Sciatica
Sciatica is the everyday word for pain that travels from the lower back down into the leg. Around nine times out of ten it comes from an irritated nerve root as it exits the lower part of your back — usually linked to a disc bulge or herniation. It can be painful and slow to settle, but it responds well to physiotherapy, and most people never need a scan or surgery.
What sciatica is — and what it isn’t
True sciatica is nerve pain. When a nerve root exiting the lower back is irritated or compressed — most often by a disc bulge or herniation — it can send pain, tingling and numbness down the leg. With genuine sciatica the leg symptoms are usually worse than the back pain, and the pain often travels below the knee.
The good news is that most sciatica settles with the right advice, graded exercise and time. It is rarely about one physical fault, and you don’t usually need a scan. What matters is a clear diagnosis and a progressive plan — not chasing a quick fix online.
A correct diagnosis is essential to focus treatment on what is actually driving your symptoms.
Signs that it’s likely to be sciatica:
Not all leg pain is sciatica
Several problems can feel like sciatica but come from elsewhere — hip joint issues or hip arthritis, proximal hamstring tendinopathy, and lateral hip (gluteal) tendinopathy. That is why we never guess: a proper neurological and physical assessment rules these in or out before we treat.
Myths we can put to bed
Despite what you will see online, bad posture, tight muscles, lifting weights and a “weak core” are being disproven as causes of sciatica. It is rarely about one physical fault — environment and lifestyle usually matter more.
Get it assessed early
Seek help early
Starting physiotherapy early helps settle your symptoms sooner, keeps you moving safely, and gives you a clear, progressive plan rather than prolonged rest or guesswork.
You rarely need a scan
Most sciatica is diagnosed and treated without imaging. We would only arrange a scan if there were widespread or worsening weakness, pain that keeps getting worse, or signs of something more serious.
A scan doesn’t always tell the full story
Disc bulges and age-related changes show up on the scans of plenty of people who have no pain at all. A scan on its own rarely changes what we do — so we only arrange imaging when there are worrying signs, or when it will genuinely change your treatment.
A careful neurological and physical assessment usually tells us far more than a picture alone.
Physiotherapy assessment for sciatica
Your initial physiotherapy appointment will consist of two key components:
Subjective assessment
A detailed discussion about how your symptoms started, what you feel, how they affect your daily activities, work and sleep, and any relevant medical history. We will also explore your personal treatment goals.
Objective assessment
A physical examination of your spinal movement and muscle strength, with neurological testing of sensation, reflexes and power in the legs, plus nerve tests such as the straight leg raise. This tells us whether a nerve is genuinely involved — and helps rule out the conditions that mimic sciatica.
At The Treatment Table, every assessment is thorough, giving you a clear diagnosis and an effective treatment plan.
Treatment tailored to you
Your treatment will depend on the cause and stage of your sciatica but may include:
Education and understanding your pain
Early symptom control
Modified exercise and movement
Ergonomics and activity changes
Graded return to normal activity
Nerve mobilisation
Strength and conditioning over time
Injection or surgical referral (long term, if needed)
There is no magic fix for sciatica. If it is truly sciatica it takes time, so we are honest about that — we settle your symptoms, give you quick wins by easing what is irritating the nerve, and build you back up with a progressive plan. Injections or surgery can have a place in the longer term, but as part of an overall plan rather than a one-off fix.
Book your sciatica assessment
If you have leg pain or sciatica, a thorough neurological and physical assessment will tell you what is really going on and set you on the right path.
Sciatica is leg pain that usually comes from an irritated nerve in the lower back — but not all leg pain is sciatica, so a good assessment is essential to tell the difference. It rarely needs a scan or surgery and responds well to physiotherapy, exercise, advice and some lifestyle changes. It can take time to settle, so we focus on a clear, progressive plan and on looking after your whole health, not just the symptom.
For more information or to book an appointment, contact The Treatment Table on 0151 559 1107 or email info@thetreatmenttable.com.
Book your assessment