The Truth About “Sciatica”

A Common but Misunderstood Problem

“Sciatica” is a term used a lot, but it’s often misunderstood or misused. People say they have sciatica when they feel pain in their buttock or down the back of the leg — but not all leg pain is true sciatica. About 5–10% of people with low back pain also experience symptoms of sciatica, and it’s a major reason people seek help from doctors and physiotherapists. Sciatica can be painful and worrying, but with the right care, most people recover without surgery.

What Is Sciatica, Really?

True sciatica happens when the sciatic nerve — the largest nerve in the body — becomes irritated or compressed, usually near the spine. This can be caused by:

• A bulging disc
• Inflammation or swelling around the nerve
• Bony changes like arthritis
• In rare cases, spinal narrowing or other serious conditions

Symptoms usually affect one leg and include:

• Shooting or burning pain
• Tingling, numbness, or pins and needles
• Muscle weakness
  The pain often starts in the lower back or buttock and travels down the leg, sometimes as far as the foot.

What Treatments Work Best?

Most cases of sciatica improve within 6–12 weeks with conservative treatment. Physiotherapy focuses on:

• Gentle movement and nerve gliding exercises
• Core and hip strengthening
• Education about posture, activity modification, and pacing
• Manual therapy to reduce stiffness or muscle tension

Pain relief (like anti-inflammatories) may be used early on, but movement and exercise are the key to long-term improvement.

What Doesn’t Help or Can Delay Recovery?

Bed rest or avoiding movement can make things worse, leading to stiffness, weakness, and fear of activity. Scans (like MRI) may be useful in some cases, but are often not needed early on — and may show changes that are normal with age.

Injections (e.g. cortisone) may help in some cases, but don’t replace rehab. Surgery is rarely needed, and only considered if there is severe weakness, bladder/bowel problems, or no improvement after several months.

What’s New in Sciatica Care?

Modern approaches focus on the nervous system, movement, and mindset. Pain neuroscience education helps people understand that nerve pain doesn’t mean permanent damage. Digital rehab tools and apps now help guide recovery from home, and researchers are developing predictive tools to identify which patients need more intensive care.

There’s growing interest in graded exposure to activity, where patients slowly build confidence in movement without fear.

How to Prevent Sciatica or Keep It Away

• Stay active and mobile — walking is one of the best things you can do
• Strengthen your core, hips, and back muscles
• Practise good lifting technique
• Avoid long periods of sitting or slouching

Manage stress and sleep — both affect pain levels