What is sciatica?
Sciatica describes pain caused by irritation or compression of the sciatic nerve. It is not a diagnosis in itself. It is a sign that something is placing pressure on the nerve somewhere along its path.
The sciatic nerve is the longest nerve in the body. It begins in the lower spine, runs through the buttock and down the back of the thigh, then branches below the knee into the lower leg and foot.
Because the nerve travels such a long distance, pain, tingling or weakness can be felt well away from where the actual problem sits. Pain in the calf or foot may originate from the lower back.
Identifying the underlying cause is the first step, because treatment depends on what is compressing the nerve.
What causes sciatica?
Sciatica develops when a structure in or around the spine presses on the sciatic nerve or its nerve roots. Several conditions can produce this.
Herniated or bulging disc
A disc that bulges or ruptures can press directly on a nerve root in the lower spine. This is one of the most common causes of sciatica, particularly in people under 50.
Spinal stenosis
Narrowing of the spinal canal reduces the space available for the nerves. Symptoms often worsen with standing or walking and ease when sitting or leaning forward.
Piriformis syndrome
The piriformis muscle sits deep in the buttock, directly over the sciatic nerve. When it becomes tight or irritated it can compress the nerve and produce sciatica-like symptoms without any spinal involvement.
Degenerative disc changes
As discs lose height and hydration with age, the space around the nerve roots can reduce. This may contribute to nerve irritation over time.
Spondylolisthesis
When one vertebra slips forward over the one below it, the shift can narrow the nerve pathway and place pressure on the sciatic nerve roots.
Sciatica symptoms
The defining feature of sciatica is pain that radiates down one leg. Symptoms usually affect one side of the body rather than both. Common symptoms include:
- Pain travelling from the lower back or buttock down the back of the leg
- Sharp, burning or electric shock sensations rather than a dull ache
- Pins and needles or tingling in the leg or foot
- Numbness along the nerve path
- Weakness in the leg, ankle or foot
- Pain that worsens when sitting, coughing or sneezing
- Difficulty standing up after sitting for long periods
Symptoms vary in intensity. Some people experience mild intermittent discomfort, while others find it difficult to sit, stand or sleep comfortably.
How is sciatica different from general lower back pain?
The two are often confused, but they present differently and are treated differently.
| Sciatica | General lower back pain | |
| Where pain is felt | Radiates from the back or buttock down one leg | Stays localised in the lower back |
| Sides affected | Usually one side only | Often across both sides |
| Type of pain | Sharp, burning or shooting | Dull, aching or stiff |
| Nerve symptoms | Tingling, numbness or weakness common | Usually absent |
| Underlying issue | Nerve compression or irritation | Muscular, ligament or joint strain |
Lower back pain that stays in the back is more likely to be muscular. Pain that travels below the knee, or comes with numbness or weakness, points to nerve involvement.
An assessment can help determine which pattern applies to you. Both are covered under our broader lower back pain treatment.
How we treat sciatica
Treatment focuses on reducing pressure on the sciatic nerve, easing the muscular tension contributing to the compression, and restoring comfortable movement. Your plan will depend on what the assessment finds.
Remedial Massage
Remedial massage targets the muscles that surround and support the sciatic nerve, including the glutes, piriformis and lower back. Releasing tension in these muscles may reduce the mechanical pressure contributing to nerve irritation.
Learn more about our Remedial Massage.
Myotherapy
Myotherapy assesses how your movement patterns and muscular imbalances may be contributing to nerve compression. Treatment combines hands-on techniques with corrective exercise to address the cause rather than only the symptoms.
Learn more about our Myotherapy.
Dry Needling
Dry needling may be used to release trigger points in the deep gluteal muscles, particularly the piriformis, which can be difficult to reach through manual techniques alone.
Learn more about our Dry Needling.
Cupping Therapy
Cupping may help improve soft tissue mobility across the lower back and gluteal region, supporting the effect of manual therapy on the surrounding muscles.
Learn more about our Cupping Therapy.
Low Level Laser Therapy
Low Level Laser Therapy may be recommended as part of a wider plan to support tissue recovery and help manage ongoing discomfort.
Learn more about our Low Level Laser Therapy.
What to expect during your appointment
Your first appointment begins with an assessment. Your practitioner will ask about where the pain travels, what makes it better or worse, and how it is affecting your daily activities. They will also assess your movement and check for signs of nerve involvement.
From there, they will build a treatment plan suited to your presentation. Depending on what the assessment finds, treatment may include:
- Soft tissue therapy across the lower back and gluteal muscles
- Trigger point therapy targeting the piriformis and deep gluteals
- Dry needling
- Cupping
- Nerve mobility and stretching techniques
- Movement and posture advice
- Home management recommendations
Plans are reviewed as symptoms change. Sciatica often improves gradually rather than all at once, so treatment is adjusted along the way.
When should you seek medical attention?
Most sciatica improves with conservative treatment. However, some symptoms require immediate medical assessment rather than manual therapy.
Seek urgent medical advice if you experience:
- Loss of bladder or bowel control
- Numbness around the groin, buttocks or inner thighs
- Progressive weakness in one or both legs
- Sciatica in both legs at the same time
- Severe pain following significant trauma such as a fall or accident
- Fever alongside back and leg pain
These symptoms can indicate a condition requiring urgent medical care. If you experience any of them, contact your doctor or present to an emergency department.
Related lower back conditions
Lower back pain has a range of causes, and sciatica is only one of them. Explore the conditions below to understand your symptoms.
Or return to Lower Back Pain Treatment Melbourne for an overview of all conditions and treatment options.
Sciatica treatment across Melbourne
We treat sciatica at all three of our clinics.
Book Online Now or call (03) 9645 9923 to schedule your first consultation.
Melbourne CBD
Suite 224, The Block Arcade, 98-100 Elizabeth Street, Melbourne
Mon to Fri: 8am to 8pm | Sat and Sun: 10am to 5pm
Southbank
P15, 3 Southgate Avenue, Southbank
Mon to Fri: 8am to 8pm | Sat and Sun: 10am to 5pm
Brunswick
1/272 Albert Street, Brunswick
Mon to Fri: 8am to 8pm | Sat and Sun: 10am to 5pm
Frequently asked questions
How long does sciatica take to heal?
Many cases of sciatica improve within four to six weeks with appropriate treatment and activity modification. Recovery time depends on the underlying cause and severity. Some people notice improvement within days, while those with ongoing disc or spinal changes may need longer term management.
Can massage help sciatica?
Massage may help sciatica when muscular tension is contributing to the nerve compression, particularly through the gluteal and piriformis muscles. It does not correct structural causes such as a herniated disc, but it can reduce the muscular load around the affected nerve and ease symptoms.
Should I rest or keep moving with sciatica?
Gentle movement is generally better than extended bed rest. Staying reasonably active helps maintain circulation and prevents stiffness. Avoid activities that sharply worsen your symptoms, such as heavy lifting or prolonged sitting, and follow the specific advice given at your appointment.
Is heat or ice better for sciatica?
Ice is often used in the first 48 hours to help manage acute inflammation, while heat may be more comfortable for ongoing muscular tightness afterwards. Many people find alternating between the two helps. Use whichever provides more relief for your symptoms.
Do I need a scan or a referral for sciatica?
No referral is needed to book an appointment with us. Imaging is not routinely required for sciatica, as most cases are diagnosed through symptoms and physical assessment. Your practitioner will advise if referral for further investigation is appropriate.
Can sciatica go away on its own?
Sciatica often resolves on its own as the irritation around the nerve settles. Treatment can help ease symptoms and address contributing factors along the way. If pain persists beyond six weeks or worsens, further assessment is recommended.
What makes sciatica worse?
Prolonged sitting, bending forward, heavy lifting, twisting movements and coughing or sneezing commonly aggravate sciatica. Long periods in one position, including driving, can also increase symptoms. Changing position regularly throughout the day often helps.
Is sciatica covered by private health insurance?
Remedial massage and myotherapy are covered by most private health funds with extras cover. Rebates vary by fund and level of cover. We can process claims on the spot at all three clinics.
Ready to address your sciatica?
If pain is travelling down your leg and affecting your work, sleep or daily activities, our team can help identify what is causing it and build a treatment plan suited to you.