Sciatica is not a diagnosis on its own. It is a symptom, the sign that a nerve in your lower back is being irritated or compressed, and the pain you feel down your leg is that nerve protesting. The reassuring part is that most sciatica improves without surgery, and guided movement is usually the fastest way through it.
What is sciatica, exactly?
Sciatica is pain that travels along the path of the sciatic nerve, which runs from the lower back through the buttock and down the back of the leg. It happens when one of the nerve roots in the lower spine is irritated or compressed. The leg pain is the headline, but the real problem is up in the back where the nerve is being squeezed or inflamed.
This distinction matters for treatment. Rubbing the sore leg will not fix sciatica, because the leg is not the cause. Treatment has to address what is irritating the nerve root at its origin, which is why a proper assessment finds the cause rather than chasing the symptom.
What causes sciatica?
The most common cause is a disc problem in the lower back. When the cushioning disc between two vertebrae bulges or herniates, the displaced material can press on or inflame a nearby nerve root, triggering the pain down the leg. Other causes include age-related narrowing of the spaces the nerves pass through, and tight or overloaded muscles in the buttock that can irritate the nerve along its path.
Often it is a combination, set off by a particular movement, a heavy lift, or a long period of sitting that loaded the lower back. Identifying which structures are involved is what shapes an effective plan, and it is the focus of how we assess back and neck pain and nerve-related leg pain.
What does sciatica feel like?
The defining feature of sciatica is pain that travels from the lower back or buttock down one leg, rather than staying local to the back. People describe it in different ways:
- A sharp, shooting, or burning pain running down the back or side of the leg, sometimes past the knee to the foot.
- Pins and needles, tingling, or numbness along the same path.
- Pain that is worse with sitting, bending, coughing, or sneezing, which load the lower back.
- A sense of weakness or heaviness in the affected leg.
Sciatica almost always affects one leg at a time. Pain that travels below the knee is more strongly linked to nerve-root irritation than pain that stops in the buttock. The pattern of where you feel it helps pinpoint which nerve root is involved.
Sciatica red flags: when to seek urgent care
Most sciatica is not dangerous, but a few warning signs point to a problem that needs emergency care the same day rather than routine treatment.
These signs are uncommon, but they are the reason any new or worsening sciatica deserves attention. If you are unsure, treat it as urgent and get assessed. Everything below is about the ordinary sciatica that makes up the vast majority of cases.
Does sciatica need surgery?
For most people, no. The large majority of sciatica improves without surgery. A herniated disc often shrinks and settles on its own over time, and as the inflammation around the nerve calms down, the leg pain eases. Most cases improve meaningfully within four to six weeks, and the symptoms have resolved in roughly six to twelve weeks for the majority of people.
Surgery is generally considered only when conservative treatment has not helped after six to eight weeks, when there is progressive weakness, or when red-flag signs are present. For the typical case, guided rehabilitation does the job and avoids the operating room entirely.
How physiotherapy helps sciatica
Staying active is one of the most important parts of recovery. Prolonged bed rest tends to prolong sciatica, while gentle, guided movement helps calm the nerve and keeps the back from stiffening. The aim is to find the positions and movements that ease the leg pain and build from there.
A physiotherapy assessment identifies which nerve root is involved and what is irritating it, then builds a plan around it. Treatment typically combines specific exercises and movements that take pressure off the nerve, hands-on techniques to settle pain and restore movement, and a graded strengthening program for the back, hips, and core. We also help you adjust how you sit, lift, and pace your day so you stop reloading the nerve while it recovers. You do not need a referral to start in BC, and you rarely need a scan to begin.
How long does sciatica take to recover?
Most acute sciatica improves significantly within four to six weeks, with the majority of cases resolving over six to twelve weeks. More stubborn cases take longer and recover in stages, which is why a structured plan that progresses as the nerve settles matters more than waiting it out.
Recovery is not always a straight line. Good days and flare days are normal early on, and the trend over weeks matters more than any single day. Your physiotherapist will give you a realistic timeline after the first assessment and adjust it as you progress. If your sciatica is not settling, is getting worse, or is limiting your daily life, it is worth getting assessed. You can book at either West Vancouver location, in English or Farsi, without a referral.