Sciatica: What It Feels Like and How PT Can Help
By Nova Physical Therapy | North Hollywood, CA | Published October 2026 | Last reviewed October 2026
It starts in your lower back or buttock. Then it shoots down the back of your leg, sometimes all the way to your foot. Sitting makes it worse. A sneeze makes you wince. You may notice tingling or numbness that won't go away.
Many people call this sciatica. The good news is that many cases improve within weeks. This article explains what sciatica feels like, what usually causes it, what helps, and which symptoms need urgent care.
The Short Answer
Sciatica is pain that travels from the lower back or buttock down the leg, along the path of the sciatic nerve. It usually comes from an irritated nerve root in the lower back, often related to a disc or narrowing around the nerve. Many cases improve within four to six weeks. Staying active and doing guided exercise usually helps more than bed rest. Loss of bladder or bowel control, or numbness in the groin or inner thighs, needs emergency care right away.
What Does Sciatica Feel Like?
Sciatica usually affects one leg. People often describe:
• Sharp, burning, or electric pain that shoots down the back of the leg
• Pain that's worse in the leg than in the back
• Tingling or "pins and needles" in the leg or foot
• Numbness in part of the leg or foot
• Pain that flares with sitting, coughing, sneezing, or bending
Not every leg pain is sciatica. Pain from the hip, muscles, or blood vessels can feel similar. That's one reason an evaluation matters.
What Causes Sciatica?
Sciatica describes a pattern of symptoms. It isn't a diagnosis on its own. Common causes include:
• A herniated or bulging disc that presses on or irritates a nerve root
• Spinal stenosis, a narrowing of the spaces around the nerves, which is more common after age 50
• Spondylolisthesis, when one vertebra slips forward over another
• Less common causes that need a physician's evaluation
Things that may raise your risk include age, inactivity, extra body weight, jobs with heavy lifting or long hours of sitting, smoking, and diabetes (Cleveland Clinic).
How Long Does Sciatica Usually Last?
Many cases improve within four to six weeks (Cleveland Clinic). Some people have symptoms that come and go, or last longer.
Recovery often isn't a straight line. Good days and bad days are normal. Leg pain often eases before numbness or tingling does. If your symptoms aren't improving after a few weeks, or they're getting worse, get evaluated.
Should I Rest or Stay Active?
Resting briefly during a bad flare is fine. Long stretches of bed rest usually don't help. Guidelines recommend staying active and learning to manage symptoms (NICE).
Things that often help:
• Short, frequent walks, if you can tolerate them
• Changing positions often instead of sitting for long periods
• Gentle movement that doesn't make your leg symptoms worse
• Noticing which positions ease your symptoms and which aggravate them, and sharing that with your physical therapist
Can Physical Therapy Help Sciatica?
For many people, yes. The APTA low back pain guideline supports these approaches for low back pain with leg pain (George et al., 2021):
• Exercise: trunk strengthening, endurance, and movement-control training
• Joint mobilization: hands-on techniques for longer-lasting back and leg pain
• Nerve mobility exercises: gentle movements combined with other treatment, for short-term relief
• Education: understanding your pain, combined with active treatment
The same guideline recommends against mechanical traction for long-lasting low back pain with leg pain. UK guidelines also recommend exercise, with hands-on therapy used only as part of an exercise-based plan (NICE).
The goal of physical therapy is to calm symptoms, restore movement, and build your tolerance for sitting, walking, lifting, and the activities you care about.
Do I Need an MRI for Sciatica?
Usually not at first. UK guidelines advise against routine imaging outside specialist settings (NICE). Imaging may be needed if warning signs are present, if symptoms are severe or getting worse, or if surgery is being considered. That decision is made with your physician.
What Happens During an Evaluation at Nova
A physical therapy evaluation for back and leg pain may include:
• When symptoms started and what you've already tried
• What makes your pain better or worse
• Screening for warning signs that need medical care
• Checks of sensation, reflexes, and strength in your legs
• Movement, strength, and flexibility tests for your back, hips, and legs
• Sitting, walking, and bending tasks relevant to your goals
From there, we build a plan around your goals. If findings call for a physician's evaluation, we refer you and coordinate care.
You Can See a Physical Therapist Without a Referral in California
California allows direct access to physical therapy. A PT can evaluate and treat you without a physician's referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
When Is Leg Pain an Emergency?
Go to the emergency room right away if you have:
• Loss of bladder or bowel control, or trouble urinating
• Numbness in the groin, buttocks, genitals, or inner thighs
• Leg weakness that is getting worse, or trouble lifting your foot
• New sciatica symptoms in both legs
These can be signs of cauda equina syndrome, a rare condition that needs urgent treatment (Cleveland Clinic).
See a doctor soon if back or leg pain comes with:
• Fever or feeling unwell
• Unexplained weight loss
• A history of cancer
• A recent fall, car accident, or other injury
• Severe, constant pain that doesn't ease with rest or position changes
We screen for these during every evaluation and refer you when findings call for medical assessment.
Frequently Asked Questions
Is sciatica the same as a pinched nerve?
People often use the terms interchangeably. Sciatica usually describes leg pain from an irritated nerve root in the lower back. Not all leg pain is sciatica, so an evaluation helps sort it out.
Can sciatica go away on its own?
Many cases improve within four to six weeks. Guided exercise can help you stay active and recover function while it settles.
Is walking good for sciatica?
For many people, short walks within your comfort level help. If walking makes your leg symptoms worse or spread, stop and get evaluated.
Should I stretch my hamstrings?
Some stretches can aggravate an irritated nerve. A physical therapist can help you choose movements that fit your symptoms.
What's the best sleeping position for sciatica?
There's no single best position. Many people find lying on their side with a pillow between the knees, or on their back with a pillow under the knees, more comfortable.
Will I need surgery?
Many people improve without surgery. Surgery is usually considered when symptoms don't improve with non-surgical care, or when there are serious nerve problems. That decision is made with a spine surgeon.
Do I need a referral?
Not to start. California allows direct access to physical therapy, within the limits above.
Schedule an Evaluation
If back or leg pain, tingling, or numbness is keeping you from sitting, sleeping, working, or exercising, a physical therapy evaluation can help identify what's limiting you and build a plan around your goals.
Nova Physical Therapy | North Hollywood, CA | Serving Burbank, Studio City, Toluca Lake, and Valley Village
Call (818) 639-3402 | Book an appointment
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Leg pain, numbness, or tingling can have many causes, and symptoms alone can't confirm sciatica or its cause. Medication, imaging, injection, and surgery decisions are made with your physician. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. Cleveland Clinic. Sciatica. Link
2. Cleveland Clinic. Cauda Equina Syndrome. Link
3. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1–CPG60. Link
4. National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). Updated December 2020. Link