If you’ve been told you have sciatica, it can sound like a big and scary diagnosis. But let’s break it down in a way that makes more sense—and hopefully makes it feel a little less intimidating.
So, what is sciatica?
“Sciatica” is a word we use to describe pain that travels down the back of your leg. This pain often starts in the lower back and moves down through your bottom and into your leg. But here’s the thing: sciatica isn’t a specific condition—it’s more of a symptom of something else going on, often involving the nerves in your lower back.
You might be wondering:
“Why is this happening to me?”
“Does this mean I’ll always have back pain?”
The good news? Not necessarily. Sciatica can come and go, and most people recover well with the right help and time.
Why Does Sciatica Happen?
There are a few ways sciatica-type pain can show up, depending on what’s going on with your nerves:
1. Referred Pain
This is when you feel pain in one area, but the actual problem is somewhere else (like your back). It’s usually a dull, achy pain and can be hard to pinpoint.
2. Radicular Pain
This pain comes from irritation or pressure on a nerve as it leaves your spine. It’s often sharp, shooting, or stabbing—and might come with pins and needles or tingling down your leg.
3. Radiculopathy
This means the nerve isn’t working quite as it should—not causing pain, but perhaps leading to muscle weakness, numbness, or changes in reflexes.
You might have one of these, or even a mix. That’s why “sciatica” isn’t a clear-cut diagnosis—it just describes what you’re feeling, not exactly why.
What Causes This Nerve Pain?
There are two main reasons why your nerve might be irritated:
🧱 Mechanical Pressure
This happens when something presses on the nerve. Common causes include:
- A bulging disc (when the soft cushion between your spine bones pushes out)
- Tight spaces in your spine (due to bone growths or thickened ligaments)
- The nerve getting slightly “stretched” or pushed out of its usual path
🧪 Chemical Irritation
This is when chemicals from a disc (or other nearby structures) leak out and irritate the nerve. Your body sees this as an invader, which can lead to inflammation and pain.
Will I Need Surgery?
Not usually!
Your body is actually pretty amazing at healing itself. In many cases, if a disc is pushing on a nerve, your body can reabsorb the material over time—especially if the bulge is large. This can reduce the pressure on the nerve naturally.
This process can take several months, and not much changes in the first 6 weeks—but that doesn’t mean you’ll be in pain the whole time. Many people start to feel better well before the disc has fully healed.
When Should I Be Concerned?
While sciatica is often nothing to panic about, there are a few symptoms that should be taken seriously:
- Numbness around your genitals or inner thighs
- Trouble controlling your bladder or bowels
- Significant weakness in the legs
If you notice any of these, get medical help right away.
How Can Physiotherapy Help?
While physios can’t “push a disc back in,” we can absolutely help in other important ways:
- Relieve pain using hands-on treatments
- Guide you on the right movements and positions to reduce nerve irritation
- Help you stay active, which can speed up your recovery
- Support your strength and fitness, which helps your body heal better
Our goal is to keep you moving, confident, and in control of your recovery.
Final Thoughts
Sciatica can be painful and frustrating—but it’s rarely permanent. With the right advice, some time, and support from your healthcare team, most people get back to normal life without needing surgery.
If you’re experiencing leg pain, don’t wait it out on your own. A proper assessment can give you peace of mind and set you on the path to recovery.
