Sciatica is the name commonly used for pain that travels along the path of the sciatic nerve, from the lower back or buttock down the back of the leg, sometimes as far as the foot. It often affects one side. People describe it as a burning, shooting or electric pain, and it may come with tingling, pins and needles, or numbness in the leg. Sitting, bending or coughing can make it worse. Sciatica is usually a sign that a nerve root in the lower back is irritated, rather than a diagnosis on its own. At Blockline Physiotherapy & Wellness in Kitchener, our physiotherapists assess what may be irritating the nerve and help you manage your symptoms and get moving again.
Common causes
- A disc in the lower back that is bulging or irritating a nearby nerve root
- Narrowing of the spaces where nerves leave the spine, which can occur with age-related changes
- Tightness or irritation around the buttock muscles
- Long periods of sitting or driving
- Lifting, bending or twisting, especially with a heavy load
- Reduced strength or endurance in the muscles that support the spine and hips
How physiotherapy can help
Your physiotherapist will start with a careful assessment. They will ask about where you feel symptoms, what positions ease or aggravate them, and how they affect your sleep, work and activity. They will look at how your back and hips move, and check the strength, sensation and reflexes in your legs to understand how the nerve is being affected. This also helps them identify anyone who needs to be referred to a doctor for further investigation.
Based on your assessment, your treatment plan may include:
- Education — understanding sciatica can make it less worrying. Your physiotherapist will explain what is likely happening and which positions and activities may ease your symptoms.
- Exercise — gentle movements to reduce nerve sensitivity, followed by exercises to build strength and mobility in your back, hips and legs as you improve.
- Manual therapy — hands-on techniques that may help reduce stiffness and muscle guarding in the back and hips.
- Posture and activity advice — practical tips for sitting, driving, sleeping and lifting while you recover.
- Massage therapy — where appropriate, massage therapy may help ease tension in the back and buttock muscles.
Sciatica often improves with time and the right approach, but recovery varies from person to person. Your physiotherapist will review your progress regularly and adjust your plan. For more on general lower back symptoms, see our page on back pain.
When to see a doctor first
Some symptoms with sciatica need urgent medical care. Go to the emergency department right away if you have:
- Loss of bladder or bowel control, or new difficulty passing urine
- Numbness in the groin, genitals, buttocks or inner thighs
- Symptoms in both legs at the same time
- Leg weakness that is getting worse, such as foot drop or trouble standing on your toes or heels
You should also see your doctor if your pain follows a significant fall or injury, comes with fever or unexplained weight loss, or is severe and constant including at night. Your physiotherapist will screen for these signs and refer you if needed.
Frequently asked questions
Is sciatica the same as back pain?
Not exactly. Sciatica refers to symptoms that travel down the leg along the sciatic nerve. Some people with sciatica also have back pain, while others feel it mostly in the buttock or leg. Your physiotherapist will assess both.
Should I stretch my leg if I have sciatica?
Some stretches can help, while others may irritate an already sensitive nerve. It is best to have your physiotherapist assess you and recommend exercises that suit your symptoms rather than pushing through painful stretches.
Do I need a referral to see a physiotherapist for sciatica?
No. In Ontario you can see a physiotherapist without a doctor’s referral. Some insurance plans do require one for reimbursement, so it’s worth checking your plan before your first visit. We offer direct billing to most insurance providers.
If sciatica is getting in the way of your day, you don’t have to sort it out alone. Book a free 15-minute consultation to talk with a physiotherapist about what you’re experiencing, or book an assessment online through Jane. Prefer to talk to someone? Call us at 519-576-1777. We’re open seven days a week, with evening appointments on weekdays, at our clinic on Block Line Rd in Kitchener.