Sciatica Explained

If you’ve ever experienced pain that starts in your low back or buttock and travels down your leg, you may have heard someone say, “That sounds like sciatica.” But what exactly is sciatica, and why can it feel so different from one person to another?

What Is Sciatica?

Sciatica is a term commonly used to describe symptoms caused by irritation of the nerves that form the sciatic nerve. These nerves begin in the lower back and travel through the buttock and down the leg. When one of the nerve roots becomes irritated or compressed, symptoms may be felt anywhere along that pathway.

Sciatica is not one specific diagnosis. Instead, it describes a pattern of symptoms that may have several different causes.

What Does Sciatica Feel Like?

Symptoms can vary significantly from person to person. You may experience:

• Pain in the low back, buttock, thigh, calf, or foot

• Sharp, shooting, or burning pain down the leg

• Numbness or tingling

• A “pins and needles” sensation

• Leg or foot weakness

• Symptoms that worsen with prolonged sitting, bending, lifting, coughing, or certain movements

Some people experience very little back pain and mostly notice symptoms in the leg.

What Causes Sciatica?

There are several reasons a nerve in the lower back may become irritated.

Common causes include:

• A bulging or herniated lumbar disc

• Age-related changes in the spine

• Narrowing around the nerves, known as spinal stenosis

• Irritation or inflammation surrounding a nerve root

• Changes in spinal or hip mobility

• Repetitive lifting, bending, or prolonged positioning

Because there are many potential contributors, two people who both say they have “sciatica” may need very different treatment plans.

Should I Stretch My Sciatic Nerve?

This is one of the most common questions we hear. And the answer is: it depends.

When a nerve is already irritated, aggressively stretching the hamstring or repeatedly pulling on the nerve can sometimes make symptoms worse. For some people, mobility exercises are helpful. For others, the first step may be finding positions that reduce pressure on the nerve, improving movement of the low back or hips, strengthening surrounding muscles, or gradually restoring tolerance to activity.

That is why an individualized evaluation is so helpful.

How Can Physical Therapy Help?

Physical therapy focuses on identifying the movements, positions, strength deficits, and mobility limitations that may be contributing to your symptoms.

Depending on what we find, treatment may include:

• Exercises to reduce or centralize leg symptoms

• Core and hip strengthening

• Mobility exercises

• Nerve mobility exercises when appropriate

• Hands-on treatment

• Posture and body mechanics education

• Guidance for lifting, sitting, sleeping, and daily activities

• A gradual return to exercise, work, or recreational activities

The goal is not simply to temporarily decrease pain. We want to help you understand your symptoms, restore your movement, and give you tools to manage your back long-term.

Does Sciatica Mean I Need Surgery?

Not necessarily! Many people with sciatica improve with time, appropriate activity, and conservative treatment such as physical therapy. Imaging findings such as disc bulges are also relatively common and do not automatically mean surgery is necessary.

However, certain symptoms should be evaluated promptly.

Seek immediate medical attention if back or leg symptoms are accompanied by new loss of bowel or bladder control, numbness around the groin or saddle region, rapidly worsening weakness, or other significant neurological changes.

Don’t Let Sciatica Keep You From Moving

Sciatica can be frustrating, especially when leg pain makes sitting, walking, exercising, working, or sleeping uncomfortable. But avoiding movement altogether is rarely the long-term solution. Our physical therapists can help determine what is contributing to your symptoms and develop a plan to help you move with more confidence and less pain.

At HIBPT, we treat the person, not just the painful body part. If low back or leg pain is interfering with your daily life, contact us to schedule an evaluation or ask about a free 15-minute screen to determine if physical therapy may be right for you.