Sciatica is pain that travels from the lower back or buttock down the back of the leg, often with tingling or numbness. It can make a flight into Nice, a drive along the coast or a night in a hotel bed miserable. Most sciatica settles over weeks, and as an osteopath I can ease the back and hip component, take mechanical pressure off the irritated nerve, and help you keep moving while it does.
I am Aloïs Ruetsch, an English-speaking osteopath and manual therapist in Nice, with 15 years of practice and more than 10,000 consultations. If you see a chiropractor or a manual therapist back home, a French osteopath is the closest equivalent.
Here is what sciatica is, what I can and cannot do, and the signs that need a doctor.
The essentials
- Sciatica is a symptom, usually caused by a bulging disc or a narrowed space irritating a nerve root in the lower back.
- Most cases improve within a few weeks to a few months; staying active beats bed rest.
- Manual therapy is recommended as part of a package with exercise and advice (NICE NG59); it eases the mechanical load but cannot shrink a disc.
- Expect two to four sessions over a few weeks, with a frank reassessment if you are not improving.
- Numbness in the saddle area, bladder or bowel changes, or weakness in both legs are emergencies. In France, dial 15 or 112.
What causes sciatica?
Sciatica is usually caused by a disc in the lower back bulging and pressing on, or chemically irritating, one of the nerve roots that join to form the sciatic nerve. The nerve runs from the lower spine through the buttock and down the back of the leg, which is why a problem in the back is felt in the thigh, calf or foot. Less often the space around the nerve is narrowed by wear and tear (spinal stenosis), which tends to affect older walkers on the hills above Nice and eases when they sit or lean forward.
Not every leg pain is sciatica. A tight piriformis muscle in the buttock, a hip joint problem, a hamstring strain or a sacroiliac joint can all mimic it. Part of my job is to work out which you have, because the treatment differs.
What does an osteopath actually do for sciatica?
I examine your back, hips and legs to confirm the pain is coming from a nerve and to check that it is safe to treat. That includes testing strength, reflexes and sensation in your legs. If anything concerns me, I send you to a doctor first.
Treatment is gentle, because an irritated nerve does not like being pushed. I use soft-tissue work on the buttock and hip muscles, careful mobilisation of the lumbar spine and pelvis, positions that open the space around the nerve, and gentle nerve-gliding movements so the sciatic nerve slides more freely. Muscle energy techniques help where a stiff hip is adding to the load. A short-lever manipulation is possible in some cases, with your consent, but rarely my first choice when the nerve is acutely irritated. You leave with advice on sitting, sleeping and walking.
Does osteopathy work for sciatica?
Manual therapy can help with sciatica, but the evidence is more modest than for plain low back pain, and time does much of the work. The UK guideline for low back pain and sciatica (NICE NG59) recommends considering manual therapy as part of a package with exercise and advice. It does not support hands-on treatment alone, traction, or belts and corsets.
Osteopathy can reduce the back and hip stiffness that adds to nerve irritation, ease muscle guarding, and keep you moving while the disc settles. It cannot shrink a disc bulge or set the speed of recovery. Most disc-related sciatica improves over weeks to months whatever you do; manual therapy makes that period more comfortable and helps you avoid the habits that prolong it. Osteopaths in France do not make medical diagnoses, so scans, prescriptions or injections go through your doctor.
How many sessions will I need?
Sciatica usually takes two to four sessions spread over a few weeks, a little more than simple back pain. The first session is about calming things down and finding the positions and movements that ease your leg. Follow-ups are spaced further apart as you improve, each with a check that your strength and sensation are stable.
If the leg pain is not changing after three or four sessions, or if numbness or weakness appears or spreads, I stop and refer you to a médecin généraliste for imaging and a medical opinion. Sciatica that has lasted many months can still respond, but progress is slower and depends on what you do between sessions.
What can I do myself in the meantime?
Keep moving in short bouts, because long sitting is what most people with sciatica tolerate worst. Walk along the Promenade des Anglais for ten or fifteen minutes several times a day rather than once for an hour. Change position every half hour at a desk, and stand up and stretch on long drives or flights.
Find your position of ease and use it. Many people are most comfortable on their back with the knees bent over a pillow, or on their side with a pillow between the knees. Heat on the lower back and buttock can relax the muscles. Pharmacists in Nice can advise on over-the-counter pain relief. Avoid heavy lifting, deep bending first thing in the morning, and intense sport until the leg pain is clearly easing, then build back gradually.
When should you see a doctor instead?
See a doctor immediately if you have numbness in the saddle area (between the legs and around the back passage), new difficulty passing or holding urine, loss of bowel control, sciatica in both legs at once, or weakness in a foot or leg that is getting worse. These can be signs of cauda equina syndrome, which needs emergency treatment. In France, dial 15 (SAMU) or 112, or go to the nearest emergency department (urgences).
Also see a doctor soon if the pain follows a major fall or accident, if you have fever, unexplained weight loss or a history of cancer, if the pain is severe at night and unrelieved by any position, or if sciatica persists for several weeks without improvement. A médecin généraliste or SOS Médecins can see you without a referral, and I work alongside them.
Osteopath, chiropractor or physio: who should I see in Nice?
For sciatica without warning signs, an osteopath is a sensible first stop in Nice, because no referral is needed, you can often be seen the same day, and the profession is the French equivalent of a chiropractor. Osteopaths and chiropractors are very similar hands-on professions. The French osteopathy degree is five years and state-recognised, and chiropractors are far fewer here.
A physiotherapist (kinésithérapeute) is the right person for a structured rehabilitation programme, usually on a doctor’s prescription. Your médecin généraliste handles diagnosis, prescriptions and scans, and refers you to a specialist if an injection or surgery is discussed. Pharmacies are a good first stop for pain relief advice, SOS Médecins visits you at home, and 15 or 112 are for emergencies. Osteopathy complements all of this; it does not replace medical care.
How do I see an English-speaking osteopath in Nice?
Message me on WhatsApp at +33 7 71 27 24 25, or book online via Doctolib. My clinic, Pôle Ostéo, is at 22 rue Gounod in central Nice, in the Musicians’ quarter. Sessions last about 45 minutes and cost €90 at the clinic. I am open seven days a week, often with same-day availability.
Sciatica can make a taxi ride unbearable, so I also treat patients at their hotel, villa, apartment or yacht at berth in Nice and along the nearby French Riviera coast for €120, with no surcharge for evenings, weekends or same-day visits. I accept card or cash and provide a receipt for your insurance, in English on request. No referral is needed in France to see an osteopath or manual therapist.
In practice
Illustrative example, details changed. A remote worker from Canada, settled in Nice for the winter, came in with three weeks of pain from the right buttock to the calf, worst after long hours at a kitchen table. Her leg strength and reflexes were normal and there were no warning signs. Treatment focused on gentle mobilisation of the lower back and pelvis, soft-tissue work on the hip muscles and nerve-gliding movements, with firm advice on breaking up her sitting. Over three sessions in four weeks the leg pain retreated towards the buttock and then faded, and she set up a standing desk to keep it that way.
Frequently asked questions
Is an osteopath the same as a chiropractor?
Can osteopathy make sciatica worse?
Do I need an MRI first?
Is sciatica the same as a slipped disc?
Can I fly with sciatica?
Book an English-speaking osteopath in Nice
Clinic at 22 rue Gounod (€90) or a visit to your hotel, villa, yacht or home in Nice (€120, no surcharge). Seven days a week, often same day. Write in English, Spanish or French.