In short
Sciatica is pain that travels from the lower back or buttock down the leg, often below the knee, because a nerve root in the lower spine is irritated. Most people improve without surgery when the plan calms the nerve and restores movement.
Reviewed by Dr. Manan Patel, PT, DPT, TPS. Updated October 17, 2026.
Common symptoms
- Burning, shooting or electric pain down one leg
- Numbness or tingling in the leg or foot
- Pain that worsens with sitting, coughing or bending
- Leg pain that is often worse than the back pain
Not sure this matches? Use the 30-second pain finder or the full symptom self-check.
What causes sciatica?
A herniated or bulging disc is the most common cause. Narrowing of the spinal canal (spinal stenosis), especially in older adults, can also irritate the nerve roots that form the sciatic nerve.
Most sciatica comes from a herniated or bulging disc. The same kind of nerve irritation in the neck causes arm symptoms instead; see pinched nerve in the neck.
How we evaluate it
Your first visit is a full 60-minute, 1-on-1 evaluation with a Doctor of Physical Therapy, and treatment often starts the same day. It can include:
- Neurological testing of strength, sensation and reflexes
- Nerve tension tests such as the straight-leg raise
- Movement testing to find positions that ease leg symptoms
- Screening for warning signs such as progressive weakness
Calming an irritated nerve: the pain neuroscience approach
Nerve pain can be frightening, and worry about making it worse often leads people to stop moving, which can slow recovery. As a certified Therapeutic Pain Specialist, Dr. Patel explains what is happening to the nerve, which changes are a good sign and which warning signs need a doctor. Understanding the pain lowers the sense of threat, which helps a protective nervous system settle.
That education is paired with positions that ease leg symptoms, carefully dosed nerve mobility exercises and a gradual return to sitting, driving, walking and work.
What this looks like in your visits
- Knowing the good signs, such as pain moving out of the leg and toward the back
- Nerve mobility exercises dosed to avoid flare-ups
- A graded return to sitting, driving and lifting
- Clear guidance on warning signs and when to see your doctor
Your treatment plan
Calm the nerve
Positions and movements that ease or centralize leg pain, plus education about nerve pain.
Restore movement
Nerve mobility, spinal and hip mobility, and building walking and sitting tolerance.
Strengthen and return
Progressive strengthening, return to work and activity, and a flare-up plan.
Recovery and what to expect
Many people with sciatica improve within weeks to a few months with conservative care, and NICE guidance recommends exercise and self-management as first steps. Get urgent care for loss of bladder or bowel control, numbness in the groin, or leg weakness that is getting worse.
Tips for daily life
- Avoid long periods of sitting; stand and move briefly every 30 to 45 minutes
- Notice positions that move pain out of the leg and toward the back, a good sign
- Keep walking within comfort
- Avoid heavy lifting with bending and twisting while symptoms are high
When to get urgent care
Questions about sciatica
Will I need surgery for sciatica?
Most people do not. Surgery is usually considered for significant or worsening weakness, or pain that does not improve after a reasonable period of conservative care. We coordinate with your physician if a surgical opinion is needed.
Is sciatica the same as a pinched nerve?
Sciatica is a type of pinched or irritated nerve in the lower back. Nerve irritation in the neck causes arm symptoms instead.
What is the best sleeping position for sciatica?
Many people find relief lying on their side with a pillow between the legs, or on their back with pillows under the knees. Avoid positions that send pain further down the leg.
When is sciatica an emergency?
Get emergency care for new loss of bladder or bowel control, numbness in the groin or inner thighs, or leg weakness that is getting worse.
Related guides
- Herniated disc on your MRI? What the findings really meanWhat disc bulges and degeneration mean, and how often herniations shrink on their own.4 min read · Patients
- Why pain can last after an injury has healedWhy pain can outlast healing, what sensitization feels like, and what actually helps.5 min read · Patients
Browse all guides in our learning center
Related conditions
- Herniated & bulging discsDisc-related back or neck pain, with or without nerve symptoms.
- Low back painAching, stiffness or sharp pain across the lower back.
- Persistent (chronic) painPain lasting 3+ months, treated with pain neuroscience.
- Rehab after neck or back surgeryRecovery after fusion, discectomy or laminectomy.
References
- National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). 2016, updated 2020.
- George SZ, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy. 2021.
- Louw A, et al. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiotherapy Theory and Practice. 2016.
Where to get treated
Book at either clinic. Same phone number, same team, same 60-minute visits. In-network with Traditional Medicare, BCBS / Anthem and Tricare; Auto MedPay, injury liens and Workers' Comp accepted; or $129 flat-rate visits for self-pay patients and out-of-network plans, including Aetna, Cigna and UHC.
Cumming clinic
Off GA-400 Exit 13 on Peachtree Parkway
Cumming, GA 30041
Alpharetta clinic
Inside Georgia Brain & Spine Physical Therapy
Alpharetta, GA 30022
