Sciatica is pain caused by an irritated or compressed sciatic nerve root, usually felt from the buttock down the back of one leg. Most cases improve without surgery, and keeping active with the right exercises helps the nerve settle.
At Tylurs com, our physiotherapists focus on finding out what is irritating the nerve and what calms it down. This guide explains the common causes, how sciatica differs from ordinary back pain, what treatment involves and the warning signs that need emergency care.
Key takeaways
- Sciatica describes symptoms from an irritated sciatic nerve root; a slipped disc is the most common cause.
- It usually improves within a few weeks to a few months, and most people never need surgery.
- Keeping gently active, graded exercise and nerve mobility work help the nerve settle.
- Sciatica in both legs, saddle numbness or bladder and bowel changes need emergency care.
Common symptoms of sciatica
The hallmark of sciatica is leg pain, often below the knee, that troubles you more than any back pain. Symptoms include:
- Pain from the buttock down the back of the leg
- Leg pain that is worse than back pain
- Burning, shooting or electric-shock pain
- Pins and needles or numbness in the leg or foot
- Weakness in the leg, ankle or toes
- Pain worse when coughing, sneezing or sitting
What is sciatica?
Several nerve roots leave the lower spine, pass out between the bones and join inside the pelvis to form the sciatic nerve. It then runs through the buttock and down the back of the thigh, branching to supply the lower leg and foot. When one of those roots is irritated, it becomes sensitive and sends pain along its path.
Common causes of sciatica
According to the NHS, the most common cause is a slipped disc, where the soft tissue between the spinal bones bulges and presses on or inflames a nerve root. Other causes include:
- Spinal stenosis: narrowing of the spaces the nerves travel through, more common in older adults. Leg symptoms build with walking and ease with sitting or bending forwards.
- Spondylolisthesis: one vertebra slipping slightly forward on the one below.
- Back injury: a fall or accident can occasionally irritate the nerve roots.
Buttock and leg pain can also come from elsewhere. Deep hip joint problems can mimic nerve pain, so we always check for hip pain during your assessment.
How sciatica differs from back pain
Some people with sciatica have no back pain at all; others have both, which is why sciatica and lower back pain are often discussed together even though they behave differently.
| Feature | Non-specific back pain | Sciatica |
|---|---|---|
| Main location | Lower back, sometimes buttock or thigh | Buttock and leg, often below the knee |
| Type of pain | Dull ache, stiffness or catching | Sharp, burning, shooting or electric |
| Nerve symptoms | Usually none | Tingling, numbness or weakness are common |
| Usually worse with | Certain movements or positions | Sitting, bending, coughing or sneezing |
Pain at the back of the thigh after a sprint is more likely a hamstring strain, but the two can be confused. A careful assessment tells them apart.
How sciatica is diagnosed
Sciatica is diagnosed from your history and a physical examination rather than a scan. We ask where symptoms travel and what eases them, then test strength, reflexes and sensation and check how the nerve tolerates movement, for example with a gentle straight leg raise. NICE advises against routine imaging in non-specialist settings. An MRI may be arranged by a doctor if red flags are present, weakness is worsening, or injections or surgery are being considered.
Physiotherapy for sciatica
Treatment aims to calm the irritated nerve, keep you active and restore strength and confidence. Care follows the NICE guideline on low back pain and sciatica, which supports exercise, self-management and, where helpful, manual therapy within a wider package. At the Tylurs com physiotherapy practice, your plan typically includes:
Understanding and adapting activity
Nerve pain can be intense and frightening, but severe pain does not mean severe damage. Rather than resting completely, we help you find a level of activity the nerve tolerates: shorter walks, less sitting, or a different way of getting in and out of the car for a few weeks.
Graded exercise and nerve mobility
As symptoms settle, we introduce exercises for your back, hips and legs, from walking and pelvic tilts to strength work for lifting, sport and work. Our guide to exercises for lower back pain has safe starting points. Gentle nerve glides help the sciatic nerve move freely without being stretched hard; if one brings on lasting pins and needles, it needs adjusting.
Hands-on treatment
Spinal mobilisation and soft tissue work can reduce pain and muscle guarding in the short term. We use them to help you move more comfortably, never as a replacement for exercise.
Easing sciatica at home
- Keep moving. The NHS advises continuing normal activities as much as possible.
- Break up sitting. Get up and move every 20 to 30 minutes.
- Use heat for spasm. A wrapped heat pack on the lower back or buttock can ease tension.
- Find positions of ease. Lie on your back with calves on a chair, or on your side with a pillow between your knees.
- Get advice on pain relief. The NHS notes paracetamol is unlikely to help sciatica, so ask a pharmacist or GP what suits you.
How long does sciatica last?
The NHS says sciatica usually improves within a few weeks to a few months, although it can last longer and may come back. Leg pain often eases before numbness or tingling fully settles, because nerves recover slowly. If severe symptoms persist, your GP or a spinal specialist may discuss injections or surgery, and the Tylurs com team can share findings with your doctor.
When to seek urgent medical help
A small number of people develop cauda equina syndrome, a medical emergency. Call your local emergency number or go to an emergency department if you have:
- sciatica in both legs, or numbness or weakness in both legs
- numbness around your genitals, bottom or inner thighs
- new difficulty passing urine, or loss of bladder or bowel control
See a GP the same day for a dragging foot, worsening weakness, a high temperature, a history of cancer or unexplained weight loss.
Book sciatica physiotherapy
If sciatica is stopping you from sitting, sleeping or working comfortably, an assessment gives you a clear explanation and a plan to calm the nerve and rebuild strength. Our back and neck pain treatment also covers the back pain that often comes with it, and you can explore other conditions we treat.
Book a sciatica assessment and get expert support from the start.
Sciatica: frequently asked questions
Can sciatica go away on its own?
In many cases, yes. The NHS says sciatica usually gets better within a few weeks to a few months, although it can last longer and sometimes returns. Recovery tends to be quicker if you keep gently active rather than resting, and physiotherapy helps you manage pain and reduce recurrences.
Should I stretch my hamstrings if I have sciatica?
Be cautious. When the sciatic nerve is irritated, a strong hamstring stretch also stretches the nerve and can make symptoms worse, even if it feels helpful at the time. Gentle nerve mobility exercises, which move the nerve without pulling it tight, are usually better tolerated. Your physiotherapist can show you how.
Why is my sciatica worse when I sit?
Sitting increases pressure on the lower discs and puts the sciatic nerve under more tension, especially when slumped in a low, soft chair. Break up sitting every 20 to 30 minutes, choose a firm chair that keeps your hips slightly higher than your knees, and stand for phone calls when you can.
Do I need surgery for sciatica?
Most people with sciatica do not. Surgery to take pressure off the nerve is generally considered only when pain stays severe despite weeks or months of other treatment, a scan confirms a matching problem, or nerve weakness is getting worse. Decisions about injections or surgery are made with a doctor or spinal specialist.
References
Sources reviewed by our physiotherapists for this guide:
