Sciatica
Sciatica & Sciatic Nerve Pain — North Vancouver
Burning down the back of the leg, pins and needles in the foot, a back that won't let you sit through a meeting. We figure out which nerve, which level, and what to actually do about it.
What it is
Understanding your sciatica / sciatic nerve pain.
Sciatica is shorthand for pain that travels along the path of the sciatic nerve — through the buttock, down the back of the thigh, sometimes into the calf or foot. It is a symptom, not a diagnosis. The same leg pain can come from a disc pressing on a nerve root in the lumbar spine, from tightness in the deep buttock muscles squeezing the nerve as it leaves the pelvis, or from joint stiffness in the lower back that is referring pain along a familiar pattern.
Getting the source right is most of the work. A disc-driven sciatica responds to one set of movements and gets worse with another. A piriformis-driven case usually needs the opposite. Treating both the same way is why so many people end up doing months of stretches that don't help.
The other thing worth knowing — most sciatica improves. It does not always improve quickly, and it almost never improves on a fixed timeline, but the trajectory bends with the right plan. The exception is the small group with true neurological signs (progressive weakness, numbness in the saddle area, loss of bowel or bladder control) — that's a same-day call to a physician, not a physio booking.
What to expect
Many sciatica cases ease in the first 2–6 weeks once the right movement bias is found. Some take longer, especially with a clear disc involvement. Your physiotherapist will set the next milestone after assessment and adjust if symptoms aren't moving in the right direction.
Get a plan
Not sure if we're the right fit?
Send us a quick note about what's going on. A physiotherapist — not a receptionist — will read it and reply with what they'd recommend. No commitment to book.
Common questions
About sciatica / sciatic nerve pain.
Do I need an MRI before starting physio?+
No. Imaging is rarely the first step in BC. We can identify the likely source clinically and refer for imaging if findings warrant it — for example, progressive weakness, failed conservative care, or red-flag symptoms. Many sciatica cases never need an MRI to get better.
Is it ever a 'don't stretch it, strengthen it' situation?+
Often. The reflex to stretch a tight hamstring or piriformis can actually wind up an irritated nerve when the underlying driver is disc-related. Part of the first assessment is figuring out which camp you're in so the home exercises help instead of hurt.
Should I be lying down or staying active?+
Staying active within a tolerated range, in most cases. Strict bed rest delays recovery for non-radicular back pain and most sciatica. We'll help you find the activities that move you forward and the ones to pause for now.
What about my numb foot — is that nerve damage?+
It is nerve irritation rather than damage in most cases, and sensation usually returns as the nerve calms. Persistent or worsening numbness, weakness, or a foot that won't lift cleanly when walking are different — those warrant earlier physician review.
Do you direct-bill ICBC and extended health?+
Yes. Direct billing for most major extended-health insurers, plus ICBC and WorkSafeBC. We handle the paperwork.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).