SciaticaNerve Pain & Recovery

Nerve‑related leg pain from the lower back—learn symptoms, causes and how physiotherapy helps recovery.

What is sciatica and how does physiotherapy help?

Sciatica describes leg pain and/or tingling from irritation of the sciatic nerve, often linked to disc or joint changes in the lower back.

Physiotherapy focuses on education, movement tolerance and strengthening. Many people improve within 6–12 weeks.

Most episodes are temporary and respond well to simple strategies: keep gently active, find easing movements, and progress walking and strength in small steps. Imaging is rarely needed early on and findings don’t always match pain levels.

Your plan is personalised: we identify positions that settle symptoms, build confidence with movement, and add progressive hip and core strengthening. Clear pacing and a flare plan reduce setbacks while you return to work, travel and sport.

Typical recovery timeline

2–6 weeks: symptom settling, improved sleep
6–12 weeks: strength, walking tolerance, return to normal tasks
12+ weeks: graded return to sport/heavier tasks

Understanding Sciatica

Common drivers

Disc irritation or minor prolapse
Facet joint related symptoms
Load spikes after inactivity

Imaging considerations

MRI is considered if severe or progressive neurological symptoms occur, or if symptoms do not follow an expected recovery curve.

UK impact

Sciatica contributes to work absence across the UK, especially in roles involving prolonged sitting or manual handling. Early physiotherapy input shortens recovery and reduces recurrence risk.

Access pathways include NHS referral via your GP and direct access to private clinics for faster appointments, depending on region and service capacity.

Red flags vs typical recovery

Typical cases improve within 6–12 weeks with education, graded movement and strengthening. Urgent assessment is required if there is progressive weakness, saddle numbness, or changes to bladder/bowel function.

Most people do not need surgery. A small subset with severe nerve compromise may be referred to spinal services after conservative care and imaging.

Common contributing factors

Load spikes

Sudden increases in lifting, sitting or travel.

De‑conditioning

Long periods of sitting or reduced activity.

Movement patterns

Limited hip rotation or stiff thoracic spine.

Stress & sleep

These can amplify pain perception.

What are the symptoms?

Primary symptoms

Leg pain: tingling, burning or aching
Numbness/tingling following the nerve distribution
Back pain: may be present or minimal
Sitting intolerance: pain increases with prolonged sitting
Walk tolerance: gentle walking often eases symptoms

Functional limitations

Difficulties with longer walks, stairs, lifting or driving
Disturbed sleep due to leg pain or night cramps
Confidence in bending, twisting, or returning to sport

How can physiotherapy help?

Care focuses on education, graded movement, and progressive strengthening to improve function and reduce recurrence.

Core components

Education, reassurance and flare‑up planning
Movement tolerance (e.g., gentle extension or flexion as indicated)
Core/hip strengthening and walking programme
Return‑to‑work and sport progressions
Nerve gliding techniques where appropriate and well‑tolerated
Pacing strategies and a simple load diary to guide progression
Sleep positions, stress management and flare‑management plan

Effective treatments

Manual therapy

Hands‑on techniques to ease pain and improve movement.

Exercise therapy

Graded mobility and strengthening to build tolerance.

Education

Load management, pacing and flare‑up strategies.

Lifestyle

Walking plan, sleep, and stress strategies.

What happens in a physiotherapy session?

Assessment reviews pain distribution, irritability, aggravating/easing factors and general health. A neurological screen (strength, sensation, reflexes) and movement tolerance tests guide safe loading.

Subjective history: onset, medication, sleep, red flags
Neuro screen: strength, sensation, reflexes, straight leg raise
Movement testing: repeated movements to find easing directions
Education: prognosis, flare plan, pacing and activity guidance
Plan: graded loading (walks, mobility, strength) with targets
Goals: time‑bound milestones (e.g., 10–15 min walks in 2–3 weeks)

Home exercises support progress across 6–12 weeks with review and progression each session.

Can you manage sciatica at home?

Many can self‑manage early symptoms with load management and simple movement practice.

Ideas to try

Short, frequent walks as tolerated
Gentle repeated movement (extension or flexion bias if it eases symptoms)
Sleep and stress strategies to support recovery

Sample weekly structure

Daily: 2–3 x 10–15 min gentle walks; 2 x sets of easing movement
3x/week: beginner core and hip strength (bridges, sit‑to‑stand, bird‑dog)
Progression: increase walk time by ~10–20% per week if symptoms stable

When should you seek help?

Urgent assessment

Progressive weakness, numbness or bladder/bowel changes
Severe trauma or unremitting night pain

Consult a physiotherapist if

Symptoms persist beyond 6–8 weeks
Difficulty with work or daily tasks
Confidence in movement is limited

Accessing care in the UK

Access physiotherapy via GP referral on the NHS, or directly through private clinics (often faster access). Insurance or employer health plans may help with costs.

FAQs

Do I need a scan?

MRI is considered if severe or progressive neurological symptoms are present or recovery is not following the expected course.

Can I keep walking?

Usually yes—short, regular walks help build tolerance. Adjust pace/distance to avoid prolonged flares.

How many sessions will I need?

Often 6–12 sessions over several weeks, tailored to goals and progress.

Will I need surgery?

Most cases recover with conservative care. Surgery is reserved for rare cases with severe or persistent nerve compromise after appropriate non‑surgical treatment and imaging.

Which positions are best for sleep?

Try side‑lying with a pillow between the knees, or back‑lying with a small pillow under the knees. Adjust pillows to keep the back comfortable and avoid long static positions.

Medical Disclaimer

This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.