01 · WHAT IT ACTUALLY IS
The nerve is irritated. It is not broken.
Sciatica is the name for leg pain coming from an irritated nerve root in your lower back, most often because a disc has pressed on it and inflamed it. The pain travels down the path of that nerve. That is why you feel it in your calf when the trouble is in your spine.
Burning, pins and needles, buzzing, patches that feel numb or oddly cold. That is what an irritated nerve does. It is not a sign that something is tearing, spreading or coming apart.
And the nerve is tougher than it feels. Moving it can hurt without harming it. Hurt and harm are not the same thing. Almost every decision you have to make from here hangs off that one.
02 · THE BIT ALMOST NOBODY IS TOLD
The disc shrinks back on its own. Usually.
When disc material presses on a nerve, your immune system starts working on it. Over the months that follow it gets broken down and shrinks back. Your body started that before you found this page, and treatment does not speed it up. What treatment does is help you cope and keep moving while it happens, which is not nothing.
That second one is the opposite of what most people assume. The angriest looking herniations tend to be the ones that shrink back the most. The size of it on a scan is not the size of your problem.
Which is also why a scan often changes nothing. Bulges and nerve contact turn up in plenty of people walking around with no pain at all, and what shows up rarely changes what you should do next. A scan earns its place when there are warning signs, or when things are severe or simply not shifting and a specialist opinion is on the table.
03 · READING THE DIRECTION
Which way it travels tells you more than how much it hurts.
How bad it feels on a given day is a poor guide. Where you feel it is a better one.
Good sign
Pain pulling back up out of the lower leg towards your back or buttock, even if the back itself grumbles a bit more. That direction usually means it is settling.
Back off
Pain spreading further down, towards the calf and the foot. Whatever you have been doing, ease off it for now.
Read it over days, not minutes. Nerve pain can flare hours after the thing that set it off, so the walk that felt fine at the time turns up at nine in the evening. Judge the direction across a few days. Hour by hour, you will end up blaming the wrong things.
A day where your back aches more but your calf has gone quiet is a good day. It will not feel like one at the time.
04 · WHAT HELPS, AND WHAT DOES NOT
Keep moving. Find the sweet spot.
Bed rest does not help sciatica. Sitting it out for days on end leaves the leg stiffer, more sensitive and harder to trust. Movement gets blood to the area, keeps the nerve gliding, and keeps you in charge of your own week.
Too much has its own price though. Push hard through pain that is spreading downwards and you buy yourself a flare and a few days of forced rest. What you want is the middle: enough to keep things moving, within pain you can tolerate, on most days. Then a bit more, as the leg lets you.
Then you rebuild. Strength through the leg, hip and back, so the leg holds when you go back to your training and your work. Settling it and rebuilding it are two different jobs. Rest only ever does the first one.
What does not help: bed rest, hunting for the perfect stretch, and treatment you lie there and passively receive. Belts, corsets and traction are not recommended for this. Hands on work has a real place in settling symptoms and I use it, but it belongs inside a plan that also loads the leg, never instead of one.
05 · THE HONEST TIMELINE
Weeks to feel a change. Months to be done with it.
Most people feel a shift within the first few weeks. Being properly done with it usually takes months. That is the normal shape of this, and if you were expecting it gone in a fortnight, week four feels like a disaster when it is actually on schedule.
It will not be a straight line either. Flare-ups happen on the way up and they are part of getting better, not proof that you have undone it. A flare means drop back a step, not start again. Go back to the last level that felt manageable and build from there.
Now the honest part. Most sciatica settles. Not all of it does, and some people are still living with it a year on. If that is you, you have not failed at this and you are not beyond helping. What you need is a plan built for where you actually are, not one written for week one.
One last thing. Stress, broken sleep and worry can turn the volume up on nerve pain. That does not mean the pain is imaginary, and it is not in your head. It means pain comes with a volume dial, and some of what moves it is within your reach.
Most sciatica settles. Knowing what to do while it does is the hard part.
Knowing what to push, what to ease off, and how to read your own leg as it changes week to week. That is what the initial Movement Therapy appointment is built around.
90 minutes. Full assessment. Hands on treatment where useful. An individualised plan and clear aftercare, so you leave knowing exactly what to do next.
When sciatica needs checking, not treating
Ordinary sciatica is safe to move with. A small number of warning signs are not. They are rare, they are time critical, and they are why this box sits above the booking button rather than below it.
Go to A&E today if any of these are new: numbness or lost feeling around the saddle area, the genitals or the back passage; trouble passing urine, a weak stream, or not being able to feel it coming out; not being able to feel a bowel movement passing, or losing control of your bladder or bowels; numbness, pins and needles or weakness coming on in both legs; or a sudden change in sexual function. Do not wait to see if it settles, and do not talk yourself out of it. Go, and be told it is nothing.
Get seen urgently, the same day if the leg is becoming clearly and progressively weaker rather than just painful, for example your foot starting to catch or drag. Same if you have a fever or feel genuinely unwell alongside the pain.
Get checked if you have a history of cancer, or unexplained weight loss, alongside new back or leg pain. Same if severe pain has come on after a minor fall or no injury at all, and you are older or have been on steroids a long time. These are not sciatica questions, but they are worth ruling out first.
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Book your assessmentOr DM MOVE on Instagram if sitting and bending keep setting the leg off.
This guide is general information, not individual advice, and nothing here is a diagnosis. If any of the warning signs above apply to you, act on them today. If your symptoms are not settling, get it assessed properly.