Sciatica isn’t a diagnosis — it’s a description. Pain that travels from the lower back, through the buttock and down the leg, sometimes as far as the foot, with pins and needles or numbness along the way. The instinct is to lie still until it passes. We see, almost daily, that this is exactly the wrong move. Active physiotherapy recovers most people in weeks, not months.
Why Sciatica Happens
The sciatic nerve is the largest in the body. When something compresses or irritates it — a bulging disc, tight piriformis muscle, narrowing in the spine, or simple inflammation — pain radiates along its path. Common triggers include:
- A heavy lift with poor technique (tradies, removalists, parents)
- Sitting badly for long stretches (drivers, office workers)
- A new training program done too fast
- Pregnancy-related changes through the pelvis
Why Rest Makes It Last Longer
Three reasons. First, the nerve gets less blood flow when surrounding muscles are tight and still. Second, deconditioned core and gluteal muscles can’t protect the spine when you do try to move again, so it flares back up. Third, the brain learns that movement equals pain — and starts protecting more aggressively than it needs to.
The Active Recovery Plan
What our Gold Coast physiotherapists actually do:
- Days 1–7: Identify the source — disc, joint or muscular. Hands-on release for tight glutes and lumbar muscles. Gentle nerve glides. Pain-free walking, often the best early medicine.
- Weeks 2–4: Specific strengthening — deep core, glute med, hip hinge mechanics. The aim is movement without symptoms, not “no movement”.
- Weeks 4–8: Return to load — gym, lifting, sport. We progressively challenge the system so it tolerates real life.
- Beyond: A 10-minute home program that maintains the gains. Most patients only need a periodic check-in after this.
When Imaging Is Worth It
Most sciatica doesn’t need an MRI. We do refer for imaging if there is progressive weakness in the leg, loss of bladder or bowel control, or symptoms that aren’t trending in the right direction by 6 weeks. The vast majority of cases recover fully without surgery.
What You Can Start Today
- Walk twice a day, even just 10 minutes
- Avoid prolonged sitting — change position every 30 minutes
- Sleep on your side with a pillow between your knees
- Stay off heavy deadlifts and toe-touching stretches until assessed
Frequently Asked Questions
Should I be worried if I have pins and needles? Pins and needles or numbness is common in sciatica. It’s worrying only if there is progressive weakness in the leg or any change in bladder or bowel function — both warrant urgent imaging.
Is heat or ice better? For most patients heat helps muscle tightness and ice helps an inflamed nerve flare. Use whichever feels better. Both are safe.
Will I need surgery? The vast majority of cases recover fully without surgery. We refer if symptoms aren’t improving by 6 weeks or if there are red flags.
Book a Sciatica Assessment
The longer it sits untreated, the more compensations build up. Call (07) 5572 6222 or book online to see a Gold Coast physiotherapist this week.
