Have I got Sciatica? - this complicated diagnosis in detail

Sometimes back pain causes pain in the legs which doctors often refer to as ‘Sciatica’ because the sciatic nerve, which runs down the back of the leg, is most commonly involved. Pain can actually be felt in the buttock, back of the thigh, calf or into the foot. There is nothing wrong with the leg itself, but the pain is caused from an injury on the spine irritating the nerve. These symptoms are often described as referred pain. You may also experience numbness or pins and needles in the legs and feet. Do I have Sciatica?

Your physiotherapist can perform certain clinical tests to give an indication as to whether symptoms in your leg are coming from your back (referred pain) and whether the is nerve root irritation (radiculopathy /radicular pain) which along with your clinical history might also point to a more specific problem. If your physiotherapist thinks there is a specific structural problem they may refer to your doctor accordingly, but this is very rare.

Why am I getting pain?

Sciatica 1
Sciatica 1

Your back is made up of 24 bones known as vertebra sitting one on top of the other. Where each vertebra meets another 3 joints are formed that include: 2 bony (facet) joints at the back and a soft inter-vertebral joint formed by the discs at the front of the spine. The discs act as shock absorbers and the facet joints control movement of the spine. At each joint there are also ligaments and muscles that attach to the vertebrae to control and assist the movement of the spine.

Sciatica 2
Sciatica 2
Sciatica 3
Sciatica 3

What can help?


A physiotherapy assessment can identify reasons why your pain is persisting and ease your pain. Your physiotherapist may choose to perform massage, spinal mobilisation or manipulationand show you some pain relieving exercises. Whether you have stiffness, weakness or instability, these exercises and treatments will help you return to your normal activities sooner. You may also gain a better understanding of what causes your pain and how to prevent the frequency of future episodes and manage them independently, if they do occur. If you find symptoms are persisting and you are not returning to normal activities, to reduce pain and improve your function your physiotherapist may develop more specific conditioning exercises for you based on your presentation.


Over-the-counter pain medication like paracetamol and ibuprofen are very effective for initial pain symptoms. Don’t wait until you have severe pain before you take pain medication. If the pain is limiting your ability to move and exercise it could also affect the time it takes for you to recover. If you have any other medical conditions you should always consult your doctor before taking any pain medication.


Your physiotherapist can also guide you on the most effective way to ease stiffness and pain. Exercise is important as your pain eases for improving muscular control, strength and stamina, general fitness, flexibility and improving your mood. If pain persists, the lack of normal movement can cause muscle to become idle and make it more likely that you could reinjure your back again in the future. So it’s important that you don’t rest for too long and you do as many of your normal activities as possible. If you are in so much pain that you need prolonged bed rest try to make sure that you gently move your back as pain will allow.

Do I need to see the doctor?

If you are in severe pain or prolonged pain that doesn’t resolve after 4-6 weeks then you may need to see a doctor. Also if you notice weakness of the muscles in your leg, especially if you can’t pull your foot up towards you, you should see a doctor. You should also seek medical advice immediately if you lose control of your bladder or bowel function or you have numbness or pins and needles in both legs.

(Sources are available on request)

If you are suffering from any of these symptoms or you think you might have Sciatica please get in touch with Guy one of our senior, highly trained Physiotherapists or contact us on 01273 667826 at one of our clinics.