What sciatica actually is
Sciatica is not a disease in itself; it is a symptom. It describes pain that travels along the path of the sciatic nerve, from the lower back through the buttock and down the back or side of the leg, sometimes as far as the foot. The pain is often burning, shooting or electric in quality, and it may come with tingling, numbness or a feeling of heaviness in the leg. It usually affects one side, and many patients tell us the leg pain troubles them far more than the back pain itself.
Coughing, sneezing, prolonged sitting and bending forward commonly aggravate it, which is why long drives on SG Highway or a full day at a desk can feel impossible during a flare.
What causes it
- A disc bulge or herniation pressing on or inflaming a nerve root, which is the most common cause in people under 55
- Narrowing of the nerve passages (spinal stenosis), more common after 60, where leg symptoms typically worsen with walking and ease with sitting
- Irritation of the nerve as it passes through the buttock muscles
- Rarely, other causes that we screen for during assessment
Red flags: when sciatica needs a doctor first
Do you need surgery? Usually not
This is the question most patients arrive with, and the research is reassuring. The large majority of disc-related sciatica improves substantially within 6 to 12 weeks of good conservative care, and long-term outcomes for most people are similar whether or not they were operated on. Surgery has a place, mainly for progressive muscle weakness, the emergency signs above, or severe pain that refuses to settle despite a genuine course of conservative treatment. Our job is to guide you safely through the recovery window, monitor your nerve signs at every visit, and tell you honestly if your case is the exception that needs a surgical opinion.
What treatment at Physio Buddy looks like
After a detailed assessment of your spine, nerve mobility, muscle power and reflexes, your plan is built from:
- The McKenzie method, which identifies the direction of movement that draws your pain out of the leg and back towards the spine, a pattern called centralisation that is one of the best predictors of recovery without surgery
- Manual therapy using Maitland techniques to ease stiff, protective spinal segments
- Gentle nerve mobility exercises that help the sciatic nerve glide without irritation
- IFT and TENS for pain relief in the early, angriest phase
- Graded exercise therapy to rebuild core and hip strength once the nerve settles
- Sitting, driving and lifting strategies for the weeks while the nerve is sensitive
Three safe starter movements
Every sciatica case has its own preferred direction, so treat these as gentle first steps, and stop anything that increases pain further down the leg.
- Walking, little and often: several short, relaxed walks a day usually sit better with an irritated nerve than one long walk or a day in a chair.
- Knee-to-chest: lying on your back, draw one knee gently towards the chest, hold for 10 seconds, 5 repetitions per side, staying well within comfort.
- Prone press-up, only if it helps: lie face down and gently prop up onto your forearms for 30 seconds. If your leg pain eases or moves up towards the back, this position is likely a friend; if leg pain increases, stop and tell us, as that information shapes your treatment.
How long does recovery take?
Most patients feel a meaningful shift within 2 to 4 weeks and are substantially better by 6 to 12 weeks. Recovery follows a fairly predictable sequence: the leg pain shrinks back towards the buttock and spine first, strength and sitting tolerance return next, and patches of numbness or tingling are often the last to fade, sometimes lingering a few months after the pain has gone. That lingering tingle is common and rarely a cause for alarm, though we keep monitoring it.
Clinic visit or home visit?
Acute sciatica can make travelling genuinely difficult, so we offer home visit physiotherapy across Chandkheda, Motera, Gandhinagar and nearby North Ahmedabad for the early phase. As soon as you can travel comfortably, clinic sessions at Shop 117, Shyam Saanvi, behind Satyamev Hospital, Chandkheda give you the fuller treatment setup. A virtual consultation also works well for reviewing your exercises between visits. Book an assessment and get a clear picture of what your nerve needs.
Frequently Asked Questions
Will my sciatica go away on its own?
Many mild episodes do settle over weeks, but guided treatment usually shortens the journey, keeps you functional while it heals, and catches the small minority of cases that need a medical referral. The riskiest approach is pushing through worsening leg weakness without anyone monitoring it.
Is walking or sitting better for sciatica?
Walking, almost always. Sitting increases pressure on the discs and most sciatica patients feel worse after long sitting. Break up desk time every 30 to 40 minutes and accumulate several short walks through the day.
Do I need an MRI?
Not usually at the start. If your examination matches a typical nerve root irritation and there are no red flags, treatment can begin without a scan. An MRI becomes useful if surgery is being considered or if your recovery stalls despite good care.
What about injections?
Steroid injections can dull severe pain for a period, and for some patients that window makes rehab possible. They do not fix the underlying mechanics, so exercise and graded loading still do the lasting work. If injections seem relevant to your case, we discuss it openly and coordinate with your doctor.
What is the best sleeping position for sciatica?
Most patients rest best on their side with a pillow between the knees, or on the back with a pillow under the knees. Avoid sleeping on your stomach if it stirs up the leg pain. A decent, evenly supportive mattress matters more than an expensive one.
Can sciatica come back?
It can, which is why the final phase of our programme is strengthening, not just pain relief. Patients who keep up core and hip strength and manage their sitting hours have far fewer repeat episodes.
Is sciatica the same as a slip disc?
Not exactly. A slip disc is one common cause of sciatica, but sciatica can arise without a disc problem, and plenty of disc bulges cause no symptoms at all. Our assessment works out which pattern you have; you can read more on our slip disc page.