Physio for sciatica: what helps and when to book

What sciatica actually is

Sciatica is pain that follows the path of the sciatic nerve, which runs from your lower back through your buttock and down the back of your leg.

Sciatica is a symptom, not a diagnosis. A common cause is irritation or pressure on a nerve where it leaves the spine, for example from a bulging disc. Other causes exist, and sometimes no single cause is found. People describe it in different ways:

• Sharp, burning or electric pain in the buttock or leg
• Pins and needles or numbness in the leg or foot
• Weakness in the leg or foot
• Pain that is worse when sitting, coughing or sneezing

It usually affects one side. Pain that stays in your lower back, without leg symptoms, is not sciatica. Our back pain guide covers that.

When to see a doctor first

Most sciatica is not dangerous. But get medical help straight away, or go to an emergency department, if you have:

• New difficulty controlling your bladder or bowels
• Numbness around your groin, inner thighs or buttocks
• Leg weakness that is getting worse, or a foot that drags
• Sciatica after a fall, car accident or other significant injury
• Fever, unexplained weight loss, or a history of cancer
• Severe pain that is not easing, or pain in both legs

Loss of bladder or bowel control, or numbness in the groin area, is an emergency. Call 000 or go to your nearest emergency department.

How a physio can help

A physio can work out what is likely causing your pain, check for signs of anything more serious, and help you move more comfortably. Care for sciatica usually focuses on staying active, not resting in bed.

• Assessment of your back, hip and leg, including movement, strength, feeling and reflexes
• Clear advice on what is safe to do and what to ease off
• Exercises to keep your back and leg moving and to build strength gradually
• Nerve gliding exercises, if they suit your symptoms
• Hands-on treatment for comfort, where appropriate
• Help with work, sitting, driving and sleeping positions
• A plan to return to your usual activities and lower the chance of flare-ups

Your physio should explain what they find, what they suggest and why. You can ask questions at any point.

What to expect at your first visit

Your physio will ask when the pain started, what makes it better or worse, and how it affects your day. They will then check how you move and test your leg strength, sensation and reflexes. Treatment often starts in the same visit.

Bring any scans or reports you already have and a list of your medicines, and wear clothes you can move in. Our guide to your first physio appointment has a fuller checklist.

Do you need a scan?

Many people with sciatica do not need a scan, especially in the first weeks. Scans can show changes that are also common in people without pain, which can cause worry without changing treatment. A doctor or physio will suggest one if your symptoms or examination point to a reason.

How long does sciatica last?

It varies. Many people improve over a few weeks, others take longer, and some have symptoms that come and go. How long it takes depends on the cause, how severe it is and how active you are. Your physio can give you an idea after assessing you, and should review your progress along the way.

See your doctor if your pain is not improving after a few weeks, or if it is getting worse.

What you can do while you wait

• Keep moving. Short, regular walks usually help more than long rests
• Change position often instead of sitting for long periods
• Heat can ease tight muscles for some people
• Ask a pharmacist or doctor about pain relief that is safe for you
• Avoid heavy lifting and long periods of bending while the pain is high

These are general tips. If something makes your leg symptoms worse, stop and ask your physio or doctor.

Questions to ask your physio

• What do you think is causing my pain?
• What should I do and avoid in the meantime?
• How many visits might I need, and how will we know it is working?
• What can I do at home?
• When should I go back to my doctor?

Cost and rebates

You do not usually need a referral to see a physio. Medicare does not usually rebate a standard private appointment, but many private health extras policies do. Our guides explain how much physio costs and whether Medicare covers physio.

Common questions

This guide is general information, not medical advice. Talk to your doctor or physio about your own situation.