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Perhaps it starts as an ache in your buttock. Then a long drive, getting out of a chair, or bending to put on your shoes sends pain down your leg. You stretch what feels like a tight hamstring, but the sensation doesn’t behave like an ordinary muscle stretch.
Pain travelling down one leg can be sciatica, particularly when it comes with tingling, numbness, or burning. But not every painful leg has the same cause. An assessment helps distinguish nerve-related pain from other problems and guides what to do next.[1,2]
At At Ease Physiotherapy, we want to understand both the symptoms and the movement you are trying to get back to. The goal is not simply to make you more flexible. It is to find a manageable way forward for your body.
What Does Sciatica Feel Like?
Sciatica describes symptoms associated with irritation or compression of the sciatic nerve or the nerve roots that contribute to it. Symptoms commonly affect the buttock and one leg, sometimes reaching the foot or toes.[1]
You might notice:
- Sharp, burning, or shooting pain.
- Pins and needles or an area of reduced sensation.
- Weakness in the leg or foot.
- Symptoms that change with movement, coughing, or sneezing.[1]
A disc-related problem is one possible cause, but it is not the only one. Your history, movement assessment, and examination of strength and sensation matter more than matching one symptom to an internet checklist.[1,2]
Seek emergency care for new difficulty passing urine, loss of bladder or bowel control, numbness around the genitals or bottom, or severe or worsening symptoms in both legs. These are not symptoms to manage with stretches or wait to discuss at a routine appointment.[1]
Looking Beyond the Sore Spot—Without Skipping It
Susannah Reid’s training includes the Integrated Systems Model, Clinical Applications for Disc Disorders, and Barral Institute Neural Manipulation Levels 1–5. Her profile also lists a teaching-assistant role for Neural Manipulation Level 1.
That background informs an approach which considers the person, their history, and the task that brings on symptoms—not just the spot that hurts. The Integrated Systems Model is a clinical reasoning framework, rather than a fixed sequence of treatments.[4]
For example, if getting out of the car is your main difficulty, an assessment might explore how you turn, shift weight, and stand. We may compare different ways of doing that task, alongside examining your back, hip, and nerve-related symptoms.
Your history of previous injuries, surgery, pelvic symptoms, and activity changes also belongs in that conversation. Those details can guide further questions; they do not automatically prove that an old scar or an internal organ is causing your leg pain.
Where Gentle Hands-On Treatment Fits
Depending on the findings and your preferences, treatment may include joint or soft-tissue techniques alongside movement practice. NICE recommends considering manual therapy for low back pain with or without sciatica only as part of a package that includes exercise.[2]
We would use a change in comfort or movement as a reason to reassess the next step—not as proof that a disc has moved back into place.
Some people may also be offered neurodynamic exercises, sometimes called nerve sliders. Research suggests neural mobilization can improve pain and disability in people with lumbar radiculopathy, but studies vary considerably and have quality and publication-bias limitations.[3]
These exercises are not the same as stretching as hard as possible. They need to be selected and adjusted for the person. Nor does research on neurodynamic mobilization validate every technique taught under the separate name “neural manipulation.”
Does Treating Deeper Tissues Mean Better Results?
Susannah also has extensive training in visceral manipulation. That is part of her broader clinical background, but it should not be presented as an established treatment for sciatica.
A systematic review found poor overall evidence for visceral fascial therapy. Findings from some low-back-pain studies cannot be assumed to apply to nerve-root pain or to show that an organ restriction caused the problem.[5]
A whole-body approach should make the plan more relevant to you—not make every symptom a reason to use every available technique.
What Can You Do While Waiting for an Assessment?
If you have no urgent warning signs:
- Keep moving in manageable amounts rather than spending long periods sitting or lying down.
- Try short bouts of gentle activity that you tolerate, instead of pushing through a long session.
- Notice which positions and activities change the leg symptoms, and bring those observations to your appointment.
- Stop a self-selected exercise that clearly worsens your symptoms; seek prompt medical advice for new or increasing weakness.[1,2]
Your rehabilitation may later include strengthening, everyday movement practice, or adapted Clinical Pilates. The exercise format should follow your assessment and goals, not the assumption that everyone with sciatica has a weak core.
Do You Need an MRI?
Not routinely at the start. NICE advises against routine imaging in a non-specialist setting for low back pain with or without sciatica. Imaging in specialist care should be considered when it is likely to change management.[2]
That does not mean symptoms are being dismissed. New neurological findings, warning signs, or an unexpected course of recovery can change the next step.
Sciatica often improves over weeks to months, although some episodes last longer.[1] Rather than promising a fixed number of visits, we would track what matters to you: sitting through a journey, walking farther, or getting dressed more comfortably.
Unsure whether your leg pain is sciatica? Contact our South Surrey clinic to discuss an assessment and the most appropriate practitioner for your needs. You can also read about our sciatica treatment.
References
- NHS. Sciatica. Patient guidance on symptoms, self-care, recovery, and emergency warning signs.
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE guideline NG59. 2016; updated 2020. Recommendations on assessment, imaging, activity, exercise, and manual therapy.
- Lin LH, et al. Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis. Life (Basel). 2023;13(12):2255. doi:10.3390/life13122255.
- Learn with Diane Lee. The Integrated Systems Model. Description of the clinical reasoning framework; not independent evidence of treatment superiority.
- da Silva FC, et al. Effectiveness of visceral fascial therapy targeting visceral dysfunctions outcome: systematic review of randomized controlled trials. BMC Complementary Medicine and Therapies. 2023;23:274. doi:10.1186/s12906-023-04099-1.
