Sciatica: Causes, Symptoms, and Treatment Options in Ipswich
Introduction
Sciatica is one of the most searched-for, and most misunderstood, causes of leg pain. Patients often tell me they’re confused by what they read online: some articles say all leg pain is sciatica, while others blame every case of sciatica on a “slipped disc.” It’s hard to know what’s true.
This guide aims to clear things up. I’ll explain what sciatica really is, how it differs from other types of back or leg pain, and why the exact cause matters for recovery. We’ll also bust some common myths and highlight what an effective diagnosis and treatment plan looks like.
What is sciatica?
The sciatic nerve is the largest nerve in the body, formed from several nerve roots in the lower spine. It travels through the pelvis and buttock down the back of the leg. When one of these nerve roots is irritated or compressed, it can produce pain, numbness, or weakness along its pathway — this is what we call sciatica.
In plain English: imagine the nerve is like an electrical cable. If it’s compressed or irritated at any point, the signals can’t travel properly, causing tingling, burning, or shooting pain in the leg.
Sciatica isn’t a single disease — it’s a symptom with many possible causes. That’s why understanding your pain and getting the right assessment matters.
The Sciatic Nerve and its Branches
Common misunderstandings
“All leg pain with back pain is sciatica.”
No. Leg pain can come from many places that aren’t the sciatic nerve. For example, the discs and joints in the lower back can refer pain down your leg, even if those problems do not create pressure or irritation of the sciatic nerve at all.
“Sciatica always means a slipped disc.”
A disc problem can cause sciatica, but so can other conditions like stiff spinal joints, spinal stenosis (see next section, or muscle-related problems.
“You always need a scan.”
Many cases can be diagnosed from a careful clinical exam; scans are for selected situations (severe symptoms, red flags, or when surgery is being considered).
“Rest is the cure.”
Long rest often makes the problem worse. Early, guided movement and a targeted plan usually help recovery.
“If coughing or sitting makes it worse, that’s sciatica.”
Those features often point to disc-related nerve root compression, which is one structural cause of sciatica — but they don’t prove the diagnosis on their own.
Can spinal stenosis cause sciatica?
Yes, but the pattern depends on the type of stenosis:
1. Foraminal stenosis
· This is narrowing of the small openings (foramina) where individual nerve roots exit the spine.
· If a nerve root that contributes to the sciatic nerve is compressed, it can produce classic sciatica: one-sided leg pain, tingling, numbness, or weakness following the nerve’s path.
· Symptoms are often triggered by specific movements or prolonged positions, similar to a disc problem.
2. Central (canal) stenosis
· This is narrowing of the main spinal canal, where the spinal cord or cauda equina passes.
· Compression here can affect multiple nerve roots, sometimes causing leg pain in both legs, often with heaviness, tingling, or cramping.
· Pain and numbness are typically worse when walking or standing and relieved by sitting or leaning forward — a pattern called neurogenic claudication.
Key point: spinal stenosis doesn’t directly “target” the sciatic nerve. Instead, it compresses the nerve roots that combine to form the sciatic nerve, producing the leg symptoms people recognise as sciatica.
Other causes of sciatic nerve compression outside the spine
Sometimes the sciatic nerve is compressed or irritated after it leaves the spine, producing classic nerve symptoms. For example:
Piriformis syndrome: the piriformis muscle in the buttock compresses the nerve.
Hamstring or compression behind the knee: tight muscles or fibrous bands can irritate the nerve along its path.
Other muscular or anatomical “hard edge” contacts: areas where the nerve passes close to tight muscles, ligaments, or bony structures.
These cases are less common than spinal nerve root compression, but they can still cause pain, tingling, numbness, or weakness along the nerve’s pathway.
Leg pain that mimics sciatica but isn’t nerve pain
Other sources can make the leg feel like it has sciatica without actual nerve involvement. For example:
Gluteal trigger points: tight spots in gluteus minimus or medius can refer pain down all the way down the leg.
Hamstring or other muscle trigger points: tight muscles may create aching, burning, or shooting sensations down the leg.
Joint problems: hip or knee issues can sometimes radiate pain in a way that feels like sciatica.
Key difference between true sciatica and mimicking pain
True sciatica is caused by actual irritation or compression of the sciatic nerve. It often follows a clear nerve pathway down the leg and may include numbness, tingling, or weakness.
Mimicking or referred pain comes from muscles, joints, or soft tissues, not the nerve itself. It can feel similar to sciatica but usually does not cause true neurological symptoms, and the treatment approach is usually different.
Typical symptoms of sciatica
True sciatica often affects one side and may include:
Sharp, burning, or shooting pain down the leg
Tingling or “pins and needles”
Numbness or reduced sensation in part of the leg or foot
Weakness in specific muscles (for example, foot drop)
How we assess sciatica at Physio7 (Ipswich)
A thorough assessment is the cornerstone of effective treatment. We combine:
History: when it started, what makes it better or worse, and how it affects daily life.
Functional testing: observing which positions or movements increase or reduce symptoms — identifying your “directional preference.”
Neurological exam: checking reflexes, muscle strength, and sensation.
Specific tests: to determine joint and muscle involvement.
Red flag screening: to determine if urgent medical review or imaging is needed.
This dual approach — structural plus functional — helps pinpoint the likely cause and guides safe, effective treatment.
Treatment options…. it depends
Because sciatica is a symptom, treatment must fit the diagnosis. Common approaches include:
Early pain-control strategies
Targeted exercise programmes: exercises are chosen based on your structural and functional diagnosis, stage of injury, and personal goals, then progressed according to tolerance.
Manual therapy: hands-on work to reduce joint stiffness or release tight muscles, including gluteal and spinal trigger points.
Neural techniques: gentle nerve-gliding exercises in selected cases.
Posture and movement coaching: teaching how to sit, lift, and move safely to reduce nerve irritation.
Pacing and return to activity: stepwise plan to rebuild strength and confidence without provoking flare-ups.
Referral options: if symptoms persist or red flags appear, we liaise with GPs, pain clinics, or spinal specialists for further tests or treatments (injections or surgery in selected cases).
Recovery and prognosis
Sciatica usually takes longer to settle than simple back pain because nerve irritation heals slowly. Recovery can take weeks to months, sometimes longer if the nerve has been heavily compressed. The severity of nerve irritation or damage greatly affects prognosis: mild cases respond well to conservative care, while severe cases may require specialist input.
Can you prevent sciatica?
Not every case is preventable, but risk can be reduced by:
Staying active and moving regularly
Strengthening core and hip muscles
Breaking up long periods of sitting and bending
Using safe lifting techniques
Addressing back or hip stiffness early
Final words
Sciatica isn’t a single problem to be “fixed” — it’s a symptom with multiple possible causes. Accurate diagnosis is key: both structural (which tissues are involved) and functional (what movements trigger symptoms).
If you’re in Ipswich and struggling with leg pain that might be sciatica, the first step is a clear assessment. At Physio7, we focus on finding the real cause so your treatment plan is tailored to your body, not a one-size-fits-all program.
Book an appointment with an expert physiotherapist in Ipswich to start your recovery.
