Sciatica
Pain travelling from the back into the leg. Frightening, usually not dangerous, and in most cases it resolves without surgery.
Common symptoms
- , Sharp or burning pain down one leg
- , Worse with sitting, coughing or sneezing
- , Pins and needles or numbness in leg or foot
- , Weakness pushing off with the foot
- , Back pain that may be milder than the leg pain
Common causes
- , Disc bulge irritating a nerve root
- , Age-related narrowing of the spinal canal
- , Deep gluteal muscle irritation
- , Prolonged sitting, including long journeys
A symptom, not a diagnosis
Sciatica means pain along the path of the sciatic nerve, caused by something irritating or compressing it, most often a disc bulge pressing on a nerve root in the lower back.
It alarms people, reasonably: the pain can be severe and it travels down the leg. But disc bulges shrink over time and the natural history is good. Most people recover fully without any surgery.
The rule that guides treatment
Watch where the pain goes, not just how much there is.
Pain retreating up out of the leg towards the back is progress, even if the back briefly feels worse. Pain travelling further down the leg means the current approach is wrong and needs changing.
We establish your pattern in the first session and it becomes the rule you follow between appointments: which matters here, because if you are in Mtwapa or across the ferry you are managing this yourself most of the week.
Sitting
Sitting compresses the lower back more than standing does, and sciatica reliably worsens with it. Long journeys are a particular problem on this coast, so if yours involves a commute or a ferry queue, tell us and we will work out how to break it up.
How we treat it
- , Finding the positions that centralise your pain
- , Nerve mobilisation techniques
- , Graded loading as symptoms settle
- , Manual therapy for the lower back and hip
- , Guidance on sitting, driving and sleeping
Typical recovery: Most cases settle substantially within 6–12 weeks
See a doctor urgently if you have
- !Loss of bladder or bowel control
- !Numbness around the groin, buttocks or inner thighs
- !Weakness in both legs
- !Rapidly worsening weakness in the foot or leg
- !Sciatica with fever or unexplained weight loss
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
Will I need an operation?
Most people will not. The majority of disc-related sciatica settles with time and appropriate rehabilitation. Surgery is mainly considered for severe pain that has not responded, or for progressive neurological weakness.
How long will this take?
Longer than you would like. Nerve pain is slower than muscular pain, meaningful improvement over six to twelve weeks rather than days. Direction of travel matters more than speed.
Should I keep working?
Usually yes, with modification. If your work involves long periods seated, break it up frequently; if it involves lifting, we will adjust what and how for a period.
Book a physiotherapist on the coast
Clinic appointments in Nyali, or a physiotherapist at your door from Mtwapa to Diani. Same-week slots.