A deep, electric pain that runs from the lower back into the buttock and down the leg is the symptom that sends most people looking for sciatica treatment, and the search usually turns up conflicting advice. Rest it or move it? Is it a disc? Will it ever go away? In clinic we see sciatica most weeks in patients from across Stockport, Woodford and Hazel Grove, and the honest starting point is that most of it recovers well with the right approach. This guide explains what sciatica actually is, how long it tends to last, what god treatment looks like, and the red flags that mean you should skip the physio and get urgent help.
What is sciatica, really?
Sciatica is not a diagnosis in itself; it is leg pain caused by irritation or compression of a lower-back nerve root, most often from a disc.
The sciatic nerve is formed from nerve roots in the lower lumbar spine and runs through the buttock and down the back of the leg into the foot. When one of those roots is irritated, the pain is referred along the nerve’s territory, which is why true sciatica is usually felt more in the leg than in the back itself. The NHS makes the same point on its sciatica page: the leg pain is often worse than any accompanying back pain, and it can come with pins and needles, numbness or weakness in the leg or foot.
This matters because a lot of pain that gets called sciatica is not sciatica at all. Referred pain from a facet joint or muscle can ache in the buttock and thigh without ever following a true nerve line or passing below the knee. Separating genuine nerve-root pain from mechanical referred pain is the first job of assessment, because the two respond to different treatment.
What causes sciatica, and who gets it?
Sciatica is most often caused by a lumbar disc bulge pressing on a nerve root, with spinal stenosis, ageing discs and sustained postural load as other common drivers.
In people under about fifty, a disc herniation is the usual culprit; the soft inner part of a disc pushes against a nerve root and sets off the inflammatory, irritable picture that defines acute sciatica. In older adults, narrowing of the space around the nerve, known as spinal stenosis, becomes more common, and the pattern shifts towards leg symptoms that build with standing and walking and ease when sitting or bending forward.
Underneath the structural label sits a load story. A spine that spends long days seated and is then asked to lift or twist without preparation is a spine working outside what it has been conditioned for. From a movement-quality point of view, the way you hinge, breathe and distribute load through the hips and trunk changes how much stress lands on a sensitised nerve root. That is the part self-diagnosis tends to miss.
How long does sciatica last, and should you rest it?
Most sciatica settles within six to twelve weeks, and resting in bed makes it worse; staying active is one of the best-evidenced things you can do.
The instinct to lie still is understandable and wrong. The National Institute for Health and Care Excellence guideline on low back pain and sciatica recommends staying active, continuing usual activities as far as pain allows, and using exercise as a core part of treatment; extended bed rest slows recovery. The nerve calms down as movement returns, not as it stops. A short course of anti-inflammatory medication, guided by a pharmacist or GP, can keep you moving through the worst days, but it treats the symptom rather than the cause.
There is a useful nuance for stenosis. Where a disc-driven sciatica often prefers gentle extension, a stenosis picture usually feels better with flexion, so the same generic stretch can help one person and aggravate another. That is exactly why a plan built around your presentation beats a printout of universal exercises.
What sciatica treatment actually involves
Effective sciatica treatment combines an accurate assessment, nerve and spinal mobility work, graded strengthening and education, rather than passive treatment or long-term rest.
The first step is confirming the mechanism: is this a nerve root, and if so, which one, and what eases and provokes it. From there, treatment usually blends nerve mobility work, spinal movement in the direction your symptoms prefer, and a graded strengthening programme that rebuilds the capacity of the hips and trunk to carry load without stressing the nerve. Manual therapy has a place, but the NICE guidance is clear that it should be used as part of a package that includes exercise, not as a standalone fix. Longer-term reconditioning, the kind that prevents the next episode, runs as structured physiotherapy rehabilitation once the acute pain has settled, and our post on back pain recovery walks through what that phase looks like in practice.
Sciatica red flags that need urgent help
New bladder or bowel problems, numbness around the saddle area, or sciatica in both legs can signal cauda equina syndrome and need same-day emergency care.
This is the section that will not be softened. Most sciatica is not dangerous, but a small number of presentations are, and they are time-critical. If you develop new difficulty passing urine, loss of control of your bladder or bowel, numbness around the back passage or genitals, or new symptoms down both legs, do not wait for a physiotherapy appointment; go to A&E or call 999. These can be signs of cauda equina syndrome, a rare surgical emergency where time to treatment affects the outcome. Sciatica alongside unexplained weight loss, fever, or a history of cancer is a see-your-GP-first pattern rather than a physiotherapy-first one.
When to see a physiotherapist for sciatica in Stockport and Woodford
See a physiotherapist if leg pain lasts beyond two to three weeks, keeps returning, or limits your work and sleep, so you get a clear mechanism and a plan.
NICE supports physiotherapy as a first-line treatment for sciatica, ahead of scans and ahead of strong painkillers. In practice the threshold is functional: if the pain is stopping you doing what you normally would, an early assessment shortens the recovery curve. The clinic sees patients for back pain treatment in Woodford from across Stockport, Bramhall, Hazel Grove and the surrounding towns. A first appointment with Rick, whose twenty years in elite sport and JEMS movement-quality training shape a mechanism-first approach, builds a working explanation for your symptoms and ends with a clear plan for the next two weeks.
Common questions about sciatica
Does sciatica go away on its own?
Often, yes. Most cases improve within six to twelve weeks with continued movement and sensible load management. If it has not improved after six weeks, or is getting worse, it is worth an assessment.
How should I sleep with sciatica?
Find the position that keeps the nerve least provoked. Many people are more comfortable on their side with a pillow between the knees, or on their back with a pillow under the knees. There is no single correct position; comfort is the guide.
What does sciatica feel like?
A sharp, burning or electric pain travelling from the lower back or buttock down the leg, sometimes with pins and needles, numbness or weakness. Leg pain that outweighs the back pain is the classic pattern.
Book an appointment
To book an in-person sciatica assessment, use Book An Appointment. If you would prefer to talk through your symptoms before committing, a free 15-minute telephone consultation is the right place to start.