diabetes (as how the body uses sugar can cause nerve damage), prolonged sitting, and your occupation.

The research we’ve linked to above suggests that you’re more likely to suffer from sciatica if you have a job that requires twisting the back, carrying heavy loads, or driving for long periods (e.g. manual labourers or lorry drivers).

Symptoms of sciatica

While sciatica is often associated with severe back pain or a shooting pain through the buttock and down the leg, it can present itself in different ways for different people.

Common signs that you might be dealing with sciatica include:

• Pain radiating from your lower back to your buttock and down the back of your leg – this can even extend into your feet and toes
• Discomfort along the sciatic nerve pathway, which can range from a mild ache to a sharp, burning sensation or excruciating pain
• Numbness, tingling, or muscle weakness in the affected leg or foot
• Worsening pain when you change position or with prolonged sitting or sudden movements like coughing or sneezing

Although sciatica often self-resolves, the pain may impact your daily life during recovery. This isn’t something you have to struggle through alone. Support from a physiotherapist can help you pin down a diagnosis and access the best treatment so that you can accelerate your recovery journey.

It can also help to minimise the chances of sciatica reoccurring, for which future you will thank you!

How physiotherapy can help sciatica

Now that we’ve covered what sciatica is and its symptoms, let’s dive into how physiotherapy can offer relief. Physiotherapy is an effective treatment approach for sciatica as it involves targeted exercises and techniques to alleviate pain, stimulate blood flow and healing, and improve function.

Initial assessment

During your first visit to a physiotherapist, they will conduct a thorough assessment to understand the root cause of your sciatica. This may include reviewing your medical history, conducting physical exams, and assessing your posture and movement.

Always let the physiotherapist know if you have:

• Had a recent injury
• Been experiencing a fever
• Problems controlling your bladder or bowels
• Recently lost weight without trying
• Had cancer in the past

Although it’s extremely rare, sciatic pain can occasionally be a sign of a fracture, infection, or even some cancers (see When to seek medical attention below).

Customised treatment plan

Based on the assessment, your physiotherapist will design a personalised treatment plan tailored to your specific needs. This can include a combination of:

• Strengthening exercises: Targeted exercises to strengthen the muscles supporting your spine and improve stability.
• Stretching exercises: Gentle stretches to improve flexibility and alleviate tension in the muscles surrounding the sciatic nerve.
• Manual therapy: Hands-on techniques such as massage, mobilisation, and manipulation to reduce pain and improve mobility.
• Education and advice: Guidance on posture, movement, and lifestyle modifications to prevent future flare-ups.

Pain relief techniques

Sciatica can be surprisingly painful, as you may well know from personal experience! Physiotherapists use various techniques to provide immediate pain relief (where possible), including:

• Heat and Cold Therapy: Applying heat to relax muscles and cold to reduce inflammation
• Shockwave Therapy: Using high-energy sound waves to promote tissue healing and reduce pain
• Acupuncture: Involves the use of fine needles to stimulate blood flow, promoting healing and pain relief in the targeted areas
• TENS (Transcutaneous Electrical Nerve Stimulation): A device that uses electrical impulses to block pain signals

Most people experience significant pain relief and a reduction in their symptoms after just one to four physiotherapy sessions.

Exercise and rehabilitation

Exercise plays a crucial role in the treatment of sciatica – as long as it’s the right kind at the right level! Your physiotherapist will guide you through specific exercises designed to:

• Improve your flexibility and range of motion
• Strengthen the core muscles, which support your spine
• Promote proper alignment and posture
• Enhance your overall fitness and prevent future injuries

It’s important to follow your therapist’s instructions and be consistent with your exercises to achieve the best results.

If there is a physical activity that you enjoy and want to get back to, a physiotherapist can help you to do this safely.

Long-term management

Physiotherapy not only focuses on immediate relief but also on long-term management. This is important whether your sciatica is a short-term issue, it flares up regularly or is a chronic condition.

Your therapist will provide you with strategies to manage the condition effectively and hopefully prevent it from happening again in the future. These strategies include:

• Regular exercise routines to maintain – and improve – your strength and flexibility
• Posture correction techniques to reduce strain on your spine
• Ergonomic advice for work and daily activities, including how to enjoy your favourite sports safely
• Tips for staying active and avoiding prolonged sitting

It’s important to tackle any residual weakness that could affect your quality of life in the future, and to safely build your activity levels back up. The strength of a personalised treatment plan is that it can be adapted as your symptoms improve.

When to seek medical attention

As we touched on above, while physiotherapy can be highly effective for most cases of sciatica, there are situations where you should seek additional medical attention. If you experience any of the following, we recommend seeing your GP, visiting a walk-in centre, or calling 111 for advice immediately:

• Severe pain that does not improve with rest or medication
• Loss of bowel or bladder control
• Significant weakness or numbness in the leg
• Symptoms that are not improving, even with physiotherapy support
• A high fever

Conclusion

Sciatica is a condition that can cause significant discomfort and impact your daily life. However, with the help of physiotherapy, many people find relief and regain their mobility. By understanding the causes, symptoms, and treatment options for sciatica, you can take proactive steps to manage your condition and feel good again.

If you suspect you have sciatica or are experiencing persistent pain, don’t hesitate to reach out to us here at The Physio Box. We can provide you with a personalised treatment plan and support you on your journey to recovery so you can get back to doing the things you love.

Together, we’ll help you to stay active, stay positive, and take it one step at a time. BOOK A CONSULTATION