I have sciatica and don’t know what to do

We understand the fear and pain people can experience with sciatica. There are lots of sleepless nights, the pain medication often doesn’t do much and the people around you can be less than sympathetic.

Sciatica is painful!

Believe it or not, this is one of the most common reasons why people come to see us.

And more often than not, it is not sciatica.

But what is it exactly?

And do you actually have it?

Sciatica: The Symptoms

The pain experienced always includes: ✔️ Pain in the back of the leg People most commonly describe it as nerve or toothache like pain radiating from the buttock and down the back of the leg. If you don’t have pain in the back of the leg, you don’t have sciatica.

It may include:

  • Numbness or tingling in the back of the leg
  • You may experience pins and needles
  • The pain or altered sensation may stay in the posterior thigh or below the back of the knee
  • These symptoms can progress all the way into the foot
  • May or may not have lower back pain
  • The symptoms are usually on one side, but can be on both sides
  • It is often aggravated by coughing, bearing down to go to the toilet, bending or twisting

What causes sciatica?

Believe it or not, sciatica in itself is not a diagnosis.

It is a symptom.

This is similar to saying you have a headache, which can be caused by lots of different things.

The sciatic nerve starts as small roots in your lower back and bundles together like a big cable in your buttock region. From here it travels close to your hip and down the back of the leg all the way to your foot.

In most cases, people can not identify a specific incident that caused the pain to start. The causes of sciatica range from spinal injury or trauma, lumbar disc bulge, bone spurs on the spine or narrowing of the space for your spinal cord.

Less serious and common causes include muscular tension and or swelling pushing on the nerve.

What’s the best, quickest and most cost effective treatment?

This is entirely dependant on what is causing the sciatica to be there in the first place. Treatment should be targeted according to the diagnosis. The good news is that most cases of sciatica will eventually go away on their own.

Your pain can be managed or reduced in the mean time. Improving your ability to move and perform daily tasks is an important aspect of care. Your practitioner will be able to provide you with specific advice according to your complaint.

What can I do to help myself?

There is lots of bad advice out there! This can come from well meaning friends, family or even out of date health professionals.

Some will say rest, some will say move, some will say do everything you normally do. What is the right approach? Firstly, we need to break the most common myth, which is rest.


This is terrible advice. It will prolong your pain.

Still feeling unsure and want to rest, read some research.

Active management is absolutely the right approach.

What does that mean?

Keys to Active Management

  • You should lightly keep moving
  • Avoid sitting
  • Avoid heavy lifting (we are not talking 20kg’s, we are talking 5kg’s until you have seen a health professional you can give you more specific advice)
  • Do not bend and twist in combination
  • Apply heat over your lower back or buttocks (this can often provide some free pain relief) and help keep you moving
  • Lay down to have a short rest when the pain is aggravated

How do I know if my health professional is up to date on sciatica?

Your practitioner should perform an examination. This should include getting you to perform movement to see what you can and can not do. In some instances, they may test nerve function. This may include using a reflex hammer, checking muscular strength and sensation. It can be appropriate to perform specific tests that can briefly aggravate your pain.

This helps form a diagnosis.

If you are experiencing changes to bladder or bowel function, altered sensation or numbness in your saddle region (groin and genitalia) you should be referred for further investigation.

Most people do not need an x-ray or MRI.

Your practitioner should provide you with a plan.

The advice should be clear and specific to your complaint. You should know what you can and can not do. There should be a clear pathway to get you out of pain and back to doing normal activities.

The research is clear that exercises should be included in your management plan. Following your injury, you should be stronger and less likely to experience the problem again.

However this can only happen if you follow the plan.

Our Osteopaths see patients experiencing sciatica every day, many of which have the same symptoms, but different problems. The approach is different and specific to your individual needs. If you or someone who care about is experiencing pain and discomfort, you can BOOK NOW.