Low back pain is one of the most common problems people experience. But many people assume that every back pain shooting to the leg = sciatica. This is NOT always true. In fact, only about 5–10% of low back pains are true sciatica.
So what is the difference—and why does it matter? Because correct diagnosis = correct treatment. Physiotherapy plays a major role in identifying the exact cause and treating it effectively.
What is TRUE Sciatica?
Sciatica happens when the sciatic nerve is irritated or compressed, usually due to:
- Lumbar disc herniation
- Spinal stenosis
- Degenerative changes
- Piriformis syndrome (less common)
Typical Symptoms of Sciatica
- Sharp, shooting pain down the back of the leg
- Numbness or tingling
- Possible weakness in leg/foot
- Pain increases with coughing or bending
- Usually affects one leg only
If It's NOT Sciatica… What Else Can Cause Low Back Pain?
Many structures in your back can cause pain without involving the nerve:
- Mechanical / Postural Back Pain — caused by poor posture, prolonged desk work, weak core muscles.
- Facet Joint Dysfunction
- Sacroiliac Joint (SIJ) Dysfunction — pain in buttock, groin, or side of hip; sometimes mistaken for sciatica.
- Muscular Strain — overuse, lifting wrong, sudden movements.
- Myofascial Trigger Points — knots in muscles that "refer pain" into the leg.
- Hip-related Pain — hip arthritis or bursitis can radiate into the thigh—often confused with nerve pain.
Why Proper Physiotherapy Assessment Is Crucial
A physiotherapist uses specific tests to identify the correct source of your pain. This avoids unnecessary fear.
Physio Assessment Includes:
- Detailed history
- Posture and movement analysis
- Special tests
- Strength and flexibility checks
- Core and hip stability evaluation
- Palpation of muscles, joints, SI joint
- Assessment of daily ergonomics
The goal: find the exact structure causing your pain → personalize treatment.
How Physiotherapy Helps (Whether It's Sciatica or Not)
- Strengthening the RIGHT muscles
- Improving mobility
- Nerve mobilisation (if sciatica is present)
- Posture correction & ergonomics
- Manual therapy
- Pain relief techniques
Not every back pain that travels to the leg is sciatica. But every back pain deserves a proper assessment. Physiotherapy identifies the cause and treats it effectively.