Once your friend is out of pain, s/he can then do some simple stretching exercises to improve the flexibility of the low back. There’s a great book called "3 Minutes to a Pain Free Life". I focus on the exercises from this book (pages 132 to 141) as they are simple to do and only take about 3 1/2 minutes to complete. They are the Bow, Arch, Lizard, Squat, Modified Split, and Sky Reach. If your friend has any experience with yoga, many of these exercises will be familiar (just different terminology).

So please encourage your friend to seek treatment as soon as possible. Life is too short and precious to spend it in pain. Once your friend is out of pain, s/he can use the stretching exercises twice a day to keep her/him out of pain.

Yours in Better Health,

Hiroyuki Nakamura
Licensed Acupuncturist
http://www.healthyonpurpose.com

If it is true sciatica…then something is pressing on the nerve roots near the base of the spine, most commonly a ruptured disc. This is usually identified on clinical exam, but a CT or MRI may be needed to confirm. The treatment is stretching, modified activity, painkillers. Some people may get relief from injection of cortisone into the spinal canal, and a very few will need surgery to take the pressure off the nerves

If it is pseudosciatica, (aka pyriformis syndrome) this is caused by a muscle in the buttock pressing/irritating the sciatic nerve itself. Again, a physical exam usually will be diagnostic. Stretching, deep massage/physio, anti-inflammatory painkillers again are helpful. It tends to be a self limiting condition, but it may go on for a few months.

As always in medicine, the proper treatment depends on a correct diagnosis in the first place.

Sciatica is an umbrella term.
If the cause of it is from a disc bulge the treatment program is longer and gentle core exercises may be indicated along with suitable treatment. Some manual therpists recommend Mckenzie exercises. From my observations of patients that try them they have largely been ineffective and i’ve found prescribing core exercises helps create stability around the spine and the disc bulge which seems to help take the pressure off the nerve root in cases where surgery isn’t indicated.
if the cause is from a facet lock pinching the nerve root then exercises to open up the facets and decompress the foramina in the spine may be indicated.
If it is from piriformis syndrome stretches into the buttock will probably help.

Another cause of shooting pain into the posterior thigh is sacro-illiac dysfunction which often gets confused with sciatica and is frequently missed (even by healthcare professionals who specialise in it).

all of these possibilities give very similar symptoms.
If the pain increases when bending backwards it is unlikely to be a disc bulge.
it it in creses when bending forwards it could be a disc bulge, sacro-illiac irritation or priformis syndrome.
If proding into your buttock is painful it could be SI irritation of piriformis syndrome.
Disc bulges tend to have clearer clinical signs such as increased pain on coughing, sneezing and defecation and dural stretch.
SI irritation almost never goes below the knee but can affect the back, side or front of the thigh.
Piriformis syndrome can shoot down all the way into the toes.
best to see a suitably trained professional who has good experience in diagnosing and treating this condition. I like the Non US steopthic model (but i am biased) but you could also see a chiro or physio.
If you are going to see a doctor see an Orthopaedic specialist first.
I wouldn’t bother as as Physio Chiro or Osteo will be able to assess you and refer you to one if you need to see one.