Quick Summary
Pain travelling from the buttock down the leg, sometimes with tingling or numbness, may be sciatica. Our New Malden physiotherapists assess your symptoms and nerve function, explain the likely cause and help you plan a gradual return to everyday activity.
Understanding Sciatica
Sciatica describes symptoms related to irritation of the sciatic nerve or its roots in the lower back. Leg pain may be more noticeable than back pain. It is a symptom pattern, not a diagnosis of exactly which structure is responsible; back pain alone is not usually sciatica.
How we assess your symptoms
We discuss the leg-pain pattern and screen strength, sensation and reflexes where appropriate. We assess how movement affects symptoms and check for urgent warning signs. Worsening weakness or symptoms that remain disabling may need GP or spinal-service review.
Do You Experience These Symptoms?
- Shooting, burning or aching pain into the buttock and leg, sometimes reaching the foot.
- Tingling or altered sensation; some people notice weakness.
- Symptoms that change with sitting, walking, coughing or particular movements.
An assessment helps guide your next step, based on your symptoms, health and goals.
What may contribute?
A disc-related problem is a common cause, but narrowing around the nerves and other spinal conditions can also contribute. Not every scan change causes symptoms. A clear history and examination help determine the next step and whether further investigation would change treatment.
A treatment plan built around you
Hands-On Manual Therapy
Hands-on treatment may help associated back or buttock discomfort where appropriate. It is used alongside exercise and activity advice, not to claim that a disc has been pushed back or a nerve permanently released.
Is Shockwave Suitable?
Shockwave is not routinely recommended for sciatica and is not a treatment to decompress a spinal nerve. We prioritise assessment, activity advice and rehabilitation, with medical referral when nerve function or persistent symptoms require it.
Targeted Exercise Programme
Your programme starts with manageable movement and gradually rebuilds walking, strength and daily activity. Any nerve-movement exercise is individually selected. Increasing numbness, weakness or a lasting escalation of leg symptoms needs review rather than pushing harder.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
- Go to A&E immediately for new numbness around your genitals or bottom, difficulty starting or controlling urine, loss of bowel control, or severe or worsening weakness in both legs. These can signal cauda equina compression. Call 999 if you need an ambulance.
- Seek urgent medical advice for rapidly worsening leg weakness, fever or feeling unwell with back pain, or significant pain after an injury. Contact your GP about unexplained weight loss, a cancer history or persistent night pain.
Your questions answered
Do I need an MRI before physiotherapy?
Not routinely. Examination often guides initial care. A specialist may arrange imaging if symptoms, neurological findings or a treatment decision make it useful.
Should I book a massage for sciatica?
Begin with a physiotherapy assessment, especially with tingling, numbness or weakness. Massage may help accompanying muscle discomfort after assessment, but it does not replace nerve assessment or an active recovery plan.
Which appointment should I book?
Choose a Physiotherapy Initial Assessment for new, persistent or uncertain symptoms. We will assess what is limiting you, explain the options and agree the next steps. If you already have a diagnosis, bring any relevant scan report or specialist advice.
Visit J&J Therapy on the ground floor of CI Tower, New Malden. Book an assessment or call our reception team on 07935 869938 if you are unsure which service to choose.
Related conditions
Lumbar radiculopathy · Slipped or herniated disc
Sources and further reading
This page is for general information only and does not replace professional medical advice.
Information updated 15 October 2026. General information to support informed choices; it is not a diagnosis or a personalised treatment plan. Suitability and any need for referral are assessed individually. Seek urgent medical help for the warning signs listed above.