Sciatica: A Physiotherapist's Complete Guide to Relief

Sciatica is one of the most common conditions seen by physiotherapists in the UK. The term describes pain that travels along the path of the sciatic nerve — from the lower back, through the buttock, and down the leg. Despite being extremely common, it's also frequently misunderstood.

What causes sciatica?

True sciatica is caused by irritation or compression of the sciatic nerve root. The most common causes include a lumbar disc herniation (prolapsed disc) pressing on the nerve root, spinal stenosis (narrowing of the spinal canal), piriformis syndrome (where the piriformis muscle irritates the sciatic nerve), and — less commonly — spondylolisthesis.

Recognising sciatica symptoms

• Pain that radiates from the lower back through the buttock and down one leg
• The pain often follows a specific pattern depending on which nerve root is affected
• Tingling, numbness, or pins and needles in the leg or foot
• Muscle weakness in the leg in severe cases
• Pain that worsens with sitting, bending, or coughing

Red flags — seek immediate medical attention if you have:

• Loss of bladder or bowel control
• Bilateral leg symptoms
• Saddle anaesthesia (numbness in the groin area)
• Progressive muscle weakness

Physiotherapy treatment for sciatica

The evidence clearly supports physiotherapy as a first-line treatment for sciatica. Your physiotherapist will assess the specific nerve root involved and tailor treatment accordingly. This typically includes neural mobilisation techniques, specific directional exercises (often McKenzie-based), manual therapy, postural correction, and activity modification advice.

Most cases of sciatica respond well to physiotherapy within 6–12 weeks. If you're experiencing sciatic symptoms, book an assessment at PhysioRevive today.