The Biggest Myths About Sciatica (and What Actually Helps)

If you’ve ever had sharp, burning, or electric pain shooting down your leg, you’ve probably heard the word “sciatica.” Unfortunately, you’ve probably also heard a lot of confusing or flat-out wrong information about it. Let’s clear up some of the most common myths about sciatica and talk about what actually helps you get better.

Myth #1: Sciatica Is a Diagnosis

Reality: Sciatica is a symptom, not a diagnosis.

“Sciatica” simply describes pain that follows the path of the sciatic nerve — typically from the low back or buttock down the leg. The cause of that pain can vary widely, including disc irritation or herniation, joint stiffness in the spine or pelvis, muscle tension (like piriformis or gluteal muscles), or nerve sensitivity without structural damage. Therefore, two people who both present with sciatica can need completely different treatments.

Myth #2: You Need an MRI Right Away

Reality: Most people with sciatica improve without imaging.

Unless there are serious red flags (progressive weakness, bowel/bladder changes, significant trauma), early MRIs often don’t change treatment. Imaging findings like disc bulges are extremely common, even in people with no pain at all. In a physical therapy evaluation, we can assess how your symptoms behave with movement, your strength, mobility, and nerve sensitivity, and identify mechanical factors that can be modified. This tells us much more than an image alone.

Myth #3: Sciatica Means You Should Rest and Avoid Movement

Reality: Prolonged rest usually makes sciatica worse.

While short-term symptom modification can help calm things down, complete rest often leads to increased stiffness, reduced circulation, and heightened nerve sensitivity. Targeted movement — the right movement — is one of the most effective tools for reducing sciatic pain.

Myth #4: Stretching Is Always the Answer

Reality: Stretching can help… or make things worse.

Aggressively stretching the hamstrings (which puts tension on the sciatic nerve) can actually increase irritation if the nerve is already sensitive. Some people feel better with mobility work; others need stabilization, posture changes, or gradual nerve desensitization first.

This is where individualized physical therapy comes into play.

Myth #5: Sciatica Always Comes From a Disc Herniation

Reality: Discs are only one possible contributor.

Many cases of sciatic pain stem from joint mechanics in the lumbar spine or SI joint, muscle guarding and asymmetry, or load intolerance (too much sitting, lifting, or repetitive movement). Treating only through the lens of disc involvement can lead to missing the bigger picture.

Myth #6: Surgery Is Inevitable

Reality: Most people improve with conservative care.

The majority of sciatic pain episodes improve significantly with physical therapy, activity modification, progressive strengthening, and education on symptom management. Surgery is typically reserved for a small percentage of cases with severe or worsening neurological deficits.

What Actually Helps Sciatica?

Evidence-based physical therapy focuses on identifying movements that reduce symptoms, improving strength and control of the spine and hips, gradually reintroducing activities you’ve been avoiding, and teaching you how to manage flare-ups confidently. The goal isn’t just pain relief. It's getting you back to living without fear of movement. Here at RTC, we can help you understand why it's happening and exactly what to do about it.

Please reach out if you have any questions or would like to book an appointment (call 757-578-2958 or email info@restorativetherapyco.com)

All the best,

RTC