Sciatica: What It Actually Is and How Physiotherapy Helps

Sciatica is one of the most commonly misused terms in musculoskeletal medicine. Strictly speaking, sciatica refers to pain that travels along the path of the sciatic nerve — from the lower back through the buttock and down the leg, sometimes as far as the foot. But not all leg pain is sciatica, and not all sciatica is the same.

What actually causes sciatica?

The sciatic nerve is the largest nerve in the body, formed from the lower lumbar and sacral nerve roots. It can be irritated or compressed at several points along its path. The most common cause is a lumbar disc bulge or herniation pressing on a nerve root as it exits the spine. Other causes include spinal stenosis (narrowing of the spinal canal), piriformis syndrome (compression in the buttock), and — less commonly — referred pain from the sacroiliac joint or hip.

How is it different from regular back pain?

The distinguishing feature of true sciatica is that the pain, tingling, or numbness radiates below the knee — often into the calf, ankle, or foot. It's often described as electric, burning, or shooting. Pure back pain that doesn't go below the knee is rarely nerve-related. If you have significant weakness in the foot or leg, or any changes to bladder or bowel function, seek same-day medical care — these are signs of a more serious neurological problem.

Why physiotherapy works

The research on sciatica is clear: for the vast majority of cases, active physiotherapy-based management produces better long-term outcomes than rest, pain medication, or surgery. Treatment typically involves neural mobilisation (nerve flossing techniques to reduce sensitisation), targeted lumbar and hip exercises to reduce compression on the nerve root, and load management advice to keep you moving without aggravating symptoms.

How long does sciatica take to resolve?

Most acute sciatica episodes improve significantly within 6–12 weeks with appropriate management. Chronic or recurrent sciatica — often driven by poor movement patterns, sitting habits, or deconditioning — requires a longer-term approach focused on building resilience. The single worst thing you can do for sciatica is rest completely. Graded movement, started early, consistently produces faster recovery.

Mobile physio for sciatica in the Eastern Suburbs

Sciatica can make getting to a clinic genuinely painful, particularly if sitting aggravates your symptoms. A home visit from Seth means you can be assessed and begin treatment in a comfortable position, without the stress of travel. Treatment can begin at your first appointment.