What is sciatica?

The sciatic nerve is the largest nerve in the body. It forms from nerve roots in the low back, passes through the buttock beneath the piriformis muscle, and runs down the back of the leg into the foot. “Sciatica” describes the symptoms when that nerve or one of its roots is irritated or compressed. It is a symptom, so finding the cause is the key to treating it.

Common causes

  • A lumbar disc bulge or herniation pressing on a nerve root
  • Muscular encroachment or impingement of the nerve, for example a tight piriformis or gluteal muscle (often called piriformis syndrome)
  • Stiff or irritated joints in the low back or the sacroiliac (SI) joint
  • Narrowing of the spaces where nerves exit the spine (stenosis), more common after age 50
  • Prolonged sitting, especially on a wallet or a hard seat

Common symptoms

  • Pain from the buttock down the back or side of the leg, usually on one side
  • Burning, electric or shooting pain, sometimes into the foot
  • Numbness or tingling in the leg, foot or toes
  • Pain that is worse with sitting, bending, coughing or sneezing
  • Weakness in the leg or foot, or a feeling the leg might give way

How we help

We examine both your spine and the muscles of your hip and buttock, because the treatment depends on where the nerve is being irritated. Your plan may include:

Chiropractic adjustmentsRestores motion in the low back, pelvis and SI joints to reduce pressure on the nerve.Spinal decompressionGentle, intermittent traction when a disc is pressing on a nerve root.High-intensity laserNon-invasive light therapy to calm nerve pain and inflammation.Therapeutic massage and ARTReleases a tight piriformis and gluteal muscles that compress the nerve.Shockwave therapyEases deep muscle tension and trigger points in the hip and buttock.Corrective exerciseNerve-gliding, core and hip exercises so symptoms settle and stay away.HIFEM + RF gluteal and core strengtheningRebuilds glute and core strength that supports the low back and pelvis.

What to expect

Your first visit includes neurological testing of reflexes, strength and sensation, plus tests that tell disc-related sciatica apart from muscle-related nerve impingement. Early care focuses on calming the nerve and finding positions that ease leg pain. As symptoms move up out of the leg, a good sign, we shift to strength and movement. We re-check your exam often and refer to a spine specialist if symptoms are not improving or are getting worse.

What you can do at home

  • Keep walking in short bouts; avoid long periods of bed rest.
  • Avoid sitting on a wallet, and get up every 30 minutes when sitting.
  • Use the positions and stretches we show you; stop any that send pain further down the leg.
  • Apply heat to the buttock and low back for muscle tension.

Related reading: herniated and bulging discs and lumbar disc displacement disorders.

When to get help right away

Seek emergency care for loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly increasing weakness in one or both legs.

Common questions

Can a chiropractor help sciatica?

Yes, for many people. Chiropractic care, decompression, laser and soft-tissue work are conservative options that can reduce pressure and irritation on the sciatic nerve, depending on the cause.

How do I know if my sciatica is from a disc or a tight muscle?

The exam tells us. Disc-related sciatica often worsens with sitting, bending and coughing and may affect reflexes. Muscle-related impingement often hurts with sitting on the buttock and hip movements.

How long does sciatica last?

Many cases improve over several weeks to a few months with conservative care. Leg pain usually eases before numbness does.

Should I stretch my piriformis?

Gentle stretching helps when a tight piriformis is involved, but the wrong stretch can aggravate a disc. We will show you which stretches suit your type of sciatica.

When is surgery needed for sciatica?

Surgery is considered for severe or progressive weakness, loss of bladder or bowel control, or pain that does not improve after a good trial of conservative care.

This page is general health information, not a diagnosis. Every patient starts with a history and examination, and we refer to other specialists when a condition falls outside chiropractic care.