What Is Sciatica?
Sciatica describes symptoms caused by irritation of a nerve that travels from the lower back into the leg.
Sciatica isn't a diagnosis by itself. It's a term used to describe symptoms that occur when a nerve in the lower back becomes irritated or compressed.
Symptoms commonly travel from the low back or buttock into the thigh, calf, or foot and may include:
- Sharp, burning, or electric-like leg pain
- Numbness or tingling
- Pain that travels below the knee
- Weakness in the leg or foot
- Symptoms that worsen with certain positions or activities
Sciatica usually affects one side, although symptoms can occasionally occur on both sides.
Common causes include a lumbar disc herniation, narrowing around a spinal nerve (foraminal or spinal stenosis), and other changes that irritate a lumbar nerve root.
Not every pain that travels into the buttock or leg is true sciatica. Hip problems, muscle or joint pain, and other conditions can produce similar symptoms, which is why an appropriate examination matters.
What Causes Sciatica?
Several conditions can irritate or compress the nerves that travel from your lower back into your leg.
Sciatica can develop for different reasons. Identifying the likely cause helps determine which treatment options make the most sense.
Lumbar Disc Herniation
A bulging or herniated disc can irritate a nearby nerve root and cause pain, numbness, tingling, or weakness into the leg.
Spinal or Foraminal Stenosis
Narrowing of the spaces where the spinal nerves travel can contribute to nerve irritation, particularly when symptoms change with standing or walking.
Degenerative Changes
Age-related changes involving the discs and joints of the lumbar spine can sometimes reduce the space available around a nerve.
Spondylolisthesis
When one vertebra shifts relative to another, it can narrow the opening around a spinal nerve and contribute to radiating symptoms.
Finding one of these changes on an MRI doesn't automatically mean it is causing your symptoms. Disc bulges, degeneration, and other spinal changes can also be present in people who have no pain.
That's why we consider your symptoms, examination findings, neurological testing, and imaging when appropriate rather than treating an imaging finding by itself.
How Do We Evaluate Sciatica?
The location of your symptoms can help us determine which nerve may be involved.
Sciatica can look different from one person to another. Some people primarily experience leg pain, while others notice numbness, tingling, weakness, or a combination of symptoms.
Your evaluation may include:
- Strength testing to look for weakness associated with specific nerve roots
- Reflex testing when appropriate
- Sensation testing to identify areas of numbness or altered sensation
- Orthopedic and neurological testing
- Lumbar and hip movement assessment
- Reviewing which positions or activities make your symptoms better or worse
Together, these findings can help determine whether your symptoms are consistent with lumbar nerve irritation and which area may be involved.
What about X-rays or MRI?
Not everyone with sciatica needs imaging.
X-rays may be appropriate when we're concerned about certain structural changes, instability, trauma, or other findings. An MRI provides much more information about discs, spinal nerves, and other soft tissues when that information is clinically necessary.
If you already have an MRI or other imaging, bring it with you and we can review the findings in the context of your symptoms and examination.
We treat the patient—not simply an MRI or X-ray finding.
How Is Sciatica Treated?
Treatment is based on your symptoms, examination findings, and the likely cause of the nerve irritation.
There isn't one treatment that works for every case of sciatica. At Northwood Chiropractic & Wellness, your treatment plan is based on what we find during your evaluation and how your symptoms respond to care.
Depending on your condition, treatment may include:
Chiropractic Care
Adjustments or other manual techniques may be used to improve comfortable movement and help reduce symptoms when appropriate.
Rehabilitation & Movement
Specific exercises can help restore strength, improve movement, and gradually increase your tolerance for work, exercise, and everyday activities.
Spinal Decompression
For certain patients with disc-related or radiating symptoms, computerized spinal decompression may be considered as part of a conservative treatment plan.
Massage Therapy
Massage may be useful when muscle tension or soreness accompanies your back and leg symptoms.
Your treatment may change as you improve. The goal isn't to keep doing the same treatment indefinitely—it's to monitor your symptoms and function and progress your care based on how you're responding.
When Is Sciatica an Emergency?
Most sciatica can be managed conservatively, but certain symptoms require immediate medical evaluation.
Seek urgent medical care if back or leg symptoms are accompanied by:
- New loss of bladder or bowel control
- Numbness in the groin, inner thighs, or saddle area
- Severe or rapidly worsening weakness in one or both legs
- Difficulty walking because of significant neurological weakness
- Symptoms following significant trauma
- Back pain with fever or other signs of serious illness
These symptoms can occasionally indicate a more serious condition requiring prompt medical evaluation.
Even when symptoms aren't an emergency, progressive weakness, persistent numbness, worsening leg pain, or symptoms that aren't improving as expected may warrant additional evaluation or advanced imaging such as an MRI.
If your examination at Northwood identifies findings that aren't appropriate for chiropractic or conservative treatment, we'll recommend the appropriate next step or referral.
Knowing when not to treat is just as important as knowing when treatment may help.
Should You Stay Active With Sciatica?
In most cases, complete rest isn't the answer.
When leg pain is intense, it can be tempting to avoid movement altogether. While temporarily modifying painful activities may be appropriate, prolonged bed rest generally isn't the goal.
Instead, we typically want to find movements and activities you can tolerate and gradually build from there.
Depending on your symptoms, that may mean:
- Taking shorter, more frequent walks
- Changing positions throughout the day
- Temporarily reducing activities that significantly aggravate leg symptoms
- Gradually rebuilding strength and mobility
- Progressively returning to work, exercise, and recreational activities
Some discomfort during recovery doesn't necessarily mean you're causing additional damage. What's more important is how your symptoms respond over time, particularly whether leg pain, numbness, or weakness is improving or worsening.
The goal isn't simply to make today's pain disappear—it's to help you safely return to the activities you want to do.
Ready to Find Out What's Causing Your Sciatica?
If you're dealing with pain, numbness, tingling, or weakness that travels from your lower back into your leg, we'll start by determining what may be causing your symptoms.
Your first visit includes a consultation, comprehensive exam, X-rays if needed, and your first chiropractic adjustment when clinically appropriate—all for just $19.
We'll explain what we find and help you determine the appropriate next step.
Start Feeling Better for Just $19
New patients only. Additional treatment, including spinal decompression, rehabilitation, or massage therapy, is not included in the $19 visit.
