What is sciatica?
Sciatica is not a condition in its own right — it is a set of symptoms caused by irritation or compression of the sciatic nerve, the largest nerve in the body. The sciatic nerve starts in the lower back (formed from the L4 to S3 nerve roots), travels through the buttock, and runs down the back of each leg to the foot. When any part of that pathway becomes irritated, you can feel sharp, burning, shooting, or electric pain anywhere along its course.
In Coffs Harbour and across the Mid North Coast, sciatica is one of the most common reasons people book a physiotherapy assessment at Tidal Motion. Approximately 40% of adults will experience true sciatica at some point in their lives, and lower back pain more broadly is now the leading cause of disability worldwide according to the World Health Organization.
Common causes of sciatica and lower back pain
Sciatica and lower back pain can be triggered by a wide range of mechanical, lifestyle and health factors. The most common causes we see in the Coffs Harbour clinic and on home visits include:
- Lumbar disc bulge or herniation — the most common cause in adults under 50, where the soft inner disc presses on a nerve root.
- Facet joint irritation — the small joints at the back of the spine become inflamed after prolonged sitting, twisting, or a sudden movement.
- Lumbar spinal stenosis — narrowing of the spinal canal, more common after age 60, which produces leg pain that eases with sitting or bending forward.
- Piriformis syndrome — the piriformis muscle in the buttock tightens around the sciatic nerve, common in runners and cyclists.
- Sacroiliac joint dysfunction — irritation of the pelvic joints, often mistaken for hip or back pain.
- Muscular deconditioning — long periods of desk work, poor sleep, or a sudden increase in physical work (a common story on Mid North Coast building sites and farms).
- Pregnancy and postnatal changes — hormonal, weight and postural shifts commonly refer pain into the buttocks and legs.
Symptoms of sciatica
True sciatica has a distinct symptom pattern. If you have three or more of the signs below, there is a good chance the sciatic nerve is involved:
- Pain that travels from the lower back or buttock down the back of the leg, sometimes reaching the calf or foot
- Sharp, burning, shooting or electric-shock quality (rather than a dull ache)
- Pins and needles, numbness, or a "dead leg" feeling
- Weakness in the calf, foot or big toe
- Pain that worsens with sitting, sneezing, coughing or bending forward
- Symptoms usually affecting one leg only
When to seek treatment urgently
Book a physiotherapy assessment within 1–2 weeks if pain is not settling with rest and gentle movement. Seek immediate medical attention (emergency department) if you notice:
- Loss of bladder or bowel control
- Numbness in the saddle/groin area
- Rapidly progressing weakness in one or both legs
- Fever combined with back pain
- Unexplained weight loss or a history of cancer
Physiotherapy treatment for sciatica
Physiotherapy is the first-line, evidence-based treatment for sciatica and mechanical lower back pain. At Tidal Motion Physiotherapy in Coffs Harbour, every plan starts with a thorough neuromusculoskeletal assessment: a subjective history, neurological screen (reflexes, sensation, strength), movement testing, and clearing of red flags.
From there, treatment is tailored to what your body is telling us. Typical interventions include:
- Manual therapy — joint mobilisation, soft tissue release and gentle traction techniques to reduce guarding and offload the nerve.
- Neural mobilisation ("nerve glides") — specific movements that restore the sciatic nerve's ability to slide through surrounding tissues without pain.
- Directional preference exercises — usually McKenzie-style extensions or flexions, chosen based on which movement relieves your leg pain.
- Dry needling — targeted needling of overactive muscles (piriformis, glute medius, quadratus lumborum) to reduce compression on the nerve.
- Progressive loading — a graduated return to bending, lifting, sitting and sport so the tissues learn to tolerate normal life again.
- Pain science education — understanding why pain persists is one of the most powerful predictors of recovery.
Exercise physiology for chronic lower back pain
When pain has been present for more than three months, the most effective long-term treatment shifts from hands-on physiotherapy to structured exercise. This is where accredited exercise physiology (EP) becomes powerful. Our EP designs a progressive strength, mobility and cardiovascular program built around your goals — whether that's returning to surfing at Sawtell, lifting grandkids, or getting through a shift at the mill.
Research consistently shows that graded exercise reduces pain intensity, lowers the risk of recurrence and improves quality of life for chronic lower back pain more effectively than passive treatments alone.
NDIS support for back pain and sciatica
If you are an NDIS participant and lower back pain or sciatica is affecting your functional capacity, physiotherapy and exercise physiology are commonly funded under Capacity Building — Improved Daily Living. Tidal Motion works with self-managed and plan-managed participants across Coffs Harbour, Sawtell, Woolgoolga, Toormina, Boambee, Urunga and the wider Mid North Coast. We can attend your home, workplace, gym or supported accommodation.
Home visit physiotherapy for back pain
For many people with acute sciatica, driving into a clinic simply is not realistic — sitting in a car often makes symptoms worse. Mobile physiotherapy in Coffs Harbour lets us assess and treat you in the space where you actually live. We can review your bed set-up, workstation, and daily habits, then coach you through nerve glides and safe movement in your own environment.
Recovery timeline
Every case is individual, but the following is a realistic guide for uncomplicated sciatica in an otherwise healthy adult:
| Stage | Timeframe | What to expect |
|---|---|---|
| Acute | 0–2 weeks | Pain is often at its worst. Focus on calming symptoms, gentle movement, and offloading the nerve. |
| Subacute | 2–6 weeks | Leg pain "centralises" back to the lower back. Introduce mobility, core control and gradual loading. |
| Rehabilitation | 6–12 weeks | Return to full function. Strength work, running, lifting, and return-to-work programming. |
| Prevention | 3 months + | Long-term conditioning to reduce recurrence — usually 2–3 sessions per week of strength and cardio. |
Prevention strategies
The best predictor of a future back injury is a past back injury, so once symptoms settle, prevention becomes the priority. Evidence-based prevention strategies include:
- Progressive resistance training 2–3 times per week (especially deadlift, squat and hip hinge variations, appropriately loaded)
- 150 minutes of moderate cardio per week — walking the Coffs Harbour Jetty, swimming, or cycling all qualify
- Interrupting sitting every 30–45 minutes with a short movement break
- Managing sleep, stress and body weight — all three independently influence back pain risk
- Learning safe lifting technique early, particularly for tradies, healthcare workers and parents of young children
Self-management advice
While you wait for your first appointment, these evidence-based strategies are safe for the vast majority of sciatica presentations:
- Keep moving. Short, frequent walks (5–15 minutes, several times a day) usually help more than resting.
- Use heat. A wheat bag or hot shower on the lower back and buttock can reduce muscle guarding.
- Try a nerve glide. Sit tall, straighten one leg with the toes pulled up, then relax. Repeat 10 times, 3 times a day on the sore side.
- Sleep smart. On your back with a pillow under the knees, or on your side with a pillow between the knees.
- Avoid prolonged sitting. Stand up every 20–30 minutes, even for a minute.
- Simple analgesia. Paracetamol or a short course of anti-inflammatories (as advised by your GP or pharmacist) can help you keep moving.