If you’ve got pain running from your lower back or buttock down one leg, you’ve probably already been told it’s sciatica. You may have rested it, stretched it, and tried physio or a chiropractor, and it still keeps flaring up. That’s frustrating, and it’s also very common.
The good news is that most sciatica does settle, and sciatica that keeps coming back usually has a reason behind it that can be found and changed. This guide explains what sciatica actually is, the symptoms to look for, what’s usually driving it, what gives relief right now, and how sciatica treatment works at our clinic in Beach Haven on Auckland’s North Shore.
What Is Sciatica?
Sciatica is pain caused by irritation or compression of the sciatic nerve, the largest nerve in the body. The nerve runs from your lower back, through your buttock and down the back of each leg. When something presses on or irritates the nerve roots in your lower back, pain can travel along the nerve’s path into your leg.
The most important thing to understand is that sciatica is a symptom, not a diagnosis. It tells you the nerve is irritated. It doesn’t tell you why. And the “why” is what decides which treatment will actually help, and whether the pain keeps coming back.
Sciatica Symptoms: How to Tell It’s Sciatica
Sciatica has a fairly recognisable pattern. The most common symptoms are:
- Pain that travels from your lower back or buttock down the back of one leg, often below the knee
- Sharp, burning, shooting or “electric” pain, rather than a dull ache
- Pins and needles, tingling or numbness in your leg or foot
- Weakness in the leg or foot
- Symptoms on one side only
- Leg pain that feels worse than the back pain
- Pain that gets worse with sitting, bending forward, coughing or sneezing
Because sciatica, general lower back pain and hip pain can overlap, it’s easy to confuse them. Here’s a simple way to tell them apart:
| Where you feel it | What it feels like | Common triggers | |
| General lower back pain | Across the lower back; may spread into the buttocks but stays above the knee | Dull ache, stiffness, tightness | Long periods sitting or standing, lifting, end of the day |
| Sciatica | Buttock and down the back of the leg, often below the knee | Sharp, burning or electric pain; tingling or numbness | Sitting, bending, coughing, sneezing |
| Hip pain | Groin, front or side of the hip, sometimes the thigh | Deep ache or pinching with movement | Walking, stairs, getting in and out of the car, lying on that side |
In practice, these often show up together. The same muscle imbalances that load the lower back also sit around the hip, which we cover in Can Poor Posture Cause Hip Pain Too?
What Causes Sciatica?
Sciatica has several possible causes, and they respond to different approaches. That’s why generic advice often doesn’t work.
Disc-related causes
The most common cause of sciatica is a bulging or herniated disc in the lower back pressing on or irritating a nerve root. This is often called a “slipped disc”, although the disc doesn’t actually slip. Many disc-related cases improve well with the right non-surgical care. If you’ve been told you have a disc problem, read our guides on therapy for a herniated disc and what to do next with a disc bulge or slipped disc.
Muscular causes
The sciatic nerve passes right beside, and in some people through, the piriformis muscle deep in the buttock. When this muscle and the surrounding deep hip muscles become tight or overactive, often from long periods of sitting or weak glutes, they can irritate the nerve and produce sciatica-type pain. This is often called piriformis syndrome. The piriformis stretch in our lower back stretches guide is a good starting point.
Posture and movement patterns
How you sit, bend, lift and move every day matters. Weak glutes and deep core muscles, tight hip flexors, and habits like rounding through the lower back to pick things up place repeated load on the discs and joints of the lower back. Over months and years, that load adds up. In our experience, this is very often the missing piece in sciatica that keeps coming back. The disc or muscle may be the immediate irritant, but the movement pattern is what keeps re-irritating it. We explain this in more detail in Bad Posture and Lower Back Pain.
Other causes to rule out
Less common causes include spinal stenosis (a narrowing of the space around the nerves, more common over 60 and often worse with walking and eased by sitting or bending forward) and spondylolisthesis (where one vertebra slips forward on another). Rarely, sciatica can be caused by infection or a tumour. These need medical assessment through your GP, sometimes with imaging.
When to See a Doctor Urgently
Most sciatica isn’t dangerous. But a small number of symptoms need urgent medical care. If you have any of the following, go to your nearest emergency department or call 111. Don’t wait for a clinic appointment:
- Loss of bladder or bowel control, or difficulty passing urine
- Numbness around your genitals, buttocks or inner thighs (the “saddle” area)
- Sciatica symptoms, numbness or weakness in both legs
- Weakness in your leg or foot that is getting worse quickly
These can be signs of cauda equina syndrome, a serious condition where the nerves at the base of the spine are compressed (Healthify NZ).
You should also see your GP promptly if your back or leg pain started after a significant fall or accident, or comes with fever, feeling generally unwell, or unexplained weight loss. If you’re unsure, you can call Healthline free on 0800 611 116 for advice.
Sciatica Pain Relief: What You Can Do Now
While sciatica is flared up, these steps can help ease the pain and support recovery alongside any sciatica treatment you’re having:
- Keep moving gently. Bed rest tends to slow recovery. Staying as active as you can with your normal activities is recommended (Healthify NZ).
- Walk little and often. Several short walks a day usually help more than one long one.
- Change position regularly. Try not to sit for more than 20 to 30 minutes at a time. Stand up, move around, then sit again.
- Use heat or cold. Many people find a heat pack on the lower back or buttock eases muscle tension. Use whichever feels better for you.
- Support your sleep. Lie on your side with a pillow between your knees, or on your back with a pillow under your knees.
- Avoid the biggest aggravators for now. Heavy lifting, repeated bending and long drives without breaks are common triggers while things settle.
- Try gentle stretches. See the stretches for sciatic nerve tension in our stretches guide.
A useful sign to watch: if a movement or stretch makes the pain spread further down your leg, stop and ease off. If the pain moves back up out of the leg towards your lower back, that’s usually a good sign.
For pain relief medication, talk to your GP or pharmacist about what’s right for you.
Sciatica keeps flaring up?
Relief tips help in the short term. If it keeps coming back, something is still irritating the nerve. We’ll find out what, and how to fix it.
Sciatica Treatment Options Compared
Most sciatica improves with non-surgical care. Surgery is reserved for a small number of people with severe or worsening symptoms, or where other treatment hasn’t helped (NICE guideline NG59). Here’s an overview of the main options:
| Option | What it involves | Best suited to |
| Activity and time | Staying active and modifying activity while the nerve settles (not bed rest) | Mild, first-time episodes |
| Medication | Pain relief advised or prescribed by your GP or pharmacist | Short-term symptom relief |
| Physiotherapy | Assessment, hands-on treatment and exercise rehabilitation | Acute episodes and rehabilitation |
| Chiropractic | Spinal manipulation and adjustment | Some people find short-term relief |
| Corrective exercise | Root-cause movement assessment and a tailored exercise programme | Sciatica that keeps coming back, and preventing future flare-ups |
| Injections | Steroid injections arranged through a medical specialist | Selected cases of severe, persistent nerve pain |
| Surgery | Procedures such as discectomy or decompression | Severe or progressive symptoms, or when other care hasn’t worked |
Physio or corrective exercise for sciatica?
This is one of the most common questions we get. When it comes to sciatica treatment, physiotherapy is often the right first step for an acute flare-up, and many good physios use exercise as part of treatment. The difference with corrective exercise is the emphasis: we spend most of our time finding the specific movement pattern or muscle imbalance that keeps irritating the nerve, then retraining it. That makes it especially useful if you’ve had physio or chiropractic care before, felt better for a while, and then the sciatica returned.
Sciatica Treatment at Back Pain Auckland: How It Works
Our approach to sciatica treatment is built around one question: what is actually irritating your sciatic nerve, and what keeps it happening?
Step 1: Root-cause assessment. We look at your history, how you move, sit and bend, your posture, your muscle balance, and which movements make your symptoms better or worse. If anything suggests you need medical assessment or imaging, we’ll tell you and refer you to your GP.
Step 2: A corrective exercise programme built for you. Disc-related, muscular and postural sciatica each need different work. Your programme targets your specific driver: releasing and lengthening what’s tight, and activating and strengthening what’s weak and underused.
Step 3: Progression and independence. As symptoms settle, we build strength and better movement habits so you can manage your back yourself and prevent future flare-ups, rather than relying on ongoing treatment.
Sessions are with Shane Lyons, a C.H.E.K. Exercise Coach and HMC Movement Coach registered with REPS as an allied health professional. We don’t diagnose medical conditions or replace your GP. We assess how your body moves, retrain it, and work alongside your medical care where needed.
How Long Does Sciatica Take to Heal?
Many episodes settle on their own. According to Healthify NZ, there’s about a 50% chance your leg pain will be better after 4 weeks, whether you have treatment or not, although it can last for several months or longer (Healthify NZ).
If your sciatica keeps coming back, that’s usually a sign that whatever is irritating the nerve hasn’t changed. With a corrective exercise approach to sciatica treatment, most people notice some relief within the first few weeks. Lasting change, the kind that keeps the sciatica from returning, typically takes a few months of consistent work.
Sciatica FAQs
Can sciatica go away on its own?
Often, yes. Many first episodes improve within weeks. But if it keeps returning, there’s usually an underlying driver, such as a disc problem, muscle imbalance or movement pattern, that needs addressing.
Should I rest or keep moving with sciatica?
Keep moving gently. Short walks and regular changes of position usually help more than bed rest. Avoid heavy lifting and repeated bending while it settles.
Do I need an MRI for sciatica?
Not usually at first. Guidelines advise against routine imaging unless the result is likely to change your treatment, and MRI findings often don’t match symptoms. Your GP will refer you if it’s needed. Read more in why your MRI might not explain your lower back pain.
Can sitting all day cause sciatica?
Long periods of sitting can contribute by increasing load on the lower back discs and tightening the hip muscles around the sciatic nerve. Regular movement breaks and a good desk setup help.
Where can I get sciatica treatment in Auckland?
Our clinic is in Beach Haven on Auckland’s North Shore, and we see clients from across Auckland.
Ready to Get to the Bottom of Your Sciatica?
Living with sciatica that keeps flaring up? Find out what’s really driving it and get a plan to fix it. Book your sciatica assessment at our Beach Haven clinic.
Sciatica keeps flaring up?
Relief tips help in the short term. If it keeps coming back, something is still irritating the nerve. We’ll find out what, and how to fix it.
