What's going on
PhysioOnClick assesses and manages sciatica by video, or with a home visit in the Glasgow area, and the guidance below reflects exactly what that assessment covers. Sciatica describes nerve root irritation, most commonly from a disc bulge pressing on or chemically irritating a nerve root as it exits the spine, producing pain, pins and needles or numbness that can travel down the leg past the knee. This is different from general low back pain because the nerve itself — not just the joint or muscle — is involved, which changes both the expected timeline and the assessment.
The reassuring evidence is that most disc-related sciatica improves within weeks to a few months without surgery, as the disc irritation and any inflammatory swelling settle. NICE guidance on managing sciatica supports a staged approach: staying appropriately active, targeted exercise and pain management, with imaging and surgical opinion reserved for cases that fail to improve or show worsening neurological signs.
What physiotherapy assessment looks at
Assessment includes straight leg raise and neural tension testing, checking reflexes, muscle power and sensation in specific nerve root distributions down the leg, and screening for the alternative pattern of spinal stenosis, where symptoms are usually worse standing and walking and ease with sitting or leaning forward.
Where recovery planning is the main day-to-day problem, assessment also looks specifically at how that symptom behaves — what makes it better or worse, and how it's changed since it started — since that shapes which part of the rehab plan gets priority first.
Practical guidance on recovery planning
A recovery plan that works has a small number of clear phases, each with its own goal and a rough (not rigid) timeframe — for example, settling symptoms and restoring basic movement, then rebuilding strength and tolerance, then returning to specific activities or sport. Without phases, progress tends to feel directionless even when it's actually happening.
Milestones should be specific and functional (walking for twenty minutes without a flare, climbing a flight of stairs without pain, sitting through a full workday comfortably) rather than vague ('feeling better'), because specific milestones make it obvious when progress has stalled and a plan needs adjusting.
When to seek extra help
Any new saddle numbness (around your genitals or bottom), difficulty starting or controlling peeing or controlling your bowels, rapidly progressive leg weakness, or sciatica in both legs are cauda equina red flags: call 999 or go to A&E, and do not drive yourself - this is one of the few genuine physiotherapy emergencies.
A practical starting point
Write down three specific milestones for the next month (not just 'less pain') and review them every two weeks — if a milestone hasn't moved in that time, that's the signal to adjust the plan rather than simply waiting longer.
This guide is part of PhysioOnClick's patient education library and is intended to support informed decisions, not replace an individual assessment. If symptoms are worsening, unclear, or affecting your confidence with movement, a full physiotherapy assessment is the safest next step.