‘Sciatica’ refers to pain and inflammation that affects the sciatic nerve, which travels from the lower back and down the leg. The source of irritation varies, but this pain can occur as a result of a bulging lumbar disc, tightness in the hip musculature and other conditions such as a spondylolisthesis. 

The pain experienced with sciatica is often worse in the affected leg compared with the back, and may be accompanied with signs such as pins and needles, numbness or weakness.

Even the mildest of sciatic pains should be treated. These injuries have a large impact on the way we move, causing a host of associated areas of muscle tightness and immobility. You may have already noticed an increased difficulty with putting on shoes and socks, crossing your legs and other general exercise. Furthermore, if the driver behind your sciatic pain is not discovered, we can continue to overload these areas resulting in worsening pain and injury.

Sciatic pain stemming from a lumbar disc often has symptoms such as pain worsening with bending forward and sitting. Coughing and sneezing can increase disc pressure which can also increase pain and discomfort. Conversely, sciatic pain stemming from the lumbar facet may be worsened by extension and closing down the area between the lumbar bones and the exiting nerve root. 

Our flowchat below can help with identifying your type of sciatic pain. However, your pain should be assessed by an expert in diagnosing and treating these conditions. 

Early pain-relieving interventions may include joint mobilisations, therapeutic massage and dry needling. However, these interventions are only appropriate for acute flare-ups of sciatica. These will generally NOT fix long-term cases of sciatic pain. 

The treatment of long-term sciatica requires an investigation of your general mobility, movement patterns and areas of weakness to determine the driving force behind your symptoms. Commonly, sciatica involves a weakness of the glutes and hamstrings which can increase load through the lumbar discs and create tightness through the buttock – hugging your sciatic nerve.

Your physiotherapist can provide expert diagnosis of these contributing factors. Your treatment here must include an exercise rehabilitation program to correct these factors, and prevent this injury from returning. 

This flowchart is a basic self-diagnosis tool for your sciatic pain. Please click on the picture to expand the image.

If you are experiencing only back pain without referral into the buttock or hamstring, please view our back pain page for information on potential diagnoses and a similar flowchart for self-diagnosing your lower back pain. 

Please Note: It is important that if you are experiencing neurological symptoms that are extending into both legs (e.g. pins and needles, numbness, weakness) that you consult a physiotherapist or medical practitioner immediately as this may be a sign of a more serious pathology.