If you’ve ever had pain shooting down your leg and someone’s said “that’s sciatica,” you’re not alone. It’s one of those terms that gets used a lot, and often not quite correctly. So let’s break it down in a way that makes sense.
What is ‘sciatica’?
Sciatica isn’t a diagnosis on its own. It’s a group of symptoms that happen when the sciatic nerve is irritated. This nerve runs from your lower back, through your glutes, and all the way down your leg. So when we talk about sciatica, we’re really talking about nerve-related leg pain that starts in the lower back.
It’s also worth clearing up what it isn’t. Sciatica isn’t just general low back pain, and it’s not the same as having tight glutes or hamstrings. A key feature is that the pain tends to travel down the leg, rather than just being in your lower back or backside (bum).
Nerve Pain Vs Muscle Pain
One of the most helpful ways to understand sciatica is by comparing nerve pain to muscle pain, because they feel quite different.
Nerve pain often feels sharp, shooting, or even a bit electric. People commonly describe burning, tingling, pins and needles or numbness. A big giveaway is pain that travels below the knee.
Muscle pain, on the other hand, is usually more of an ache or tightness. It tends to stay local, and you can often point to one specific sore spot. It might feel worse after activity or certain movements, but it doesn’t typically shoot down the leg.
A lot of people come in thinking they just have a tight glute, but when we look a bit deeper, it’s actually the nerve referring pain into that area. That distinction matters, because it changes how we treat it.
What causes sciatica?
Sciatica happens when something is irritating the nerve. In most cases, that irritation comes from the lower back. Common contributors include things like disc irritation, stiffness in the joints of the lower back or inflammation around the nerve. It can also be triggered by prolonged sitting or a sudden increase in load, like lifting something heavy or ramping up exercise too quickly.
Sometimes people get worried about disc bulges or what shows up on scans. The reality is that a lot of people have disc changes and no pain at all. So we always look at the full picture, not just imaging.
How long does it last?
One of the biggest questions people have is how long sciatica lasts. The good news is that most cases improve within six to twelve weeks. That said, everyone’s timeline is a bit different. It depends on how irritated the nerve is, how long symptoms have been there, and how the condition is managed early on.
A common trap is either doing too much too soon or going the other way and completely avoiding movement. Both can slow things down. Finding the right balance is key.
Physiotherapy Management Strategies
From a physio perspective, treatment is less about aggressive stretching and more about calming the nerve down and gradually building things back up.
Early on, the focus is on reducing irritation. That might involve small changes to how you sit or sleep and temporarily modifying activities that flare things up. We often use specific movements that open the space in your lower back to help reduce nerve sensitivity and ease symptoms. Many people will feel like they want to stretch the muscles down the back of the leg, however we often advise against this as it can actually worsen the symptoms.
As things start to settle, we look at what’s called directional preference. This means finding certain repeated movements that actually help bring the pain out of the leg and back toward the spine. That’s a really positive sign and something we guide quite closely in clinic.
From there, we gradually reintroduce strength and movement. This usually includes:
• building strength through the trunk and core
• improving glute strength and control
• returning to functional movements like bending, lifting, and walking
Nerve mobility exercises can also be helpful, but timing matters. Introducing these too early or pushing them too hard can sometimes flare symptoms, so they need to be prescribed carefully.
Education is a big part of recovery as well. Understanding what’s going on and knowing how to pace your activity can make a huge difference in how quickly things improve.
The main takeaway is that sciatica can be painful and frustrating, but it’s very manageable with the right approach. It’s not just a tight muscle or a “bad back,” and it shouldn’t be ignored or pushed through. With the right guidance, most people recover really well and get back to doing what they enjoy without ongoing issues.
Frequently Asked Questions
Is sciatica caused by a disc bulge?
Not always. While disc irritation can contribute to sciatica, symptoms can also be caused by inflammation, joint stiffness, or irritation around the sciatic nerve itself. Many people have disc bulges on scans without any pain.
Can sciatica go away on its own?
Yes, many cases of sciatica improve over time. However, the right treatment and activity management can often help reduce pain faster and lower the risk of symptoms returning.
Should I rest if I have sciatica?
Complete rest is usually not recommended. Staying gently active and avoiding prolonged inactivity is often more helpful than strict bed rest. The key is finding the right level of movement that does not significantly aggravate symptoms.
Is walking good for sciatica?
For many people, walking can help reduce stiffness and improve symptoms. However, if walking significantly increases leg pain, it may need to be modified temporarily.
When should I see a physio for sciatica?
It is worth booking an assessment if:
- Symptoms have lasted longer than 1–2 weeks
- Pain is worsening
- You are experiencing numbness or weakness
- Sitting or walking is becoming difficult
- Symptoms keep returning
Early treatment is often easier and may help prevent symptoms from becoming more persistent.
Do I need a scan for sciatica?
Not always. Most cases of sciatica can be assessed clinically by a physiotherapist. Scans are usually only recommended if symptoms are severe, not improving, or there are concerns about more serious underlying conditions.
Can stretching help sciatica?
Not always. Aggressive stretching, especially hamstring stretching, can occasionally irritate the nerve further. Treatment is usually more effective when focused on reducing nerve irritation, improving movement, and gradually rebuilding strength.
