Sciatica: Causes, Symptoms & Exercises

What Is Sciatica?

Sciatica is more of a general term used to describe pain caused by irritation of the sciatic nerve, or more commonly, the smaller nerves that join together to form it.

Think of it like a road network. The smaller roads are the nerves that come from the low back. They join up in the buttock to make the sciatic nerve (like the motorway).

What Are The Common Symptoms Of Sciatica?

Sciatic pain can be felt almost anywhere in the leg and even the foot. It is most commonly only in one leg but can be both. The most common symptoms include:

• Sharp shooting pain into the buttock or leg
• Aching into the buttock, hamstring or calf
• Burning or deep nerve pains
• Tingling, pins and needles, or numbness
• Heaviness in the legs
• Weakness in leg or foot muscles (more severe cases)
• Pain worse with sitting or driving
• Pain triggered by bending, coughing, sneezing or lifting

Not everybody will experience all of these symptoms and severity can vary widely.

The most common ‘classic’ pain patterns I see in clinic are:

• Buttock → back of thigh → calf
• Buttock → outside of thigh → shin or top of foot

Sciatic pain vs hamstring or gluteal muscle pain

It’s quite common for people to feel like they may have a simple muscle pull or strain rather than sciatica, especially in the early stages. The common differences are:

• Muscle pains are generally localised and easy to feel where the injured muscle is
• Nerve pains are harder to put your finger on
• Muscle pains won’t normally have any of the associated nerve symptoms (pins and needles, numbness, tingling, pain on coughing etc.)
• Sciatica is often painful when sitting
• Sciatica often has no obvious reason for starting (more on this shortly)
• Muscle strains normally start to improve within days or weeks

What Causes Sciatica? (Most Common Reasons)

Sciatica isn’t one single thing — it’s a symptom caused by anything that irritates or pinches the nerves along its pathway. One of the most important things I do in clinic is help people understand what is causing their sciatica, as different causes need slightly different strategies.

Here are some of the most common causes:

Disc bulge or herniation

This is the most common cause. A disc can irritate a nerve in the low back, causing symptoms to travel down into the leg.

Spinal Stenosis (also linked with neurogenic claudication)

This is a type of sciatica that I see more commonly in patients over 70. Stenosis basically means narrowing, and relates to narrowing of the gaps where the nerves come out of the spine. When somebody is suffering with sciatic pain due to spinal stenosis, it is also known as neurogenic claudication.

This often happens when the spine starts to develop:

• Arthritic changes
• Bony spurs
• Osteoporosis (decreases in bone density)
• Disc degeneration

Stenosis-related sciatic pain is normally worse with walking and standing, and relieved with sitting and bending forward.

Piriformis Syndrome

The piriformis is a muscle in the buttock. Tightness in this muscle can put pressure on the sciatic nerve, causing sciatica.

In my experience a true piriformis syndrome is far less common than a disc-related problem, despite how much attention it gets online.

Lifestyle and Overload Factors (often the cause of flare-ups)

Even with the above potential causes, sciatica flare-ups are often triggered by:

• Prolonged sitting
• Repetitive bending or twisting
• Poor sleep, stress, or poor general health
• A sudden increase in training or activity
• Lack of muscle strength or flexibility

This is why many patients do not know what has caused the problem. Usually something is gradually building up in the background such as a disc bulge. It is then pushed over the edge by one or several of the above factors, leading to inflammation and nerve irritation.

What Tends To Make Sciatica Worse?

Sciatic flare-ups are often predictable once you start spotting the trends. Here are the things to look out for:

Prolonged sitting

For example: cars, sofas, the office.

Helpful changes:

• Stand up and walk around every 20–30 minutes
• Improve your sitting setup (lumbar support, chair height, screen height)
• Regular low back mobilisation — Try this exercise first
• Use a standing desk if you can vary positions during the day — see my review

Repeated bending or twisting

Bending activities often increase disc pressure and can irritate symptoms.

Helpful changes:

• Use your hips and knees when bending or lifting rather than rounding the back
• Activity modification: break tasks up into smaller chunks

Clinic example: I have had many patients over the years who reported feeling worse each week after doing a whole day of housework chores. When I asked them if they could split the housework over two to three days, there was often no reason why they couldn’t. It had just become a habit to do it all in one day. Once they made this change — alongside others — their sciatica started to ease.

Poor mattress support

Many patients report sciatic pain in bed at night due to poor mattress quality. If you’ve not been finding your bed comfortable or your mattress is getting old, it may be worth replacing.

Helpful changes:

• Sleeping on your side with a pillow between your legs can sometimes help relieve sciatic nerve pain in bed

Inappropriate stretching

A common mistake is when people are advised to stretch the hamstring muscle to relieve tightness. This will most likely really hurt (not in a nice stretching way) and only serve to irritate the nerve.

What Usually Helps?

Which approach works for you depends on the type of sciatica you have. It can be a bit of trial and error, but having read this information you should have a much clearer idea of where to start.

Sciatica usually improves best with three main goals:

• Calm the irritation
• Keep moving (if it relieves the pain)
• Build strength and tolerance

Calm it down stage

Helpful options include:

• Regular short walks
• Gentle mobilisation in a pain-free range (try the McKenzie Extension first)
• Ice or heat, depending on preference
• Avoiding prolonged sitting or standing (variety is the key)

Keep moving without overdoing it

Complete rest often makes sciatica worse. However, for the minority of you who feel worse when standing or walking, you need to stop as soon as you start feeling the pain — ideally before.

Improving sitting and desk setup

I have seen so many patients improve when they have improved their office setup. This is an absolute must.

Once tolerated, progress through the appropriate exercise recommendations for sciatica.

True story: I had an influx of low back and sciatic problems during the Covid pandemic. Many people were suddenly working from home on dining-room tables, not paying attention to their postural setup. They couldn’t work out why they were suddenly in pain — until they came to see me of course.

NB: The key is not to do everything at once, but to start with what clearly relieves your symptoms and build gradually from there.

To see the ergonomic chairs that I recommend to my patients, read my full review here.

How long will it take to get better?

This is one of the most common questions I get asked in clinic and the honest answer is: it depends.

Recovery time varies based on:

• The underlying cause
• How irritated the nerve is
• Your daily habits
• How long you’ve had it for

As a very general guide:

• Mild or early sciatica: often improves after 2–4 weeks
• Moderate symptoms: typically settle over 4–8 weeks
• Long-standing or recurring sciatica: can take several months, especially if lifestyle factors aren’t addressed

It’s often a rocky road to recovery. Flare-ups along the way are very common. This doesn’t mean you are getting worse again — it’s often just part of the healing process.

The most important thing is to reduce nerve irritation as best you can with everything you do. Keep moving in ways that feel relieving, and gradually rebuild strength and tolerance over time.

Prolonged sitting is one of the most common aggravating factors for this condition. If you work at a desk, it may be worth reviewing your setup. We’ve reviewed standing desks and ergonomic office chairs with lower back and nerve pain specifically in mind.

Final Thoughts

Sciatica can be painful, frustrating and at times worrying. It can affect every aspect of life. The good news is that most cases improve with time and the right approach, once the underlying cause is understood.

Use the links on this page to explore the cause most relevant to you, the exercises that feel appropriate, and the lifestyle changes that can support recovery.

Next steps

• Explore the related conditions on the lower back hub
• Start the appropriate exercises
• If your symptoms aren’t improving, find out how Christopher can help