Physiotherapy condition

Sciatica坐骨神经痛

Sciatica is pain that radiates along the sciatic nerve — from the lower back through the buttock and down the back of the leg, sometimes as far as the foot. It is not a diagnosis in itself but a symptom of an underlying problem compressing or irritating the nerve. Most cases resolve within 6–12 weeks with physiotherapy that targets the specific cause.

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Sciatica at a Glance

Detail	Information
Key symptom	Shooting or burning pain from the lower back down one leg
Typical recovery	6–12 weeks with conservative treatment
Session duration	45–60 minutes
GP referral needed?	No
Insurance accepted	Multiple panels
Clinicians	AHPC-registered

What Causes Sciatica?

The sciatic nerve is the longest and thickest nerve in the body. It exits the lower spine, passes through the buttock and runs down each leg. Sciatica occurs when something compresses, irritates or inflames the nerve along this path. The most common causes are:

Herniated (slipped) disc — the most frequent cause, accounting for roughly 90 % of cases. The disc bulges and presses against the nerve root.
Degenerative disc disease — age-related narrowing of the disc space can compress the nerve exit point.
Spinal stenosis — narrowing of the spinal canal, more common in adults over 50.
Piriformis syndrome — the piriformis muscle in the buttock tightens or spasms around the sciatic nerve. Often seen in people who sit for long hours.
Spondylolisthesis — one vertebra slips forward over the one below, narrowing the space available for the nerve.

Why Is Sciatica Common Among Office Workers in Singapore?

Prolonged sitting — particularly in a slouched or forward-leaning posture — increases the pressure on lumbar discs and tightens the hip flexors and piriformis. Singapore's desk-heavy work culture, combined with long MRT commutes and limited movement breaks, makes this a pattern our physiotherapists see regularly.

What Does Sciatica Feel Like?

The symptoms depend on where the nerve is compressed and how severely. They typically affect one side only:

Shooting, burning or electric-shock pain running from the lower back or buttock down the back of the thigh and calf
Numbness or tingling (pins and needles) in the leg or foot
Weakness in the affected leg — difficulty lifting the foot or pushing off when walking
Pain that worsens with sitting, bending forward or coughing
Lower back pain that accompanies the leg symptoms

Red flags — seek urgent medical attention if you experience:

Loss of bladder or bowel control
Numbness in both legs or around the groin and saddle area
Rapidly worsening weakness in one or both legs

These may indicate cauda equina syndrome, which requires emergency assessment.

How Does Physiotherapy Help with Sciatica?

At Physio & Sole Clinic, physiotherapy for sciatica follows a systematic approach: identify the specific structure causing the compression, relieve it, and rebuild the strength and mobility that prevent recurrence.

Step 1: Assessment and Diagnosis

Detailed nerve tension testing to locate the level and cause of compression
Lumbar spine mobility and strength assessment
Hip and piriformis flexibility testing
Postural analysis — desk setup, habitual sitting posture, movement patterns
Neurological screening — reflexes, sensation and muscle power in the leg

Step 2: Pain Relief and Nerve Decompression

Manual therapy — spinal mobilisation and manipulation to open the space around the compressed nerve
Nerve mobilisation (neural gliding) — gentle, specific movements that restore the nerve's ability to slide freely through surrounding tissue
Dry needling — releases trigger points in the piriformis, gluteals and deep spinal muscles
Directional preference exercises — specific postures and movements (often extension-based) that centralise the pain and move it out of the leg

Step 3: Core Stabilisation and Strengthening

Deep core activation — targeting the transversus abdominis and multifidus, which stabilise the lumbar spine
Hip and gluteal strengthening — reduces the load on the lumbar discs
Progressive loading — a graded programme that builds resilience without flaring symptoms

Step 4: Ergonomic and Lifestyle Modification

Workstation ergonomics — seat height, monitor position, movement breaks
Sitting posture retraining — neutral lumbar curve, hip position, screen breaks
Return-to-activity planning for sport, gym or running

When Should You See a Physiotherapist?

Pain that shoots from the lower back or buttock into the leg
Leg numbness, tingling or weakness that has lasted more than a few days
Back or leg pain that worsens with sitting
Symptoms that return after a previous episode of sciatica
Pain that is not improving with rest or over-the-counter medication

Early physiotherapy produces better outcomes. Sciatica that is left untreated can lead to persistent nerve irritation, muscle weakness and changes in the way you move that create secondary problems in the hip and knee.

Book an appointment at any of our 11 clinic locations across Singapore — no GP referral is needed.

Frequently Asked Questions on Sciatica

How long does sciatica last?

Most cases improve significantly within 6–12 weeks of physiotherapy. Mild cases may resolve in a few weeks, while disc-related sciatica with significant nerve compression can take longer. The key factor is whether the underlying cause is addressed, not just the pain.

Is sciatica the same as lower back pain?

No. Lower back pain stays in the back; sciatica produces pain that radiates into the leg. The two often coexist, but sciatica specifically involves nerve compression or irritation, which is why it causes shooting pain, numbness or weakness beyond the back itself.

Should I rest or keep moving?

Short periods of rest are fine during a flare, but prolonged bed rest makes sciatica worse by stiffening the spine and weakening the muscles that support it. Guided movement — particularly the directional preference exercises your physiotherapist prescribes — is one of the most effective treatments.

Can sciatica be caused by sitting too much?

Yes. Prolonged sitting increases lumbar disc pressure and tightens the piriformis and hip flexors, both of which can compress the sciatic nerve. Regular movement breaks and a properly set-up workstation reduce the risk substantially.

Will I need surgery for sciatica?

Most cases do not require surgery. It is typically considered only when conservative treatment has not produced meaningful improvement after three or more months, or when there are progressive neurological deficits such as worsening leg weakness. Your physiotherapist will refer you to a specialist if surgery needs to be discussed.

Can sciatica come back?

Yes, recurrence is common — particularly if core stability, hip strength and movement habits are not addressed. A prevention-focused programme that continues after the acute pain resolves significantly reduces the risk of future episodes.

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