Lumbar Radiculopathy
Sciatica
Protection → Controlled Motion → Return to Function
What Sciatica Is
Sciatica is pain — often with numbness, tingling, or weakness — that travels from your low back or buttock down the leg, usually because a nerve root in the lower back is being irritated or compressed. The most important idea in recovery is centralization: finding the movements that pull the pain OUT of your leg and back toward your spine, and avoiding the ones that send it further down.
- Primary — Nerve-root pain — back or buttock pain that radiates down the leg, sometimes with numbness or tingling, that changes with position and movement. This protocol is for it.
- Secondary — Progressive or severe — significant or worsening leg weakness, or any bowel/bladder changes, are red flags that need urgent assessment, not exercise.
Involved tissues: A lower lumbar nerve root (often from a disc or a narrowed space) and the sciatic nerve it feeds, plus the low-back structures around it and the deep stabilizers that protect them.
Two pillars for sciatica: first, centralize — find your directional preference (the movement that pulls symptoms out of the leg toward the spine) and use it, while avoiding the direction that peripheralizes them; second, keep the nerve gliding and build deep-core control, then gradually reload. Get the symptoms out of the leg, then rebuild.
Centralize — get it out of the leg
The single most useful sign in sciatica is which way your symptoms move. When a movement or position pulls the pain OUT of your leg and toward your spine ('centralizing'), that's the direction to favor — it means the nerve is being decompressed. When symptoms travel FURTHER down the leg ('peripheralizing'), that direction is aggravating the nerve, so you avoid it for now. Alongside that, gentle nerve gliding keeps the sciatic nerve moving freely, and deep-core control protects the segment. As the leg symptoms retreat, you rebuild strength and load. Watch the leg, chase centralization, and protect the nerve.
⚠️ Screen Before You Start — Get Assessed First If You Have:
- ●Numbness in the saddle/groin area, or changes in bowel or bladder control — emergency, get seen now
- ●Progressive or significant weakness in the leg or foot (foot drop, the leg giving way)
- ●Symptoms in BOTH legs, or numbness that keeps spreading
- ●Fever, unexplained weight loss, or feeling unwell with the pain
- ●Severe unrelenting pain not eased by any position, or after major trauma
This is education, not a diagnosis, and doesn't replace hands-on care.
🌡️ Finding your stage
Take your movement temperature, watching the leg: strong leg symptoms, easily provoked = Protection. Symptoms centralizing toward the spine = Controlled Motion. Mostly back-based and ready to load = Return to Function. The golden sign you're on track: pain retreating out of the leg toward your spine. Re-check every session.
Phase 1 · Acute
Protection Phase
🌡️ Strong leg symptoms · easily provoked
Goal: Calm the nerve, find the direction that centralizes symptoms, and stay gently active.
Manual treatment: Pain-relief modalities and gentle motion in the centralizing direction.
Frequency: Little and often.
A. Calm & Find Directional Preference
SoftWave Therapy
Video coming soon- Dose
- As scheduled
- How
- Applied to the low back to calm the irritated tissue and nerve.
- Watch for
- The anchor of the early phase.
Directional Preference (centralizing)
Video coming soon- Dose
- Gentle sets · often
- How
- Find the movement that pulls symptoms out of the leg toward the spine — often gentle extension/press-ups, sometimes flexion — and repeat it gently.
- Watch for
- Centralizing (pain retreating up the leg) = do more. Peripheralizing (pain moving down) = stop, try the other direction.
Stay Gently Active
Video coming soon- Dose
- Ongoing
- How
- Keep moving within comfort and avoid prolonged sitting and the provoking positions — not bed rest.
- Watch for
- Bed rest slows recovery. Move gently and often.
B. Gentle Nerve & Core
Sciatic Nerve Glides
Video coming soon- Dose
- 1–2 × 5–10 gentle
- How
- Gentle sequences that slide the sciatic nerve without flaring symptoms.
- Watch for
- Gentle — must NOT increase the leg symptoms.
Gentle Core Draw-In
Video coming soon- Dose
- 10 × 5 sec
- How
- Gentle transversus abdominis activation.
- Watch for
- Low effort — start protecting the segment.
Watch the leg — favor what pulls symptoms toward the spine; avoid what sends them down. Nerve glides gentle, never into a flare. Stay active, not bedbound.
✅ Ready for the next phase when:
Leg symptoms are centralizing and the sharp pain is settling.
Tracking Your Progress
The weekly stability check: am I better, the same, or worse than last week?
Better
Stay the course; progress load as leg symptoms retreat and stay centralized.
Same
Change the direction, dose, or drill; re-check your directional preference.
Worse
Drop back a phase; if symptoms peripheralize or any red flags appear, get seen.
The Rules That Govern This Protocol
- 1Centralize — favor what pulls symptoms out of the leg; avoid what sends them down.
- 2Keep the nerve gliding gently and the deep core protecting the segment.
- 3Rebuild load and endurance gradually as leg symptoms retreat.
- 4No lasting increase in pain — and watch for centralizing, not spreading — after a session.
Movement You Love Is Therapy. This protocol is general education based on course rehabilitation materials and standard principles. It is not medical advice, diagnosis, or treatment, and does not create a provider–patient relationship. If pain is severe, worsening, or unexplained, see a licensed provider.