How long does sciatica last?

NHS guidance on sciatica describes most cases easing within four to six weeks, and that broadly matches what we see. Some take longer, particularly when the leg pain has been there for months before anyone looked at it. Pins and needles and numbness often fade last, sometimes weeks after the pain itself has gone.

Is my sciatica a slipped disc?

Discs do not slip. A disc can bulge or tear and irritate a nerve root beside it, which is what produces the leg pain, but nothing slides out of position and nothing needs putting back. Most disc-related sciatica settles without surgery. The label matters far less than whether your leg strength and sensation are stable.

Which exercises should I avoid with sciatica?

There is no universal banned list. The test is your leg, not your back: an exercise that pushes symptoms further down the limb is the wrong one today, and one that pulls them back up towards the buttock is worth repeating. Deep seated forward bends and heavy lifting from a rounded spine are the usual early offenders.

Do I need a scan before physiotherapy?

Not usually. NICE guideline NG59 advises against routine imaging for back pain and sciatica outside specialist settings, because scans show disc changes in plenty of people with no symptoms at all. A scan becomes useful when someone is considering an injection or surgery, or when weakness is progressing. Then it changes the plan.

Physiotherapy for Sciatica in Manchester

Q: Do I need a GP referral to book at Megazee.com?

No referral is needed. You can book with Megazee.com directly, and every physiotherapist here is registered with the Health and Care Professions Council and chartered with the Chartered Society of Physiotherapy. Bring loose clothing, because we will need to see you walk, bend and heel-raise. If your GP should be involved, we write to them with your consent.

It is the leg that brings people in, not the back. A line of pain down the back of the thigh into the calf, sometimes as far as the foot, often with pins and needles or a patch of skin that will not quite wake up. Sitting makes it worse. The first ten steps out of the car are worse. And somewhere around the second broken night, the searching starts.

That searching lands on slipped discs and surgery within about four clicks. Most sciatica goes nowhere near either. This page deals with the genuinely urgent part first, then the difference between sciatica and back pain without leg symptoms, how long it tends to take, and what treatment involves. It sits alongside the other problems we treat at our Manchester clinic.

Symptoms that need emergency care, not a physiotherapist

Read this section even if you read nothing else on the page. Sciatica is very rarely dangerous. One pattern is, and it is time-critical.

999 or A&E today, do not wait and do not book with us: any change in bladder or bowel control, difficulty starting to pass urine or not feeling it flow, numbness or altered feeling around the back passage, genitals or inner thighs, sciatica affecting both legs, or new problems with sexual function. Together these can indicate cauda equina syndrome, where the window for treatment is counted in hours.
Urgent GP or NHS 111, within days: leg weakness that is getting worse rather than better. A foot that drags, catches on the edge of a step or slaps the floor as you walk. Numbness spreading across a larger area instead of shrinking.
Urgent GP: fever alongside the back and leg pain, a previous cancer diagnosis, unexplained weight loss, or pain that is unrelenting at night and unchanged by any position.
Also worth a call: severe pain that your usual pain relief is not touching at all. That warrants a medical review on its own.

This list is not exhaustive and nothing on a website is a diagnosis. If you are unsure, ring NHS 111. Our medical disclaimer sets out the limits of what anything written here can tell you.

Sciatica, or ordinary back pain?

The line we use is the knee. Pain, numbness or pins and needles that travel below the knee into the calf, shin or foot suggest a nerve is involved, and that is sciatica. An ache into the buttock or the back of the thigh is common with an ordinary sore back and does not mean a nerve is trapped.

Worth knowing: sciatica is a description, not a diagnosis. It names a symptom pattern along the course of the sciatic nerve. NHS guidance on sciatica treats it the same way, which is why nobody can tell you what is wrong from the word alone.

What is actually irritating the nerve

Most often a disc. The outer wall tears or bulges and the material inside sits against a nerve root, irritating it chemically as much as squashing it. That explains something people find confusing: a leg can burn ferociously without anything being badly compressed.

In people over about sixty the usual cause is different. The space the nerve travels through narrows, and the giveaway is a supermarket trolley. Leaning forward over the handle opens that space and the legs go quiet. Standing tall closes it and the ache returns within a few hundred metres.

The pattern tells us which nerve root is involved. Pain over the top of the foot with a weak big toe points one way. Pain into the heel and sole with a weak calf points another.

How we assess sciatica at Megazee.com

The first question is not where it hurts. It is what you have stopped being able to do: twenty minutes in the car, sitting through a meal, the walk to the postbox and back. One of those becomes the measure we retest against.

Then the neurological screen, which matters more here than anywhere else in the spine. We test big toe strength against our thumb, compare light touch down both legs, check reflexes, and count single-leg heel raises on each side. That last one is deliberately unsubtle. A calf that manages twenty-two heel raises on one side and six on the other tells us something no description of pain can. A straight leg raise and a slump test then separate a sensitised nerve from a tight hamstring.

We also move you repeatedly, watching which direction pulls symptoms up the leg and which pushes them down, and your chosen task gets retested before you leave. The wider detail on imaging decisions and onward referral sits on our page about spinal assessment at our Manchester clinic.

How long sciatica usually takes to settle

The honest answer is a shape rather than a date, and some cases do run long.

First two weeks. Usually the angriest. Sitting, and standing up from sitting, are typically harder than walking.
Weeks two to six. In most people the pain starts retreating up the leg: calf, then thigh, then buttock. That retreat is the signal we watch for, and it often happens while the back itself feels no better.
Beyond six to twelve weeks. Slower, and worth a proper plan rather than more waiting. Still treatable, and still usually without surgery.
Pins and needles and numbness. Frequently the last to go. A numb patch lingering after the pain has gone is common rather than alarming.

Bad days do not undo good weeks. A flare in week four is a flare, not a return to week one.

What treatment involves at Megazee.com

Exercise does most of the work. NICE guideline NG59 covers low back pain and sciatica together, puts an exercise programme at the centre of care, and positions manual therapy as something delivered alongside exercise rather than instead of it. That is how we run it.

Nerve mobility work is not stretching the nerve. It is small, rhythmic movement at either end of it, meant to restore glide without provoking the thing. Done too enthusiastically it flares for two days, which is why the dose gets set in clinic rather than sent to you as a video. Where the spine is stiff and guarded as well, manual therapy and nerve mobility work belong in the same session.

Directional loading comes out of what your repeated movement testing showed. Two or three exercises, not twelve, with the soreness rule written down: sore during, settled within an hour, no worse the next morning. Anything that sends symptoms further down the leg gets dropped that day.

Sitting tolerance is built deliberately, in increments you can count, because the desk and the car are where most setbacks come from.

If leg weakness progresses, or months pass with no shift at all, an injection or a surgical opinion becomes a reasonable conversation, and we write to your GP. What we will not do is tell you a vertebra has slipped out of place. No examination can show that, and the idea keeps people fragile for years.

What helps between appointments

Let the leg be the compass. Symptoms moving up towards the buttock means you are heading the right way, even when the intensity has not dropped yet.
Shorten your sitting stints before the pain does it for you. If the calf lights up at twenty minutes, stand at twelve.
Treat the car seat as the worst chair you own. Plan a stop on a long drive rather than pushing through.
Walk in small, frequent doses. Three short walks beat one long one in the first fortnight.
Sleep however hurts least. A pillow between the knees on your side, or under them on your back.

Two things to stop doing: testing the leg every hour to see whether it still hurts, and reading about disc surgery at two in the morning.

Booking physiotherapy for sciatica at Megazee.com

You do not need a GP referral. Every physiotherapist at Megazee.com is registered with the Health and Care Professions Council and chartered with the Chartered Society of Physiotherapy, and our fees and funding page sets out charges and how insurance works.

Bring shorts or loose trousers, because the assessment involves walking, bending and heel raises. Book a physiotherapy assessment, or speak to a physiotherapist before you book if you would rather describe the leg to someone first.

One last time, because it is the only urgent thing on this page: any change in bladder or bowel control, numbness around the saddle area, or sciatica in both legs means A&E today, not an appointment with us.

Physiotherapy for Sciatica at Megazee.com, Manchester