Source identified
Neurological testing and directional assessment to separate disc-related, canal-related and gluteal compression.
Physiotherapy
Sciatica Management
Pain in the leg, cause in the back — usually.
- 45 minutes
- Session length
- 8 to 14 sessions
- Typical course
- Short sets, several times daily
- Home work
Overview
Sciatica is a symptom, not a diagnosis. It describes pain travelling along the sciatic nerve, and it can come from a lumbar disc pressing on a nerve root, from narrowing in the spinal canal, or from the nerve being compressed as it passes through the buttock. Each of those needs a different response, so naming the source is the first job.
Once the source is clear, management combines nerve mobilisation, treatment of the lumbar segment involved, and a return to loading at a pace the nerve tolerates. Most cases settle without surgery. We also screen for the specific signs that mean urgent medical referral instead.
Consider this if
- Pain travelling from the lower back or buttock down the back of the leg
- Burning, shooting or electric sensations rather than a dull ache
- Numbness or pins and needles in the leg or foot
- Symptoms that worsen with sitting, coughing or sneezing
What it does
Sciatica Management
Centralisation
Working out the movement direction that pulls symptoms back out of the leg and towards the spine — a strong sign of progress.
Nerve mobility
Graded neural mobilisation so the nerve glides again instead of being tethered and irritable.
Safe return
Structured progression back to sitting, driving and lifting without repeatedly reigniting symptoms.
Inside a session
Screen
Neurological examination, reflexes, strength and sensation, plus red-flag screening for cauda equina signs that require urgent referral.
Direct
Repeated movement testing to find the direction that centralises symptoms.
Mobilise
Lumbar segmental mobilisation and neural gliding within the range the nerve tolerates.
Load
Trunk and hip strengthening reintroduced as leg symptoms retreat.
Common questions
When is sciatica an emergency?
Numbness in the saddle area, loss of bladder or bowel control, or rapidly progressing weakness in both legs need immediate hospital assessment, not physiotherapy. We screen for these at the first visit and will send you straight on if they are present.
Will I need surgery?
The large majority of sciatica cases settle with conservative management. Surgery is considered for persistent, severe symptoms that have not responded, or where there is progressive neurological loss.
Why do short sets several times a day?
Irritable nerve tissue responds better to frequent, brief, gentle exposure than to one long session. A single heavy bout tends to flare it.
This page is general information, not a diagnosis or a treatment plan. What is right for you is decided at assessment. If your symptoms are severe, worsening quickly, or follow an injury, seek medical care first.
Also in this discipline
Not sure this is the right one?
That is what the first consultation is for. Ninety minutes of assessment before anything is recommended — including recommending nothing.