Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave knowing what is wrong, why it happened, and exactly what we are going to do about it.
Concern
Low Back Pain & Sciatica Treatment in London
Most low back pain and sciatica is non-specific and recovers well with physiotherapy, exercise, and education. Left to drift, though, an episode that should settle in weeks can become the recurrent, fear-driven pain that the World Health Organization now ranks as the single leading cause of disability worldwide. We provide NICE-aligned treatment for low back pain and sciatica at our Liverpool Street clinic in the City, without routine imaging, opioids, or unnecessary bed rest.
Overview
Understanding low back pain and sciatica
Most adults experience low back pain at some point, and the majority of episodes are non-specific, meaning no single structure can be pinpointed as the cause. Sciatica describes leg pain, tingling, or numbness that follows the sciatic nerve, usually from irritation of a lumbar nerve root.
NICE guidance (NG59) recommends physiotherapy, exercise, and self-management education as first-line care. It also advises against three things people often expect:
- Routine scans, which rarely change treatment and often show harmless findings.
- Opioid painkillers for non-specific back pain.
- Prolonged bed rest, which tends to slow recovery.
Most acute episodes settle within 6 weeks. Recurrent or persistent pain responds well to exercise rehabilitation combined with manual therapy, with acupuncture available as an adjunct where pain lingers. We consider how your work, sport, and daily life load your spine, and build the plan around getting you back to those activities with confidence.
Excellent
From 6 five-star Google reviews
Source: Google
I saw Amanda for a problem I've been having with a painful shoulder. She explained to me what the problem was, did a thorough treatment session and gave me some exercises to do to improve it. Very professional and friendly, I highly recommend her.
I booked with Michelle for my first appointment. When I stood up I said to her it feels like heaven as my continuous back pain had totally gone. I was totally pain free for 7 hours so bless you Michelle.
I first visited Amanda following a maisonneuve fracture. That day I walked 107 steps in a camboot with two crutches. I have visited weekly. Yesterday I walked 13,315 steps (no crutches, no boot). The transformation is truly amazing.
After my son's sports injury we spent many months trying to get help from various other doctors. It was so reassuring to finally speak with someone who really understood what was going on. Michelle was worth every penny!
Michelle was absolutely amazing during my pregnancy with the multiple issues I had. She diagnosed and treated pain in my knee and my back, and got me from a place where I couldn't kneel at all, to fully weight bearing in a short space of time.
Excellent treatment of my lower back and related sciatica injuries from CrossFit. Definitely my go-to therapist when in dire need of pain relief.
Physiotherapy for low back pain and sciatica can help to:
Settle the current episode of pain
Most low back pain and sciatica is non-specific and recovers well with hands-on treatment, exercise, and clear guidance. Combined manual therapy and progressive exercise is the NICE-aligned first-line approach, and an acute first episode often settles in three to six sessions.
Understand what is driving your symptoms
Sciatica describes leg pain, tingling, or numbness that follows the sciatic nerve, usually from an irritated lumbar nerve root, while most back pain has no single structure to blame. We explain your diagnosis in plain terms so you know what to do and what to stop worrying about.
Stay active and avoid unnecessary tests
NICE advises against routine scans, opioids, and prolonged rest for non-specific back pain and sciatica. Staying as active as your pain reasonably allows beats bed rest, which slows recovery, and we reserve imaging for genuine red flags or symptoms that fail to improve.
Rebuild strength to defend against recurrence
A graded, individual exercise programme rebuilds strength and load tolerance in the lumbar spine, which is the strongest evidence-based defence against the pain coming back. We account for how your work, sport, and daily routine load your spine when we build it.
Manage persistent or recurrent pain
Recurrent or longer-standing pain responds well to structured exercise rehabilitation combined with manual therapy, typically over six to twelve sessions. Where pain is persistent, acupuncture from our AACP-registered physiotherapists can be added as an adjunct in line with NICE guidance.
Recognise when it needs urgent care
Loss of bladder or bowel control, numbness around the saddle area, or progressive weakness in both legs can signal cauda equina syndrome, a rare emergency needing hospital assessment within hours. We will always tell you when a symptom needs A&E rather than physiotherapy first.
Why it happens
What causes low back pain and sciatica?
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Sustained postural loading: long desk hours, driving, or repetitive manual work
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Sudden mechanical overload: lifting beyond capacity or abrupt twisting under load
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Irritation or compression of a lumbar nerve root (the usual driver of true sciatica)
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Deconditioning: reduced strength and movement after time off, illness, or surgery
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Pregnancy: biomechanical changes that load the lumbar spine and pelvis
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Stress, poor sleep, and low mood: well-evidenced amplifiers of pain perception
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Recurrent flares from a long-standing weakness or unhelpful movement pattern
At your first appointment we look for the cause, not just the sore spot: your history, how you move, and what your work, sport and life ask of your body.
Your first visit is a full musculoskeletal assessment: a detailed history, then testing of movement, strength and the affected area. We explain the working diagnosis in plain English and agree a plan with you before any treatment begins.
You leave with a written summary of what we found and a home exercise programme built around your diagnosis and your goals, so progress keeps going between visits.
Back to the work, sport and life you love. We settle the pain, get to what is driving it, then rebuild the strength that keeps it away, so you leave each visit a step stronger than the last.
- Based in the City of London, inside UNTIL at 280 Bishopsgate, with a second clinic in Essex.
- Rated 5.0 on Google across 11 patient reviews.
- Chartered, HCPC-registered physiotherapists with more than ten years of combined clinical experience.
Fees and booking
You can refer yourself, with no GP letter needed, and book online in a couple of minutes at whichever clinic is easier for you to reach.
- Self-referral: book directly, no GP referral required
- Two clinics, both led by our chartered physiotherapists
- Open Monday to Friday, 7am to 7pm
- Two minutes from Liverpool Street station, with free parking at our second clinic
- A written summary and a home exercise programme after every appointment
Your journey
with The Physio Rooms
It starts with finding the cause. Whether you are a City professional stuck at a desk or a weekend athlete chasing a comeback, we treat what is driving the problem, then build the strength that keeps it fixed.
Hands-on treatment
Manual therapy chosen for your presentation, with Western medical acupuncture added where it helps. Treatment is not the goal in itself: it creates the window to move more freely and load the tissue.
Rebuild
Progressive, coached exercise rehabilitation restores the strength and load tolerance you lost. Both clinics have full gym facilities, and this is the stage that decides whether the fix lasts.
Stay well
Each follow-up reassesses you against your baseline. We discharge you when you have the strength and the tools to manage on your own, with clinical Pilates and TPI golf screening on hand to keep you moving.
We specialise in:
- Musculoskeletal physiotherapy for back, neck, shoulder and joint pain
- Progressive exercise rehabilitation, with full gym facilities at both clinics
- Western medical acupuncture within the AACP framework
- Clinical Pilates with Pilates by Janie
- TPI golf physiotherapy movement screening with Amanda
- Post-operative and sports-injury rehabilitation
- Home-based rehabilitation, supported and progressed remotely
Treatment approach
How do we treat low back pain and sciatica?
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
Frequently asked
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
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