Sciatica / Lumbar Disc Herniation

When irritation of a spinal nerve can cause pain into the leg

What is Sciatica?

Sciatica describes pain caused by irritation or compression of one or more nerves that contribute to the sciatic nerve.

It commonly produces symptoms from the lower back or buttock into the:

  • Hip
  • Thigh
  • Calf
  • Foot

One possible cause is a lumbar disc herniation, where part of an intervertebral disc pushes beyond its normal boundary and may irritate a nearby nerve root.

However:

Not every disc bulge or disc herniation causes symptoms.

An MRI finding needs to be interpreted together with the person’s symptoms and clinical examination.

What are the symptoms?

Symptoms may include:

  • Low-back pain
  • Buttock pain
  • Shooting or burning pain down the leg
  • Tingling
  • Numbness
  • Muscle weakness
  • Changes in reflexes
  • Pain aggravated by certain positions or movements

Symptoms may occur in one leg and can sometimes extend into the foot.

Important warning signs

Seek urgent medical assessment if there is:

  • New loss of bladder or bowel control
  • Numbness around the groin/saddle region
  • Rapidly worsening leg weakness
  • Severe or progressive neurological symptoms

These can indicate serious nerve compression and require urgent assessment.

What is the cause?

Possible contributors include:

  • Disc herniation
  • Age-related disc changes
  • Repetitive loading
  • Lifting or twisting
  • Previous episodes of back pain
  • Genetic and lifestyle factors

Often, there is no single event that explains why a disc becomes symptomatic.

When should you see a physiotherapist?

Physiotherapy assessment is appropriate when:

  • Leg pain persists
  • Symptoms are affecting walking or sleep
  • You have difficulty sitting, standing or working
  • You have recurrent episodes
  • You are becoming afraid to move
  • You need help returning to normal activity

A physiotherapist should also screen for neurological changes and red flags.

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How is it treated?

At Elevate, we tailor-make a complete “Road Map” based on the patient’s biopsychosocial status, keeping in mind their concerns and goals to return to the activities they enjoy the most. For many people, initial management is non-surgical.

It may include:

  • Education and reassurance
  • Staying appropriately active
  • Avoiding prolonged bed rest
  • Individualised exercise
  • Movement strategies
  • Progressive strengthening
  • Walking/aerobic activity
  • Functional rehabilitation
  • Work and activity modification

A 2025 systematic review found physiotherapy had a beneficial effect on radicular leg pain in 5 of 7 studies judged to have low-to-moderate risk of bias, although the authors emphasised the need for stronger research.

6. What is the treatment process like?

Stage 1 – Assess

Check neurological function, symptoms and red flags.

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Stage 2 – Reduce Fear and Irritation

Understand which movements/positions aggravate symptoms without unnecessarily avoiding movement.

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Stage 3 – Restore Comfortable Movement

Introduce appropriate mobility and activity.

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Stage 4 – Build Strength and Capacity

Progress trunk, hip and lower-limb conditioning.

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Stage 5 – Return to Normal Function

Gradually resume work, exercise and sport.

Surgery may be considered in selected cases, particularly when significant or progressive neurological problems are present or symptoms remain disabling despite appropriate conservative management.

7. How long does recovery take?

Many cases improve over weeks to a few months, although recovery varies.

Disc material can also reduce in size over time.

A 2023 meta-analysis found spontaneous resorption after conservative treatment in approximately 70% of lumbar disc herniations overall, with higher rates for extruded and sequestrated discs.

This does not mean that 70% of people are guaranteed to become pain-free—it refers specifically to imaging evidence of disc resorption.

Evidence at a Glance

  • A 2025 systematic review of 87 studies examined incidence and risk factors for lumbar disc herniation with radiculopathy, highlighting that this is a clinically important cause of leg pain and disability.
  • A separate 2023 meta-analysis involving 2,233 conservatively treated patients found an overall disc-resorption rate of approximately 70.4%.

The Good News Is

Sciatica can be very painful, but pain does not necessarily mean permanent nerve or spinal damage. Many people improve without surgery.

Recovery Pathway


Assess nerve function → Reduce fear/irritation → Stay appropriately active → Restore strength → Return to normal activity

Note: Urgent neurological symptoms require medical assessment and this information does not replace an individual clinical examination.