Sciatica is one of the most common reasons people seek help for back and leg pain.
Despite the name, sciatica is not a diagnosis in itself, but a description of symptoms caused by irritation or compression of a nerve root in the lower back.
It can feel painful, worrying, and disruptive — especially when symptoms travel down the leg or affect daily movement.
The good news is that most cases improve with time, movement, and appropriate rehabilitation.
⚡ What Is Sciatica?
Sciatica (more accurately called lumbar radicular pain) occurs when a nerve root in the lower spine becomes irritated or compressed.
This nerve irritation can cause pain, altered sensation, or weakness along the pathway of the nerve into the leg.
🔥 What Does Sciatica Feel Like?
Common symptoms include:
📍 Pain pattern
- Pain starting in the lower back or buttock
- Radiating into the thigh and often below the knee
- Can reach the calf, ankle, or foot
⚡ Pain quality
- Sharp or stabbing pain
- Burning or electric shock-like sensations
- Pain that “travels” or shoots down the leg
🧠 Neurological symptoms
- Pins and needles
- Numbness in the leg or foot
- Possible weakness (e.g. foot drop or reduced control)
📉 Common triggers
- Sitting for long periods
- Bending forward
- Coughing or sneezing
- Certain spinal positions
🧬 What Causes Sciatica?
Sciatica occurs when a nerve root becomes irritated. Common causes include:
Lumbar disc herniation
A disc in the spine bulges or herniates and may irritate a nearby nerve root.
This is one of the most common causes and often improves over time without surgery.
Age-related degenerative changes
Changes such as:
- Facet joint thickening
- Ligament thickening
- Narrowing around the nerve (foraminal stenosis)
These changes can reduce space for the nerve and contribute to symptoms.
Lumbar spinal stenosis
Narrowing of the spinal canal that may compress nerve structures.
Symptoms are often worse with walking and improved by sitting or bending forward.
Does a Scan Always Explain Sciatica?
Not necessarily.
Research shows that disc bulges and degenerative changes are common in people without any pain at all.
This means MRI findings must always be interpreted alongside symptoms and clinical examination.
Current UK spinal pathways recommend imaging only when clinically indicated or when red flag features are present.
🚶♀️ Should I Rest or Keep Moving?
Complete rest is rarely helpful for sciatica.
In most cases, graded movement and staying active within tolerance is recommended.
This may include:
- Gentle walking
- Position changes
- Avoiding prolonged bed rest
- Gradual return to normal activities
Movement helps maintain strength, reduce sensitivity, and support recovery.
🧑⚕️ What Does Physiotherapy Involve?
Physiotherapy aims to support recovery by:
- Helping you understand your symptoms
- Reducing fear around movement
- Improving confidence with activity
- Restoring strength and mobility
- Guiding graded return to exercise and function
Treatment may include:
- Education and reassurance
- Movement advice
- Targeted exercises
- Load management strategies
- Functional rehabilitation
There is no single “best exercise” for sciatica — management should be individualised.
🚨 When Should You Seek Urgent Help?
Seek urgent medical assessment if you experience:
- Loss of bladder or bowel control
- Numbness in the saddle area (groin, buttocks, inner thighs)
- Rapidly worsening leg weakness
- Difficulty walking or severe neurological deterioration
These symptoms require urgent same-day assessment. Click the links below for more info about symptoms to be concerned about. https://wellwomanphysio.co.uk/red-flags-back-neck-pain /https://www.macpweb.org/learning-resources/cauda-equina-information-cards.aspx
🧭 Sciatica vs Other Types of Leg Pain
Not all leg pain is sciatica- click here for more info on scciatica symptoms and other causes of leg pain https://wellwomanphysio.co.uk/sciatica-symptoms-explained/
True sciatica tends to:
- Follow a nerve pattern
- Go below the knee
- Include numbness, tingling, or weakness
Other common causes include:
- Hip or gluteal tendinopathy
- Referred back pain
- Peripheral nerve irritation
- Knee or vascular conditions
A clinical assessment helps distinguish between these.
🔑 The Bottom Line
Sciatica is common, painful, and often improves with time and appropriate management.
While symptoms can feel alarming, most cases do not require surgery or advanced imaging.
Understanding what is happening, staying active, and following a structured rehabilitation approach are key parts of recovery.
If symptoms are severe, persistent, or associated with neurological changes, a clinical assessment is important to guide next steps.
