Sciatica is pain that travels along the sciatic nerve — from the lower back through the buttock and down the back of the leg. It is a symptom rather than a diagnosis in itself, and the usual cause is a nerve root in the lower spine being compressed or irritated.

What it feels like

• Pain running from the lower back or buttock down one leg, sometimes past the knee
• A burning, shooting or electric quality rather than a dull ache
• Pins and needles, numbness or weakness in the leg or foot
• Worse with prolonged sitting, standing up, coughing or sneezing
• Usually one-sided

Common causes

• Lumbar disc herniation — the most frequent cause, where disc material presses on a nerve root
• Spinal stenosis — narrowing of the spinal canal, more common with age
• Degenerative disc changes in the lower spine
• Piriformis syndrome — irritation of the nerve where it passes through the buttock
• Spondylolisthesis — one vertebra slipping forward on another

How physiotherapy helps

Most sciatica settles over weeks rather than days, and the evidence supports staying active rather than resting in bed. Your physiotherapist assesses which movements ease your symptoms and which provoke them, then builds a plan around that. Treatment commonly includes:

• Directional exercises chosen to reduce the pain travelling down the leg — often the single most useful part of treatment
• Manual therapy to improve movement in the lower back and hips
• Nerve mobility work to restore the sciatic nerve’s ability to glide as you move
• Strengthening for the deep abdominal, back and hip muscles that support the spine
• Advice on sitting, lifting and sleeping positions, which often matters more than any single exercise
• Spinal decompression, electrotherapy or dry needling where they suit your presentation

What to expect at your first visit

Your physiotherapist takes a history, tests your movement, strength, reflexes and nerve sensitivity, and works out which structure is likely involved. They will explain what they have found and agree a plan with you. Most people begin treatment in the same appointment.

When to see a doctor instead

Go to an emergency department rather than booking physiotherapy if you have numbness around the groin or inner thighs, loss of bladder or bowel control, or sudden severe weakness in both legs. These are rare but need urgent medical assessment. Also see your physician if the pain follows a significant fall or accident, or comes with fever or unexplained weight loss.

Booking an appointment

You do not need a doctor’s referral to see a physiotherapist in Ontario. Some extended health plans ask for one before they will reimburse you, so it is worth checking your policy.

We are at 2600 Skymark Avenue, Building 3, Unit 102, Mississauga, open Monday to Friday 9:00 AM – 10:00 PM and Saturday and Sunday 9:00 AM – 7:00 PM, with free parking. See our fees or call 647-998-4727.

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This page is general information, not medical advice. An assessment with a registered physiotherapist is the way to find out what is causing your symptoms and what will help.