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The answer is a definite yes. In fact a recent study showed that starting Physio right away, rather than taking the usual watch and wait approach, helped improve the function and other outcomes for patients experiencing recent-onset back pain with sciatica (1).

But before we lose ourselves in the details of the research let us unpack the basics of sciatica and how Physio can help you overcome any symptoms associated with sciatica.

What is sciatica?

Sciatica is a term used to describe nerve pain that follows the distribution of the sciatic nerve. The sciatic nerve is the longest and thickest nerve in the body. Hold up your pinkie and take a good look at it- that is roughly the thickness of your sciatic nerve!!!

It originates from several nerve roots in the lower back (the lumbar plexus) and then runs through the buttocks, continuing down the back of each leg.

Sciatica usually only affects one side and is literally “a pain in the butt”. The pain can vary greatly from patient to patient- for some it is a mild irritation whilst for others it can be debilitating. For some it can be a constant pain in the back, the buttock, the leg and for others there could be associated burning/tingling/numbness or even weakness down the affected leg.

What causes sciatica?

The aforementioned symptoms are usually caused by a compression, inflammation or restriction of the sciatic nerve.

Here are some examples of what would irritate your sciatic nerve:

  • A herniated/prolapsed or bulging disc (please note discs don’t slip or go out- that is a topic for a whole blog in itself!!)
  • Narrowing of the spinal canal and intervertebral disc space. e.g. stenosis or osteoporosis (usually occurs in the older population)
  • Narrowing of the intervertebral foramen (the hole where the nerve roots exit from the spinal cord) e.g. arthritis or spinal misalignments
  • Tightness of the piriformis muscle (a muscle in the buttock through which the sciatic nerve has to travel to get to the leg)
  • Prolonged sitting, especially if done in an awkward position (think slouched on the couch with the legs up on a coffee table, or hunched over your laptop from your ‘home office’)
  • A traumatic injury to the back or buttock

How can Physio’s treat sciatica?

Since sciatica is due to pressure on the sciatic nerve, it stands to reason that treatment involves removing this pressure. However before treatment can commence a thorough assessment must be undertaken. Starting with your history, then followed by a physical examination, in order to determine which body part is most likely causing your symptoms. Physiotherapy treatment aims to reduce pressure/irritation on the sciatic nerve by restoring balance to the muscular system, the skeletal system and the neural system.

This is achieved by using a combination of the following techniques:

  • Spinal mobilisations– a technique used to keep the joints mobile and prevent stiffness
  • Massage, trigger point therapy/dry needling
  • Stretching tight muscles and joints
  • Strengthening and control of core muscles, including gluts and psoas
  • Neural mobilisations– exercises that help to get the nerve moving and improve its ability to glide alongside surrounding tissues
  • Advice on your ergonomics (work-station) and your posture- Physio’s can give great tips in these areas which can have profound effects on your symptoms
  • Education– understanding why you have your symptoms and how to manage them are key tools which your Physiotherapist can teach you

In addition to the hands-on treatment, you will be given a series of home exercises to maximise the benefit of your Physio session. In the past bed rest was the primary treatment of choice for sciatica, however there has been a large shift towards modified activity and specific exercises as the preferred treatment of choice. These shifts are based on numerous studies that have come out in support of these findings.

The referenced study showed significant differences between the control group (received no therapy, just advice to remain active) and the group who started immediate therapy. The group who received immediate treatment reported less disability at the 4 week, 6 month and 1 year mark, compared to the control group.

So if you are suffering with sciatica at the moment please do not delay – you can achieve the best results when you address the symptoms early.

Contact us to book an appointment.


  1. Elizabeth Lane, Molly McFadden, Gerard Brennan, et al. Physical Therapy Referral From Primary Care For Acute Back Pain With Sciatica: A Randomised Controlled Trial. Annals of Internal Medicine 0;0, doi:https://doi.org/10.7326/M20-4187