Sciatica
Sciatica describes pain that radiates along the sciatic nerve — usually from the lower back into the buttock and leg. Most cases settle with targeted physiotherapy.
Common symptoms
- Sharp or burning pain down one leg
- Numbness or tingling in the leg or foot
- Weakness in the calf or foot
- Pain worse with sitting, coughing or sneezing
Common causes
- Lumbar disc bulge compressing a nerve root
- Foraminal stenosis
- Piriformis syndrome
- Spondylolisthesis
When to seek help
Sciatica is the catch-all name for pain that travels along the sciatic nerve — most often from the low back, through the buttock and down one leg. It’s often sharp, sometimes burning, occasionally tingly. It can be miserable.
Most cases settle in six to twelve weeks. Book in if:
- the leg pain is worse than the back pain and isn’t easing
- sitting for more than ten minutes is unbearable
- you’re getting numb patches or pins and needles that aren’t going away
- you’re weaker than usual when pushing off the foot or lifting the toes
- pain or weakness is getting steadily worse rather than steadily better
Lose control of your bladder or bowel, or develop numbness in the saddle area? That’s the rare red flag — go to a hospital emergency department, not us.
How we treat sciatica
Sciatica treatment is partly about settling the irritated nerve and partly about figuring out why it got irritated in the first place. Some people respond best to early movement and graded loading. Others need a few sessions of careful positioning, manual therapy and nerve-glide work before they can tolerate exercise.
A small number of people benefit from a short course of anti-inflammatories or a nerve-root injection alongside physio. If that conversation needs to happen, we’ll have it with you and write to your GP.
Why nerve pain feels so different to other pain
Nerve pain tends to be sharper, more electric, and to travel in clear lines that match a specific nerve’s pathway. It’s usually worse with positions that compress or stretch the nerve — for many people that’s sitting, bending forward, or coughing.
Because it’s so different to ordinary muscular pain, people often worry something is badly wrong. Most of the time it isn’t. The nerve is irritated, not damaged. Once the irritation settles, the pain settles.
What recovery usually looks like
In the first one or two weeks, leg pain is often the worst symptom. Around weeks two to four, the leg pain tends to ease but the back can feel stiff and tender. By six weeks, most people are noticeably better. Twelve weeks is the standard benchmark for "mostly recovered" — though some people take longer, especially if symptoms were severe at the start.
A helpful sign is when the leg pain begins to retreat upward — the pain that was in the foot moves to the calf, then the thigh, then the buttock. That’s called centralisation and it usually means things are heading in the right direction.
What to expect in the first appointment
A first appointment for suspected sciatica usually runs 45 minutes. We work through the story: when it started, what makes it worse, what makes it better, how it’s changing over a day. Then we do a neurological screen — reflexes, sensation in specific dermatomes, and strength testing of the muscles each nerve root supplies. The pattern tells us roughly which nerve is irritated.
You’ll leave with a clear plan: positions and movements that help, a small set of exercises, and an honest sense of how long this is likely to take. We’ll flag the warning signs that mean you should come back early, and we’ll book the next session at a sensible interval rather than committing you to a long pre-paid block.
Common questions about sciatica
Do I have a disc bulge?
Possibly. Disc-related nerve-root irritation is the most common cause of sciatica in people under 60. But the term "sciatica" really just describes the symptom, not the cause — piriformis syndrome, foraminal stenosis and several other things can cause similar leg pain.
Should I be using ice or heat?
Whichever you find more comfortable. Neither is a magic bullet for nerve pain. Most people find heat helps the muscular tightness around the lower back, and ice helps when things flare up after activity.
Is walking good or bad for sciatica?
Usually good, in moderate doses. Most people with sciatica do better with short, frequent walks than with long stretches of sitting. If walking makes the leg pain worse rather than better, that’s useful information and we’ll adjust the plan.
How long before I can run again?
It depends on severity. Mild sciatica settled in a fortnight can return to running in three or four weeks. More severe cases often take eight to twelve weeks before running is a comfortable option. We’ll build a graded return that doesn’t flare the nerve.
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