New patient offer: use code NEW10 for 10% off your first booking.Book with NEW10

Sciatica exercises

Sciatica is the name for pain that travels from the lower back or buttock down the leg, sometimes past the knee and into the foot, following the path of an irritated nerve root. The commonest cause is a disc bulge pressing on or inflaming the nerve where it leaves the spine. It often comes with pins and needles, patches of numbness, or a leg that feels weaker than usual.

Discs bulge far more often than people realise, and many bulges are completely painless. Symptoms usually appear when one sits close enough to the nerve to inflame it, and that inflammation is the part that makes the leg so sore. It can start after a specific bend or lift, or build up over days with no obvious trigger at all.

Day to day, the leg pain usually outweighs the back pain. Sitting, driving and bending forward tend to be the worst, coughing or sneezing can send a jolt down the leg, and finding a comfortable position at night takes some experimenting. Walking is often easier than sitting, and many people notice the symptoms slowly withdrawing back up the leg as things improve.

It can be very painful, but the outlook is genuinely good: the large majority settle without surgery as the inflammation around the nerve calms down. It is slower than ordinary back pain, often several weeks to a few months, and progress tends to come in steps rather than a smooth line. This programme reduces nerve sensitivity with gentle movement, keeps the back and leg working, then rebuilds strength and walking tolerance.

Who this programme is for

Adults with back-related leg pain, tingling or numbness where bladder and bowel function is normal and any weakness is mild and not getting worse. It suits both a first episode and one that has been grumbling on. Rapidly progressing weakness or saddle numbness is an emergency (see red flags).

Get urgent help now if

  • You find it hard to start peeing, cannot pee or cannot control when you pee, cannot control your bowels, or have numbness around your genitals or bottom - call 999 or go to A&E. Do not drive yourself.
  • Sciatica on both sides, or weakness or numbness in both legs, especially if it is severe or getting worse - call 999 or go to A&E. Do not drive yourself.
  • Weakness in one leg or foot that is getting worse - go to A&E now, or call NHS 111 straight away if you are not sure where to go. Do not drive yourself if you feel very unwell.
  • The area is hot, very swollen and red, especially if you also feel feverish or unwell - go to A&E now, or call NHS 111 straight away if you are not sure where to go. Do not drive yourself if you feel very unwell.

Get checked by a clinician first if

  • Fever, unexplained weight loss, or a history of cancer alongside the pain
  • The pain followed a significant accident, fall or direct blow and you have not been checked over
  • You feel unwell with the pain - a fever, night sweats, or losing weight without trying
  • Pain that is severe, steadily getting worse, or keeps you awake every night and does not ease with a change of position

Not sure it's this? Try a self-check

Quick movement tests you can try at home to see what your symptoms might point towards. A guide, not a diagnosis.

The staged programme

Stage 1

Calm the nerve

For the irritable early phase. Use gentle nerve gliding and positions that ease the leg symptoms, and keep walking in short, frequent bouts. Avoid prolonged sitting and end-range bending if they clearly worsen the leg.

Stage 2

Build strength

Progress as the pain centralises - moving out of the leg and back towards the spine. Add trunk and hip strengthening and gradually extend how long you can sit, stand and walk.

Stage 3

Return to activity

The final stage restores full function. Rebuild lifting, bending and walking or running distance in graded steps, and reintroduce activities you have been avoiding.

How long recovery takes

The NHS says sciatica tends to ease over a period of weeks to months. It depends on your condition; your physiotherapist will give you an estimate after your assessment. Some numbness or tingling can take longer to settle, so tell us if it is not changing. We review your progress regularly and adjust your plan.

Knowing when to progress

Use centralisation as your guide: exercises and positions that pull the pain out of the leg and towards the back are moving you in the right direction, even if the back itself feels a bit more sore. Progress the strength and walking work as the leg quietens, and back off anything that consistently sends pain further down the leg.

Common questions

Should I avoid bending and sitting completely?

Not completely, but in the irritable phase it helps to limit long periods of sitting and repeated deep bending if they flare the leg. Change position often and build tolerance back up as symptoms settle.

Do I need surgery?

Usually not. Most sciatica settles with time and exercise. Surgery is considered mainly for severe or worsening weakness, or for leg pain that remains disabling after a few months of good conservative care.

Is the tingling and numbness a bad sign?

It reflects an irritated nerve rather than permanent damage, and it typically improves as the nerve calms down. Weakness that is getting noticeably worse, however, should be assessed promptly.

Can I still exercise with sciatica?

Yes, and you should. Walking and the gentle exercises in this programme help. Choose activities that keep the leg symptoms stable or improving, and avoid pushing into movements that clearly worsen them.

Related

This programme is generic - you're not

Get a plan personalized to you

Book an online assessment with an HCPC-registered physiotherapist and get a rehab plan matched to your condition and stage - not a generic starting point.

Get my personalized plan