Understanding Sciatica

Sciatica refers to irritation or compression of the sciatic nerve — the largest nerve in the body — which runs from the lower spine through the buttocks and down each leg. When this nerve becomes compressed or inflamed, it can lead to:

• Sharp, burning pain radiating down one leg
• Numbness or tingling in the lower limb
• Muscle weakness or difficulty standing and walking
• Increased pain when sitting or bending forward

Common causes include a herniated or bulging disc, spinal stenosis (narrowing of the spinal canal), muscular tightness in the glutes or piriformis, or poor posture and prolonged sitting.

Why Physiotherapy Is Important for Sciatica

Physiotherapy focuses on treating both the symptoms and the root cause of sciatica. Instead of masking pain, it aims to restore mobility, strengthen supporting muscles, and improve posture — leading to long-term relief and prevention of recurrence.

Here’s how physiotherapy makes a difference:

1. Pain Relief and Nerve Desensitisation

The first goal is to calm the irritated nerve and reduce inflammation. Physiotherapists use manual therapy, gentle mobilisations, dry needling, or soft-tissue release to ease pressure around the affected area. Simple movement-based techniques can also help desensitise the nerve, improving comfort and mobility in the early stages of treatment.

2. Restoring Movement and Flexibility

When pain sets in, the body often compensates by restricting movement, leading to stiffness and imbalance. Physiotherapy works to restore natural spinal and hip mobility through guided exercises, gentle stretches, and posture correction. Improving flexibility around the lower back, glutes, and hips reduces strain on the sciatic nerve and encourages smoother movement patterns.

3. Strengthening Core and Supporting Muscles

Weak core and gluteal muscles often contribute to sciatica by allowing excess pressure on the lower spine. A structured exercise plan helps strengthen these key stabilising muscles, providing better support for the back and pelvis. Over time, this reduces nerve irritation and enhances spinal stability, making flare-ups less likely.

4. Posture and Ergonomic Training

Prolonged sitting, poor lifting habits, and slouched posture are common triggers for sciatica. Physiotherapists assess your day-to-day movements and teach you how to maintain proper alignment, whether you’re at your desk, driving, or exercising. Adjusting posture and improving ergonomics can dramatically reduce recurring episodes of sciatic pain.

5. Functional Rehabilitation

Once the pain begins to settle, physiotherapy shifts focus to functional movement and real-life activities. Exercises become more dynamic — incorporating lifting, bending, or twisting movements to rebuild coordination and confidence. This helps patients transition safely back to work, sport, or other physical activities without fear of aggravating their symptoms.

6. Long-Term Prevention

Physiotherapy doesn’t stop when the pain disappears. A strong focus is placed on education — understanding your triggers, maintaining mobility, and adopting a consistent exercise routine to prevent future episodes. You’ll also learn simple at-home stretches and strengthening drills that keep the sciatic nerve and lower back healthy over time.

What to Expect During Physiotherapy for Sciatica

Each physiotherapy plan is tailored to your individual needs, but most follow these general stages:

Stage 1: Assessment and Pain Control

Your physiotherapist begins with a detailed assessment of your symptoms, lifestyle, and movement patterns. Treatment initially focuses on easing pain and inflammation using manual therapy, targeted mobility exercises, and advice on safe movement and rest positions.

Stage 2: Restoring Mobility

As pain decreases, you’ll work on improving flexibility and range of motion in the lower back, hips, and hamstrings. This helps reduce pressure on the sciatic nerve and restore natural movement.

Stage 3: Strength and Stability Training

Next, your therapist introduces strengthening exercises for the core, glutes, and legs to support spinal alignment. This stage is essential for building resilience and preventing future flare-ups.

Stage 4: Functional and Postural Retraining

Finally, you’ll focus on integrating new movement habits into your everyday life. Your therapist will help you refine posture, lifting mechanics, and work ergonomics to ensure long-term comfort and performance.

How Effective Is Physiotherapy for Sciatica?

Physiotherapy is widely recommended as a first-line treatment for sciatica because it addresses both pain relief and movement restoration. Research suggests that early intervention can reduce pain intensity, improve function, and shorten recovery time compared to passive treatments or prolonged rest.

However, the outcome depends on several factors, including the severity of nerve involvement, the underlying cause, and patient commitment to the prescribed exercises. While not every case improves instantly, most people experience significant benefits when physiotherapy is started early and followed consistently.

When to Seek Further Medical Help

While most cases of sciatica improve with conservative care, there are situations that require urgent medical review. You should see a doctor immediately if you experience:

• Loss of strength or sensation in the leg or foot
• Difficulty controlling bladder or bowel movements
• Unrelenting pain that worsens despite therapy
• Pain following trauma or a fall

These may indicate more serious nerve compression that requires specialist assessment.

The Bottom Line

Physiotherapy offers a comprehensive and evidence-based way to manage sciatica — focusing on pain relief, improved mobility, muscle strengthening, and long-term prevention. With consistent effort and expert guidance, most people can regain pain-free movement and prevent future flare-ups.

If you’re struggling with sciatic pain or unsure where to begin, consider reaching out to The Movement Mill. Their experienced physiotherapists take a holistic approach — combining hands-on care, movement therapy, and personalised exercise plans to help you recover faster and move with confidence again.