Sciatica: What It Is, Treatment and Physiotherapy Exercises
Sciatica describes pain travelling along the sciatic nerve, usually from irritation of a nerve root in the lower back. Most cases improve over weeks with gradual movement, nerve mobility work and strengthening. Progressive weakness, numbness in the saddle area or loss of bladder control require urgent medical attention.
Leg pain that runs from the buttock down the back of the thigh is frightening, especially when it does not settle with rest. Understanding what sciatica is makes the recovery plan far less intimidating.
What sciatica actually is
Sciatica is a symptom, not a diagnosis. It describes pain travelling along the path of the sciatic nerve, most often caused by irritation or compression of a nerve root in the lower back, sometimes by a disc bulge, sometimes by age related narrowing. Occasionally the nerve is irritated deeper in the buttock. Symptoms can include burning pain, tingling, numbness or a heavy leg.
How physiotherapy helps
Treatment focuses on reducing nerve sensitivity and restoring tolerance to movement. That may include positions that centralise symptoms towards the spine, nerve gliding exercises, hands on treatment for the lower back and hip, and a graded strengthening programme. Education matters too: knowing that most sciatica improves without surgery changes how people move.
Recovery timelines
Many people notice symptoms moving out of the calf and foot back towards the buttock within a few weeks, which is generally a good sign. Full recovery can take six to twelve weeks and sometimes longer where symptoms have been present for months.
Exercise programme
Work within a comfortable range. Mild discomfort is common, sharp or increasing pain is not.
1. Sciatic Nerve Glide
BeginnerStarting position: Sitting upright on a chair with a slight slouch avoided.
- 1Straighten one knee while gently tucking your chin down.
- 2Bend the knee again while looking slightly up.
- 3Move rhythmically and never hold at the end of range.
Suitable for: Nerve related leg symptoms that are settling.
This should not increase your leg pain. Reduce the range if it does.
2. Prone Press Up
BeginnerStarting position: Lying face down with hands under your shoulders.
- 1Press your upper body up while keeping your hips down.
- 2Only go as far as symptoms allow.
- 3Lower slowly and repeat.
Suitable for: People whose leg symptoms improve with back extension.
Stop if symptoms travel further down the leg during the exercise.
When to stop and get assessed
- Symptoms moving further down the leg rather than closer to the back.
- Increasing numbness or weakness in the foot.
When to see a physiotherapist
Get assessed if leg pain lasts longer than a week, is worsening, or is disturbing sleep. Seek emergency care for numbness around the groin or buttocks, difficulty passing urine, or rapidly progressing leg weakness.
Related physiotherapy services
Frequently asked questions
How long does sciatica take to settle?+
Many cases improve substantially within six to twelve weeks, although timelines vary with severity and how long symptoms have been present.
Should I rest or stay active with sciatica?+
Gentle activity within comfort is generally recommended. Complete rest tends to stiffen the back and slow recovery.
Do I need surgery for sciatica?+
The large majority of cases do not require surgery. It is usually reserved for persistent severe symptoms or significant nerve compromise.
Can physiotherapy help sciatica?+
It often does, by reducing nerve sensitivity, restoring movement and rebuilding strength, alongside advice about daily loading.
Medical disclaimer: this article is general education and does not replace a personal assessment. If your pain is severe, worsening, or accompanied by numbness, weakness or loss of bladder or bowel control, seek care promptly.
Book with N S Physiotherapy
In clinic in Eco Park, Centurion, or home visits across Centurion and Midrand.
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