Sciatica: Symptoms, Causes & Physical Therapy Treatment
Updated October 20261 minute read
Sciatica is pain that travels along the sciatic nerve — from the lower back through the buttock and down the leg — usually because a nerve root is irritated, often by a herniated disc. It can feel sharp, burning, or electric, sometimes with numbness or tingling. Most sciatica improves within a few weeks to a few months with physical therapy and staying active. Groin numbness or loss of bladder/bowel control is an emergency.
What is sciatica?
Sciatica isn't a diagnosis by itself — it's a description of symptoms caused by irritation of a lower-back nerve root or the sciatic nerve. The most common underlying cause is a herniated disc, but spinal stenosis and other issues can also produce it. If your main complaint is pain radiating down the leg, that guide maps the pattern in plain language.
Symptoms
The defining feature is radiating leg pain along the path of the nerve — typically one-sided, running into the buttock, back of the thigh, calf, and sometimes the foot. You may also have numbness, tingling, or weakness in the leg. Leg symptoms often bother people more than the back itself.
What causes it / risk factors
A herniated disc pressing on a nerve root is the leading cause; spinal stenosis and, less often, piriformis-related irritation can contribute. Prolonged sitting, heavy lifting, and deconditioning increase risk.
How it's diagnosed
Diagnosis is clinical, based on your symptom pattern and a neurological exam that maps which nerve is involved. Imaging is added only for severe, persistent, or worsening cases.
Physical therapy treatment
What a PT does. Your therapist finds positions and movements that ease ("centralize") the leg pain, frees up nerve mobility, and rebuilds strength and tolerance. Exercises & progression (overview). Directional-preference exercises, nerve gliding, walking, and graded core and hip strengthening. Active care is recommended first-line. Recovery timeline. Many cases settle within 6–12 weeks; some take longer.
Treatment options compared
PT and time are first-line. Injections may help selected cases. Surgery is reserved for severe or progressive nerve compromise that doesn't respond to conservative care.
Red flags
Seek emergency care for groin numbness, loss of bladder/bowel control, or fast-worsening leg weakness.
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Frequently asked questions
Most cases improve within a few weeks to a few months with active care.
Sources (5)
- MedlinePlus: Sciatica. — NIH/MedlinePlus
- AAOS OrthoInfo: Sciatica. — AAOS OrthoInfo
- Peul WC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007. — PubMed
- Qaseem A, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017. — PubMed
- Liu C, et al. Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials. BMJ. 2023. — BMJ
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.