Sciatica
Sciatica refers to pain that travels along the path of the sciatic nerve — from the lower back through the buttock and down one or both legs. It is typically caused by compression or irritation of a nerve root in the lumbar spine. While the pain can be severe and disabling, physiotherapy is highly effective and the majority of patients avoid the need for surgery.
Symptoms
- —Sharp, shooting, or burning pain from the lower back into the leg
- —Pain that is often worse sitting, better when walking
- —Numbness or tingling in the leg, foot, or toes
- —Muscle weakness in the affected leg
- —Reduced reflexes at the knee or ankle
- —Worsening with coughing, sneezing, or straining
Causes
- —Lumbar disc herniation impinging on a nerve root — the most common cause
- —Spinal stenosis narrowing the foramen through which the nerve exits
- —Piriformis syndrome — the piriformis muscle irritating the sciatic nerve
- —Spondylolisthesis
- —Less commonly: tumour, abscess, or other space-occupying lesion
How we treat it
- —Differential diagnosis to determine the exact pain source
- —Neural mobilisation techniques to restore sciatic nerve mobility
- —Joint mobilisation to the lumbar spine to decompress the affected level
- —Specific exercises to centralise and reduce leg pain
- —Piriformis stretching and hip mobility work
- —Activity modification advice to reduce nerve irritation
- —Graded return to normal activity
Recovery expectations
Sciatica from disc herniation frequently resolves naturally within 6–12 weeks. Physiotherapy accelerates this process and reduces recurrence risk. Most patients complete a full course of treatment in 6–10 sessions. Cases with severe neurological deficit or non-resolving symptoms may be referred for imaging and surgical review.
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