Sciatica most commonly affects adults between the ages of 30 and 60, with increased prevalence in individuals exposed to occupational or lifestyle risk factors such as prolonged sitting, heavy manual labour, or poor movement mechanics. The underlying structures contributing to sciatic symptoms include intervertebral discs, facet joints, ligaments, and surrounding musculature such as the piriformis, which may compress or irritate the nerve along its course. Importantly, not all cases are purely compressive; inflammatory radiculopathy can occur even in the absence of significant mechanical impingement, reinforcing the need for a comprehensive clinical approach.
Evidence-based management of sciatica emphasises conservative care as a first-line strategy. Manual therapy may help reduce pain and improve mobility through modulation of neural and musculoskeletal function, while exercise therapy is strongly supported in the literature to restore movement, improve strength, and reduce recurrence risk. Adjunct modalities such as dry needling and extracorporeal shockwave therapy may provide additional benefit by targeting myofascial contributors and modulating pain pathways. In more persistent or severe cases, spinal injections, including epidural corticosteroids, may be considered to reduce inflammation and provide short-term symptom relief, (although offering joint injections, these specific spinal injections are not offered at Core Body Clinic). Overall, a multimodal, patient-specific approach is recommended to address both the mechanical and inflammatory components of sciatica and to optimise functional recovery.