Low Back Pain & Sciatica — Physiotherapy in London & Essex
Most low back pain and sciatica is non-specific and recovers well with physiotherapy, exercise, and education. We provide NICE-aligned care at our Liverpool Street and Wickham Bishops clinics — without routine imaging, opioids, or unnecessary bed rest.
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What you're seeing
The concern
Why it happens
What drives it
- Sustained postural loading — long desk hours, driving, or repetitive manual work
- Sudden mechanical overload — lifting beyond capacity or abrupt twisting under load
- Irritation or compression of a lumbar nerve root (the usual driver of true sciatica)
- Deconditioning — reduced strength and movement after time off, illness, or surgery
- Pregnancy — biomechanical changes that load the lumbar spine and pelvis
- Stress, poor sleep, and low mood — well-evidenced amplifiers of pain perception
- Recurrent flares from a long-standing weakness or unhelpful movement pattern
Treatment approach
How Amanda treats it
Physiotherapy
Price on enquiryCombined assessment, manual therapy, and progressive exercise is the NICE-aligned first-line treatment for both non-specific low back pain and sciatica.
See treatment detail →Exercise Rehabilitation
Price on enquiryA graded, individualised exercise programme rebuilds strength and load tolerance in the lumbar spine, which is the strongest evidence-based defence against recurrence.
See treatment detail →Acupuncture
Price on enquiryOffered as an adjunct by our AACP-registered physiotherapists to help manage persistent pain alongside the core rehab plan, in line with NICE guidance on chronic pain.
See treatment detail →FAQ
Common
questions
When should I go to A&E for back pain or sciatica?
Go to A&E immediately if you develop loss of bladder or bowel control, numbness around the saddle or genital area, or progressive weakness in both legs. These can signal cauda equina syndrome — a rare emergency needing imaging and surgery within hours. Also seek urgent care after significant trauma. Physiotherapy is not appropriate first in these cases.
Do I need an MRI scan for my back pain or sciatica?
Usually not. NICE advises against routine imaging for non-specific low back pain and sciatica because it rarely changes management and often shows incidental findings — disc bulges or mild degeneration — that are common in pain-free people. We reserve imaging for genuine red flags or symptoms that fail to improve and suggest a specific cause needing further investigation.
Should I rest or stay active when my back or leg hurts?
Stay as active as your pain reasonably allows. Bed rest beyond 24 to 48 hours actually slows recovery and raises the risk of persistent problems. Walking, gentle movement, and keeping to your normal routine where possible are recommended even during an acute flare. Your physiotherapist will guide what to modify and what to safely keep doing.
How long does sciatica take to get better?
Most sciatica improves within 4 to 6 weeks, and the majority resolve within 12 weeks without surgery. With physiotherapy, an acute first episode of low back pain often settles in 3 to 6 sessions over 4 to 8 weeks. Recurrent or longer-standing pain responds more slowly — typically 6 to 12 sessions over 8 to 16 weeks.
Related Concerns
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The Physio Rooms • 280 Bishopsgate, Liverpool Street, London EC2M 4RB
BookAppointments typically available within 1–2 weeks