Sciatica Physiotherapy: What Helps and When to Seek Care

Sciatica is one of the most common reasons people search for help with back pain. The good news is that many episodes settle over a period of weeks with the right mix of movement, advice and hands on care. Knowing what is going on can also make the pain feel less frightening.

What is sciatica?

Sciatica describes pain, tingling or numbness that travels along the sciatic nerve, from the low back or buttock down the back of the leg and sometimes into the foot. It is a description of symptoms rather than a diagnosis. It is often linked to irritation of a nerve root in the lower spine, for example from a disc bulge or narrowing around the nerve.

Common signs

• Pain that spreads from the buttock down one leg
• Tingling, pins and needles or numbness in the leg or foot
• Symptoms that are worse with sitting, bending or coughing
• Leg pain that feels stronger than the back pain

What physical therapy for sciatica may involve

Your physiotherapist starts by listening and assessing how you move, which positions ease or aggravate your symptoms and how your nerves are responding. From there, a plan often includes:

• Positions and gentle movements that calm leg symptoms
• Advice on sitting, sleeping and staying active within comfortable limits
• Hands on treatment where appropriate
• Progressive strengthening for the back, hips and legs as symptoms settle
• A gradual return to work, sport and daily tasks

Chiropractic care, osteopathy and massage therapy may also play a role. Your assessment helps decide which combination suits you.

What usually helps at home

• Keep moving gently. Short, regular walks are often better than long periods of rest.
• Change position often instead of sitting for long stretches.
• Notice which positions ease your leg symptoms and use them during the day.
• Avoid pushing through sharp or worsening leg pain.

When to seek urgent care

Most sciatica is not dangerous, but some symptoms need urgent medical attention. Call 911 or go to the nearest emergency department if you notice loss of bladder or bowel control, numbness in the groin or inner thighs, or weakness in the leg that is quickly getting worse.