Sciatica

A hot wire from the low back through the buttock and down one leg. Sitting makes it worse, standing doesn't fix it, and nobody sleeps well with it. Sciatica isn't a diagnosis — it's a symptom pattern, and the job is finding what's pressing on or irritating the nerve.

What’s actually going on

The sciatic nerve is the body's largest, formed from nerve roots that exit the lumbar spine. 'Sciatica' means those roots or the nerve itself are being irritated — commonly by a disc bulge, a narrowed passage (stenosis), joint inflammation, or a tight piriformis muscle imitating the same pattern. Which one it is changes what care should look like — which is why the exam matters more than the label.

Common causes we see

• Lumbar disc bulge or herniation pressing a nerve root
• Spinal stenosis — narrowing that crowds the nerves (often age-related)
• Facet or sacroiliac joint inflammation referring pain down the leg
• Piriformis syndrome — a deep hip muscle irritating the nerve directly
• Prolonged sitting on a wallet, long drives, sudden lifting twists

How we evaluate it

Straight-leg-raise and nerve tension tests, neurological screening (strength, reflexes, sensation by nerve level), hip and sacroiliac testing to separate spine causes from imitators, and red-flag screening. The goal is a working answer to one question: what, specifically, is irritating this nerve?

How chiropractic care may help

Depending on findings, care may include specific spinal adjustments, flexion-based positioning and traction, soft-tissue work for piriformis patterns, physiotherapy modalities for pain control, and progressive home exercises (nerve glides, McKenzie-style movements when they test well). Many sciatic episodes improve substantially with conservative care over several weeks; if yours doesn't follow that arc — or neurological signs progress — we say so and coordinate referral for imaging or a surgical opinion.

What to expect

Sciatica timelines are honest here: many patients feel movement within a few weeks, but nerve irritation can be stubborn. We track specific markers (how far the pain travels down the leg, strength, sleep) so progress is measured, not guessed.

Care-approach context: ACP low back pain guideline (2017); nerve-tension examination is standard orthopedic practice.