What is sciatica?

The sciatic nerve originates in the spinal cord of the lower back, travels through the buttocks, and extends down the back of each leg to the foot. Sciatica refers to pain, tingling, numbness, or weakness that radiates along the path of the sciatic nerve.

The proportion of people in the UK who experience sciatica at some point in their lifetime ranges from 13-40%.

Causes of sciatica?

Sciatica occurs when pressure is placed on the sciatic nerve somewhere along its course. This nerve irritation usually occurs to the nerve root in the lumbar spine. It can be a result of:

  • Posture for prolonged periods including sitting and standing
  • Repetitive movements
  • Slips and falls
  • Lumbar spinal stenosis (narrowing)
  • Lumbar disc herniation or bulge (slipped disc)
  • Sudden trauma

There are certain risk factors for sciatica include:

  • Age
  • Obesity
  • Occupation
  • Diabetes

Symptoms of sciatica

Symptoms of sciatica can be felt at any one point or a combination of points along the pathway of the sciatic nerve including the:

  • Low back
  • Buttock
  • Back of the thigh
  • Back and outside of the calf
  • Outside of the foot
  • Sole of the foot

Symptoms are more commonly felt across the low back and spinal cord and into one leg. In some instances, symptoms can be felt in both legs.

Sciatica pain can manifest in different ways, including:.

  • Numbness
  • Pins and needles
  • Burning pain
  • Searing pain
  • Soft tissue muscle spasm
  • Sciatic pain with coughing and sneezing
  • Changes in bowel and/or bladder function
  • Weakness

Physiotherapy treatment for sciatica

Sciatic pain can be severe and debilitating, but it’s important to note that 85% of cases resolve with conservative treatments in 3 months.

Physiotherapy treatment may include:

  • An exercise programme
  • Manual therapy including massage
  • Education
  • Modification of activity

In more severe cases or when conservative treatment does not provide relief, further intervention might be considered, such as:

  • Medications for pain and inflammation
  • MRI and/or x-ray
  • Injections (12% of cases)
  • Surgery (3% of cases)

Our West London practice will help you understand your sciatica pain better and provide you with a clear plan to help reduce your pain so that you can get back to enjoying the things that you love to do.

Exercises for sciatica

Exercise remains the primary preventive measure for recurrent episodes of sciatica. Our W4 clinic will provide you with an exercise programme involving:

  • Strengthening
  • Mobility
  • Muscular stretching exercises
  • Nerve mobility and stretching

When to see a physio for sciatica

It’s advisable to see a physio at the onset of symptoms. Early intervention can help identify and address the underlying causes and help long-term management. 

If you have had long-term irritation of the nerve or recurrent episodes of sciatica, seeking prompt physiotherapy evaluation and treatment would be recommended if it is worsening over time or is accompanied by other concerning symptoms such as:

  • Leg weakness
  • Changes to bowel/bladder function
  • Symptoms in the perineum
  • Difficulty sleeping


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Does physiotherapy help with sciatica?

Yes, physiotherapy is effective in treating sciatica. It offers targeted exercises, manual therapies, and pain-relief techniques that address the root cause, alleviate symptoms, and prevent recurrence.

What are the top 3 exercises for sciatica?

There is no single group of exercises that best addresses sciatic nerve pain. Various exercises positively impact sciatic pain, with no specific method being the best. For acute sciatica, we try to get our clients to move little but often to help reduce lumbar spine and soft tissue spasm. These may include:

  1. Pelvic tilt
  2. Walking
  3. Knee to chest mobility
What is the best physical therapy for sciatica?

For sciatic pain, physiotherapists employ evidence-based strategies encompassing exercises, hands-on manual therapy, and postural guidance. They target the underlying issue, delivering lasting relief and measures to prevent long-term problems.

What is the fastest way to cure sciatica?

The fastest way to cure sciatica often involves a combination of treatments: physiotherapy exercises, manual manipulation, and posture education. Addressing the root cause and consistent adherence to the prescribed regime accelerates recovery. However, each individual is unique, so it’s crucial to consult a physiotherapist for a tailored treatment plan.

What is the difference between sciatica and a hamstring strain?

Sciatica is pain radiating along the sciatic nerve from the lower back to the leg due to sciatic nerve irritation. A hamstring strain involves a tear or stretch in the hamstring muscles at the back of the thigh. While both can cause pain in similar areas, their origins and characteristics differ. A physio can accurately diagnose and differentiate the two.

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