Sciatica is a symptom, not a diagnosis — it describes pain, tingling or numbness radiating from the lower back into the leg, following the path of the sciatic nerve. At Thrive, we identify the source, decompress the nerve and build the strength and mobility to prevent it returning.
Sciatica most commonly results from a lumbar disc herniation pressing on a nerve root — but it can also arise from spinal stenosis, piriformis syndrome or other causes. The key is identifying which structure is involved and why, then using a targeted program of movement, loading and neural mobilisation to settle symptoms and restore function.
A bulging or herniated disc at L4–5 or L5–S1 can compress the sciatic nerve, causing pain, tingling or numbness along the back of the leg into the foot.
The sciatic nerve passes through or under the piriformis muscle in the buttock. Tightness or spasm here can compress the nerve, producing sciatic-like symptoms without disc involvement.
Narrowing of the spinal canal — typically in older adults — can compress nerve roots bilaterally, producing pain and heaviness in the legs with walking.
Persistent sciatica involving central sensitisation requires a combined approach of graded movement, education and progressive exercise over a longer program.
The vast majority of sciatica — even from confirmed disc herniations — resolves with physiotherapy without surgery. Discs have remarkable capacity to heal. Surgery is reserved for cases with severe, progressive neurological deficit or cauda equina syndrome. Most people with sciatica are back to normal within 3 months with the right management.
We identify which movements centralize your pain (move it from the leg toward the back) and which peripheralise it — this determines your specific exercise prescription.
Sciatic nerve mobilisation to restore nerve movement, combined with lumbar loading in your direction of preference. We progress load gradually as your symptoms improve.
Core and gluteal strengthening to support the lumbar spine long-term — the most important strategy for preventing sciatica returning.
Not necessarily — and in most cases, no. Studies show that disc herniations visible on MRI are present in a large proportion of people with no symptoms at all. More importantly, most herniations reabsorb over time. Surgery is indicated for progressive neurological deficit or cauda equina symptoms — both of which are rare.
Seek immediate medical attention if you experience: loss of bladder or bowel control, numbness in the groin or inner thighs (saddle anaesthesia), or weakness in both legs. These may indicate cauda equina syndrome — a rare but serious condition requiring urgent surgical assessment.
No — physio is effective at any stage. Chronic sciatica (>12 weeks) responds well to a graded, education-based approach. We’ll be honest about realistic timelines and what to expect.
Yes — and in most cases, you should. The right exercises in the right direction will actually reduce your leg pain. We’ll show you exactly what to do and what to avoid based on your directional preference.
Book an assessment and we’ll identify your directional preference and design a program that moves the pain in the right direction.
Parramatta, NSW · In-clinic & Home Visits · Private, Medicare, WorkCover, NDIS
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