Do you get a burning or shooting pain in the back of
your leg when you stand or sit for too long?
Do you experience numbness, pins and needles or
tingling in your leg or foot?
Are you looking for alternatives to tablets, injections
or surgery to get rid of these symptoms?
Sciatica refers to compression or irritation of the sciatic
nerve (the largest nerve in your body) which forms just
outside your lower back and passes through the buttock,
down the back of the leg and ends at the foot. The sciatic
nerve contains many nerve fibres which transmit
information about sensation, as well as transmitting
signals to the leg for movement. When the sciatic nerve is
compressed (squashed) anywhere along its path the
patient will start to experience one or more of the
symptoms described above. If it is REALLY squashed
(think stepping on a hose) then the signals cannot “get
through” and the patient will experience weakness or loss
of control of the leg.
What Causes Sciatica?
The sciatic nerve can be squashed anywhere along its
path, from the lower back to the foot, but the most
common sites of compression are in the lower back or the
buttock. A disc bulge or disc herniation, arthritis of the
small joints in the lower back, or tightness of the deep
muscles of the buttock are the three most common causes
of sciatica that we see in our practice. Less common
causes of sciatica include a swelling or mass somewhere
in the buttock or leg putting pressure on the sciatic nerve.
How Do I Know If I Have Sciatica?
Sciatica is nerve pain and so to correctly diagnose it you
should have nerve related symptoms, which include pins
and needles, numbness, burning or shooting pain. You
must also have one or more positive nerve tests in the
clinic. An MRI can only show you about structure and
cannot predict the level of pain, weakness or difficulty you
might have—it supplements a good physical examination
and should come AFTER a proper physical assessment,
Can Physio Help Me?
Physio is helpful for around 75% of patients with sciatica.
The key is to understand the cause of your sciatica (do
you have a disc herniation, facet joint arthritis, problem in
the buttock…) and then focus on treating the cause.
It can take 2-3 weeks of treatment before the patient
begins to really feel better, but in many situations we are
able to resolve the patient’s problem and help them get
back to normal.
Often patients tell us they have been prescribed strong
painkillers like lyrica, tramadol and others with limited
success. The problem here is that these drugs act on the
brain NOT on the sciatic nerve itself. If you have sciatica
you need to treat the problem, not just mask the
symptoms. Remember, the first step is to understand the
CAUSE of your sciatica.
What To Do Next:
If you are struggling with sciatica and you identify with
the symptoms and problems described above, there are
3 things you can do:
1. Nothing… Not Recommended! When we ignore
problems with our health, they usually worsen over time,
not just resolve and get better on their own.
2. Book an Appointment to see one of our experienced
Physiotherapists. They will take a proper history and
complete a thorough physical examination to work out if
you do indeed have sciatica and what the cause is. Once
we know the cause, we can begin treatment to address
that cause… And get you feeling and moving better!
3. If you’re NOT SURE if you have sciatica, or whether
we can help, call Mary or send us an email, titled Help
Needed. Describe your symptoms, how long you’ve had
them for and what you have done so far to help. We will
reply with some advice and suggest what to do next.
Send the email to:
To Your Better Health,
The Team at Personal Best