Condition
Sciatica.How we help.
Sciatica is the name for pain that starts in your lower back and travels down through the hip and leg, and sometimes all the way to the foot. It often flares up after long hours of sitting, a long drive on Jaipur's roads, or when a disc in the spine presses on a nearby nerve. Many people also feel tingling, numbness or a heavy, weak feeling in the leg.
How we help
- A careful check to find which nerve is involved and what is setting off your leg pain
- Hands-on treatment and gentle movement to ease pressure on the irritated nerve
- Exercises to calm the pain and slowly rebuild strength in your back and leg
- Where suitable, your physiotherapist may add options like robotic spinal decompression, Class IV laser or dry needling
What to expect
Your first visit begins with a detailed check of your back, hips and leg, along with how your pain moves and what makes it better or worse. We then explain in plain language what is likely going on, and build a step-by-step plan so you know what to do at home and at work.
What sciatica actually is
The sciatic nerve is the largest peripheral nerve in the body. It is formed from several nerve roots in the lower lumbar and sacral spine, passes through the buttock and runs down the back of the leg, which is why symptoms can turn up anywhere along that line rather than staying where the trouble started.
The word itself describes a pattern, not a cause. It tells you the symptoms are following that nerve; it does not tell you what is irritating it, and that second part is what shapes the treatment. When there are neurological symptoms alongside the pain, the term you may hear used is lumbar radiculopathy.
Not everything that travels down a leg is sciatica either. The hip joint, the deep muscles of the buttock and other nerves in the leg can produce something that feels much the same. That is one of the first things an assessment works through: whether the pattern fits a nerve root in the lower back, or whether something closer to the hip or buttock accounts for it better.
What causes it
Sciatica arises when a nerve root in the lower spine becomes irritated, inflamed or compressed. The reasons that commonly sit behind that:
- A herniated or slipped disc, where disc material pushes out and sits against a nearby nerve root. This is one of the common ones.
- Lumbar spinal stenosis, where the spinal canal or the small openings the nerves pass through narrow and leave a nerve less room.
- Age-related changes in the discs, joints and bone of the lower spine, which can add to that narrowing.
- Spondylolisthesis, where one vertebra shifts out of line with the one below it and crowds the space around a nerve.
- Sudden or repeated physical demand. Lifting, bending and twisting can aggravate a spinal region that was already sensitive.
- Earlier episodes of back pain or nerve irritation, which can change how much the area tolerates now.
It is rarely one movement or one bad posture that did it. Spines change with age in everyone, and symptoms usually appear where several things meet: the changes already there, how much the back is being asked to do, how much it can currently handle, and how sensitive the nerve has become.
How symptoms differ from one person to the next
Two people can be given the same label and describe two quite different legs, because the picture shifts with which nerve root is involved and how long things have been going on. The differences that matter most:
- How far it travels. For some it reaches the buttock or thigh and stops there; for others it runs past the knee and into the foot.
- How it feels. Sharp, shooting or burning for some, tingling or pins and needles for others.
- Which end dominates. Some people have a great deal of leg pain with very little back pain, while others have both.
- What sets it off. Particular movements and positions increase the symptoms, and sitting, standing or walking for any length of time can become uncomfortable.
- One side or both. Sciatica usually affects one side, and less commonly both.
- How you move. Walking or standing differently to protect the leg is common, and it often happens without you noticing.
A few symptoms sit outside that range of normal variation. Leg weakness that is increasing rather than easing, numbness spreading through the groin or the inner thighs, symptoms arriving in both legs at once, or any change in bladder or bowel control all need prompt medical assessment rather than a physiotherapy appointment.
Where rehabilitation usually starts
Rehabilitation rarely opens with strengthening work. The first job is settling the symptoms and finding how much movement the leg will tolerate, so that an ordinary day can carry on without stirring things up.
From there it builds in a fairly consistent order. Movement comes before strength, strength comes before retraining the way you move under it, and all of that comes before rebuilding the physical demands your own day makes: standing for hours, a long commute, a day at a desk.
How quickly that sequence moves depends on how the leg responds rather than on a calendar, so the programme is adjusted as the symptoms change. The exercises you do at home carry most of the work, because they are what happens on the days between appointments, and progress is judged by what you can do again: how far you can walk, how long you can sit, what you have been able to go back to.
Diagnosis, imaging, medication and any decision about injections or spine surgery sit with a doctor rather than with a physiotherapist, and physiotherapy works either side of that decision rather than in place of it.
Common questions
Why does my leg hurt when the problem is in my back?
The nerve that gets irritated in your lower back runs all the way down the leg, so the pain is often felt along its path. Your physiotherapist will explain which nerve is involved in your case.
Do I need complete bed rest for sciatica?
In most cases, full bed rest is not helpful and gentle movement is better. Your physiotherapist will guide you on how much to rest and when to start moving again.
Will I need surgery?
Many people with sciatica improve with physiotherapy and do not need surgery. Your physiotherapist will assess your condition and tell you if a doctor's opinion is needed.
When should I see a doctor as well?
Most sciatica settles with physiotherapy and simple care at home. But if you notice sudden weakness in the leg, numbness around the groin, or any change in bladder or bowel control, please contact a doctor promptly. Your physiotherapist will also guide you if a medical opinion is needed.
My MRI shows a disc bulge. Does that explain my leg pain?
Not on its own. Disc bulges and age-related changes show up on the scans of plenty of people who have no leg pain at all, so a scan finding has to be read next to what your symptoms are actually doing and what an examination finds. It is one piece of the picture rather than the whole of it.
How long does sciatica take to settle?
It varies, and nobody can give you a date at a first appointment. Many people improve over several weeks with consistent conservative care. Nerve symptoms that are more severe, or that have been there a long time, usually take longer to settle. What helps more than a promised timeline is having checkpoints, so you can see for yourself whether walking distance, sitting tolerance and the symptoms in the leg are moving in the right direction.
Are sciatica exercises the same for everyone?
No. Gentle spinal mobility, nerve gliding movements, core work and hip strengthening all have a place, but which of them helps depends on the cause and on how your leg responds to them. A movement that suits one presentation may not suit another, which is why they are picked after an assessment and reviewed as you improve, rather than worked from a standard sheet.
Related treatments
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This page is educational and does not replace a proper assessment. Outcomes vary by individual; Trivayu Physio Center makes no guarantee of specific results.
Related videos
Filmed at our centre in Vaishali Nagar. These are general demonstrations, not a plan for your particular problem. Always follow the plan your own physiotherapist gives you.
Assisted straight leg raise
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