Sciatica Treatment in Winchester – Evidence Based Care for Leg Pain
Lower back pain radiating into the leg can be sciatica.
Is All Leg Pain Sciatica?
If you have pain that travels from your lower back into your buttock, thigh, or even down to your foot, chances are someone has told you:
“That sounds like sciatica.”
But is all leg pain actually sciatica?
The short answer is no — and this distinction matters far more than most people realise. Mislabelled leg pain often leads to the wrong treatment, ongoing symptoms, and frustration when things don’t improve.
At Winchester Spine Centre, we see people every week who have been living with leg pain for months or even years, often after being given a generic diagnosis and generic advice. Our approach is different. As a McGill Certified Provider, my assessments and treatment plans are grounded in the research of Professor Stuart McGill, one of the world’s leading experts in spine biomechanics and pain.
Let’s break this down properly.
What Is Sciatica — Really?
Sciatica is not a diagnosis in itself. It’s a description of symptoms.
True sciatica refers to pain caused by irritation or compression of the sciatic nerve, the largest nerve in the body. This nerve originates from several nerve roots in the lower spine and travels through the buttock, down the back of the leg, and into the foot.
Classic features of true sciatica include:
Pain radiating below the knee
Sharp, electric, or burning pain
Numbness or tingling in the leg or foot
Pain that worsens with certain spinal movements
Symptoms that follow a recognisable nerve pattern
However — and this is critical — not all leg pain follows this pattern, and not all nerve-related pain is true sciatica.
Sciatica Assessment in Winchester – Why Accurate Diagnosis Matters
In our role, providing spinal pain treatment in Winchester, we frequently see people who have tried multiple treatments for sciatica with little success. In most cases, the issue isn’t effort — it’s accuracy.
Professor Stuart McGill’s research consistently shows that treating the wrong pain mechanism leads to ongoing symptoms, even when the treatment itself is well delivered.
This is why our sciatica assessments at Winchester Spine Centre focus on:
Identifying the specific movement or load causing leg pain
Distinguishing true sciatica from referred pain
Determining whether the spine, hip, or nervous system is the primary driver
This approach allows us to create a clear, evidence-based plan, rather than relying on trial and error.
Common Causes of Leg Pain That Are Not Sciatica
One of Professor McGill’s most important contributions to clinical practice is the emphasis on precise assessment. His research repeatedly shows that treating “pain labels” instead of identifying the actual mechanical cause leads to poor outcomes.
Here are some common sources of leg pain that are often mistakenly called sciatica:
1. Referred Pain from the Spine
Structures in the lower back — discs, joints, ligaments — can refer pain into the buttock or thigh without nerve compression.
This pain:
Often stops above the knee
Feels deep, aching, or tight
Changes with posture or loading
Does not cause numbness or tingling
Treating this as sciatica with stretching or nerve-focused treatments often makes it worse.
2. Hip Joint Pain
Hip pathology can refer pain into:
The groin
The buttock
The thigh
Many patients we see in Winchester with leg pain are surprised to learn that what feels like “back and leg pain” is actually coming from the hip. McGill’s assessment framework places strong emphasis on differentiating hip pain from spine pain, because the management is completely different.
3. Piriformis-Related Symptoms
The piriformis muscle sits deep in the buttock, close to the sciatic nerve. In some cases, it can irritate the nerve locally.
However, McGill is very clear:
The piriformis is rarely the primary problem.
More often, it becomes overworked because the spine is unstable or moving poorly. Treating the piriformis without addressing spinal mechanics is a short-term fix at best.
4. Hamstring and Soft Tissue Injuries
True hamstring injuries and chronic tendon problems can mimic sciatica, especially during sitting or bending.
These cases require:
Load management
Progressive strengthening
Movement re-education
Not spinal manipulation or nerve flossing.
What Actually Causes True Sciatica?
When sciatica is present, it is usually due to mechanical irritation of a nerve root. Common causes include:
Disc bulges or herniations
Loss of spinal stability
Repeated poor loading patterns
Sustained flexion or twisting under load
Degenerative changes combined with poor movement strategies
Professor McGill’s research has shown that disc injuries are often not caused by one single event, but by repeated exposure to damaging movement patterns over time.
This is why simply “strengthening the core” or “stretching more” often fails — and sometimes makes symptoms worse.
Why Generic Sciatica Treatments Often Fail
Many people with leg pain are given advice such as:
“Stretch your hamstrings”
“Do more yoga or Pilates”
“Strengthen your core”
“Just keep moving”
While well-intentioned, this advice ignores a fundamental principle in McGill’s work:
The spine must first be protected before it is trained.
If a movement or exercise repeatedly triggers leg pain, continuing to load that movement is not rehabilitation — it’s irritation.
The McGill Approach to Sciatica and Leg Pain
At Winchester Spine Centre, our assessment process follows the principles taught by Professor Stuart McGill and used with elite athletes, military personnel, and complex pain patients worldwide.
Step 1: Identify the Pain Mechanism
We don’t start with scans.
We start with how your pain behaves.
Key questions include:
What movements make symptoms worse?
What positions reduce pain?
Does unloading the spine centralise symptoms?
Does repeated motion worsen or improve leg pain?
This allows us to identify whether the pain is:
Disc-related
Joint-driven
Stability-based
Load-sensitive
Nerve-dominant
Step 2: Remove the Pain Triggers
McGill’s research consistently shows that removing the mechanism that causes pain is essential before recovery can occur.
This may involve:
Modifying sitting posture
Changing how you bend or lift
Temporarily avoiding certain exercises
Adjusting work or daily habits
This is not about “rest forever” — it’s about strategic rest from the movements that are damaging you.
Step 3: Restore Spine Stability (The Right Way)
Once pain has settled, we introduce targeted stability exercises, not generic core workouts.
McGill’s “Big 3” exercises are often used:
Modified curl-up
Side plank
Bird dog
But the key is how and when they are used — dosage, form, and progression matter.
Poorly prescribed core work can increase spinal load and worsen symptoms.
Step 4: Gradual Reloading and Resilience
The final stage is rebuilding tolerance to the activities that matter to you:
Sitting
Walking
Lifting
Sports
Work demands
This phase is where many rehab plans fall apart. McGill’s approach emphasises:
Spine-sparing movement strategies
Progressive loading
Long-term resilience, not short-term pain relief
Do I Need a Scan for Sciatica?
Scans can be useful — but only in the right context.
Research, including McGill’s work, shows that:
Many people without pain have disc bulges
Imaging findings do not always match symptoms
Clinical assessment is often more predictive than MRI alone
We only recommend imaging when:
Symptoms are not behaving mechanically
There is worsening neurological loss
Progress stalls despite appropriate care
How Long Does Sciatica Take to Improve?
There is no single timeline.
Some people improve within weeks once the pain trigger is removed. Others with long-standing symptoms may require a longer, more structured approach.
What matters most is:
Correct diagnosis
Removing the cause
Gradual, intelligent progression
Quick fixes rarely last.
When Should You Seek Professional Help?
You should have your leg pain properly assessed if:
Pain is travelling below the knee
You have numbness, tingling, or weakness
Symptoms persist beyond a few weeks
Pain worsens with certain movements
Previous treatment hasn’t helped
Early, accurate assessment prevents chronic problems.
Sciatica Treatment in Winchester – Our Approach
At Winchester Spine Centre, we specialise in:
Accurate diagnosis of leg and back pain
Evidence-based care
McGill-informed assessment and rehabilitation
Clear explanations and practical plans
We don’t guess.
We assess, identify, and address the cause.
Final Thoughts: Is All Leg Pain Sciatica?
No — and assuming it is can delay recovery.
Leg pain is complex, and the spine is not something to experiment with. Professor Stuart McGill’s research has shown that precision matters, and that the right diagnosis leads to the right solution.
If you’re dealing with leg pain and want answers based on evidence — not assumptions — we’re here to help.
Written by Mark Kennedy BSc (Chiropractic), DC, CCEP
Chiropractor at Winchester Spine Centre
Mark Kennedy is a UK-registered chiropractor (General Chiropractic Council Reg; 00019) and a Certified McGill Method Practitioner with over 25 years of clinical experience treating back pain, neck pain, joint injuries, and chronic musculoskeletal conditions in Winchester.
This article is published by Winchester Spine Centre, a regulated chiropractic clinic based in Winchester, Hampshire.
Frequently Asked Questions About Sciatica Treatment in Winchester
Is all leg pain sciatica?
No. While sciatica refers to irritation of the sciatic nerve, many types of leg pain come from other sources such as the lower back joints, discs, hips, or soft tissues. In our Winchester clinic, a large number of patients who believe they have sciatica are actually dealing with referred pain rather than true nerve compression. Accurate assessment is essential to ensure the right treatment approach.
What are the most common causes of sciatica?
True sciatica is usually caused by mechanical irritation of a nerve root in the lower spine. Common causes include disc bulges or herniations, loss of spinal stability, and repeated poor loading patterns over time. Research by Professor Stuart McGill shows that these issues often develop gradually rather than from a single incident.
How is sciatica diagnosed?
Sciatica is diagnosed primarily through a detailed clinical assessment rather than imaging alone. At Winchester Spine Centre, we assess how your pain behaves with specific movements and positions, helping us identify whether the sciatic nerve is truly involved and what mechanical factors are driving your symptoms. Scans such as MRI may be recommended in specific situations, but they are not always necessary.
Should I stretch if I have sciatica?
Not always. Stretching can be helpful in some cases, but in others it may worsen symptoms, particularly if the nerve is already irritated. Professor Stuart McGill’s research highlights the importance of first removing the movements and loads that trigger pain before introducing exercise. This is why a personalised assessment is so important.
How long does sciatica take to improve?
Recovery time varies depending on the cause, severity, and how long symptoms have been present. Some people experience improvement within weeks once the pain trigger is identified and removed. Others with long-standing leg pain may require a longer, structured rehabilitation plan. The key factor is addressing the underlying cause rather than simply managing symptoms.
Can chiropractic treatment help sciatica?
Chiropractic care can help sciatica when it is guided by accurate diagnosis and evidence-based principles. At Winchester Spine Centre, our approach focuses on identifying the specific mechanical cause of leg pain and restoring spinal stability using McGill-informed methods, rather than applying the same treatment to every patient.
Do I need an MRI for sciatica?
Not necessarily. Many people without pain have disc bulges on MRI, while some people with significant symptoms show minimal changes on scans. Clinical assessment is often more informative than imaging alone. MRI may be recommended if symptoms are worsening, not behaving mechanically, or not improving as expected.
When should I seek professional help for leg pain?
You should seek assessment if leg pain persists for more than a few weeks, travels below the knee, is associated with numbness or weakness, or is not improving despite previous treatment. Early assessment can prevent acute issues from becoming long-term problems.
Is walking good for sciatica?
Walking can be helpful for many people with sciatica, particularly when it reduces symptoms or helps them feel looser. However, walking that increases leg pain or causes symptoms to spread further down the leg should be modified. We often use walking strategically as part of a graded recovery plan.
Looking for Sciatica Treatment in Winchester?
If you’re struggling with leg pain and want a clear, evidence-based explanation of what’s actually going on, our team at Winchester Spine Centre can help.
We specialise in:
Sciatica and nerve-related leg pain
Persistent lower back pain
Disc-related injuries
McGill Method assessment and rehabilitation
Our clinic has been helping people in Winchester recover from back and leg pain for over 25 years, with a focus on accurate diagnosis, honest advice, and long-term results. Book an appointment at Winchester Spine Centre.