Sciatica Explained: Causes, Symptoms, Treatment & Recovery Tips

Sciatica is a common condition, and it’s estimated that around 40% of people in NZ will experience sciatica at some point in their lives.

If you’re dealing with pain that shoots from your lower back into your buttock, leg, or calf, you may be experiencing sciatica. The good news is that most cases improve with the right, conservative approach.

In this blog post, we’ll cover:

• What sciatica is
• Common causes of sciatic nerve pain
• Symptoms to look out for
• How sciatica is diagnosed
• Treatment options and recovery strategies
• Tips to help prevent sciatica in the future

One of the most important things to understand is this: Sciatica is a symptom, not a diagnosis. That means the real goal is to identify what is irritating the nerve, and then treat the underlying cause.

What Is Sciatica?

Sciatica refers to pain that travels along the path of the sciatic nerve. This pain typically starts in the lower back or buttock and radiates down the leg.

The sciatic nerve is the largest and longest nerve in the body. It forms from nerve roots in the lower spine and pelvis (commonly involving the L4, L5, S1, S2 and S3 nerve roots). These nerves join together and travel through the pelvis and down the back of the thigh.  Just after the knee, the sciatic nerve branches into two major nerves:

• The Tibial nerve (travels down the back of the lower leg into the foot)
• The Common fibular/Peroneal nerve (travels down the outer/front part of the lower leg)

​Depending on where and how the nerve is irritated, sciatica may also involve:

• Weakness in the leg or foot
• Numbness or tingling
• Altered deep tendon reflexes 
• Pins and needles 

What Causes Sciatica?

Sciatica occurs when the sciatic nerve itself (or its nerve roots) becomes irritated, compressed, or inflamed.  The irritation most commonly occurs in the lower lumbar spine, but it can also occur in the pelvic or hip region.
​
Common causes of sciatica include:

• Disc Bulge or Disc Herniation
  • This is one of the most common causes. A disc bulge or disc herniation (often at L4-L5 or L5-S1) can press on or irritate a nerve root, leading to sciatica symptoms.
  • Related Blog Post: What is a disc bulge? Causes, anatomy, and symptoms (part 1)
  • ​Related Blog Post: Disc bulge treatment: Diagnosis, recovery options and what you can do at home (part 2)
• Joint Dysfunction or Arthritic Changes
  • Degenerative changes in the spine, such as osteoarthritis, can narrow the spaces where nerves exit, irritating the nerve roots and leading to possible sciatica symptoms.
• Muscle Spasm or Piriformis Syndrome
  • In some cases, tight muscles in the pelvis, especially the piriformis muscle, can irritate the sciatic nerve (see section on Piriformis Syndrome below).
• Other Less Common Causes may include:
  • Pelvic or spinal fractures
  • Pregnancy-related changes. Sometimes during pregnancy, the baby can compress nerves in the lower lumbar spine (My wife suffered from this during her pregnancy)
  • Spinal instability
  • Tumours
  • Inflammation or infection (rare)

Sciatica is more common in people aged 30–50, and tends to occur more often in people who sit for long periods or do manual work involving lifting and bending.

Symptoms of Sciatica

The most common symptom of sciatica is pain that starts in the lower back or buttock and travels down the leg.
Sciatica pain may be felt in:

• The buttock
• The back of the thigh
• The calf or shin area
• The ankle or foot

In some cases, you may have little or no lower back pain at all, and the discomfort is mostly in the leg.
Depending on how the where and how the nerve is irritated, sciatica could also cause:

• Numbness or tingling (pins and needles) in the leg or foot
• Burning or electric-shock type pain
• Weakness in the leg or foot
• Changes in reflexes in the legs

Symptoms may worsen with:

• Prolonged sitting
• Bending forward
• Lifting
• Twisting
• Coughing or sneezing
• Straining or bearing down

If you’re seeking help for sciatica, it can be very useful to take note of things like:

• Where the pain travels to in the leg?
• What makes it worse?
• What positions relieve it?
• How it started?

These details can help a health professional identify the underlying cause of your sciatica more accurately.

How Is Sciatica Diagnosed?

​Because sciatica is a symptom, diagnosis is about identifying what is causing the nerve irritation. A proper assessment usually begins with a detailed history, including questions such as:

• When did it start?
• What triggers it?
• Does it travel below the knee?
• Is there numbness or weakness?
• What positions help it or aggravate it?
• Are there any changes in bowel or bladder control?

From there, a physical assessment may include:

• Range of motion assessment
• Neurological testing (reflexes, sensation, strength)
• Orthopaedic tests
• Joint function testing of the lumbar spine and pelvis

Do You Need a Scan?
In some cases, imaging may be recommended. The most common options are X-rays and MRI.

• X-rays show bones and joint structure, but do not show spinal discs.
• MRI scans are the best imaging method for confirming a disc bulge or disc herniation.

NOTE: Just because a scan shows a disc bulge does not automatically mean it is the cause of your pain.  Disc bulges are extremely common even in people with no symptoms. Imaging should always be interpreted alongside a thorough clinical examination.

How Do You Treat Sciatica?

​Treatment for sciatica depends on the cause of the sciatic nerve irritation and how severe the symptoms are.  At Elevate Chiropractic, we aim to approach sciatica from multiple angles.

• Restore Joint and Nervous System Function
  • Chiropractic adjustments can help improve spinal joint function and mobility, reduce irritation, and support nervous system function.
• Manage Pain and Reduce Aggravation
  • In the acute stage, the priority is often reducing pain and inflammation and avoiding positions that repeatedly irritate the nerve.
  • This may include:
    • Heat or ice therapy (see video linked below)
    • Gentle movement strategies
    • Specific resting positions such as the static back position (see related blog posts below)
    • Self-massage or soft tissue techniques
    • Advice around sitting, standing, and getting out of bed without pain
  • Related: How to sit with an L4/L5 or L5/S1 disc bulge
  • Related: 4 ways to speed up recovery from your L4/L5 or L5/S1 disc bulge​

• Modify Daily Activities
  • Many people with sciatica can aggravate the nerve without realizing it.  Simple modifications to daily activities can make a big difference. These can include:
    • Changing sitting posture regularly
    • Avoiding prolonged slouched sitting
    • Improving lifting techniques
    • Reducing bending and twisting under load
    • Looking at how you get in/out of chairs or bed
    • The video linked below will show a few things you can try

• Strengthen and Rebuild Resilience
  • Once symptoms begin to settle, the focus shifts to long-term recovery.  This may include:
    • Core stability exercises
    • Back strengthening
    • Learning healthy movement habits like the hip hinge (see linked video below)
    • gradual return to normal movement and activity

Chiropractic care often works very well alongside other supportive therapies such as physiotherapy, massage therapy, and acupuncture.

When Conservative Care Isn’t Enough
In some cases, further investigation or medical treatment may be needed. Severe nerve compression or progressive neurological symptoms may require specialist care.

Piriformis Syndrome (A Common Sciatica Look-Alike)

Piriformis syndrome occurs when the piriformis muscle (a deep muscle in the buttock) becomes tight or irritated and compresses the sciatic nerve. In most cases the sciatic nerve runs close to this muscle and if it is in spasm, it can irritate the nerve. In rare cases, the sciatic nerve has been found to actually run through the middle of this muscle.

A common pattern with piriformis-related sciatica is:

• Pain mainly in the buttock and back of the thigh
• The symptoms in the back of thigh usually do not go past the knee
• There are fewer neurological signs. You often don’t get the numbness, weakness or reflex changes that can be seen with traditional sciatica

​That said, not everyone’s body has read the textbook though, and there are always exceptions to the rule. A proper assessment is still important to determine the true cause of your discomfort.

Can Sciatica Be Prevented?

Sciatica cannot always be prevented, but you can reduce your risk by improving the health and resilience of your spine and movement habits.  Helpful strategies include:

• Maintaining good spinal mobility
• Building a strong core and glutes
• Practicing good lifting techniques (and make sure you don’t get distracted when lifting as this could increase the risk of injury by up to 25x)
• Reducing prolonged sitting
• Improving posture and movement patterns (like the hip hinge mentioned above)
• Keeping active with regular walking and strength work

Sciatica Red Flags

​If you experience sciatica alongside:

• Loss of bowel or bladder control
• Numbness in the saddle region
• Progressive weakness in the leg

This may be a medical emergency and requires urgent medical attention.

Need Help with Sciatica?

Sciatica can be painful, frustrating, and at times debilitating, especially when it affects your ability to sit, sleep, work, or exercise.

The most important thing to remember is that sciatica is a symptom, not a diagnosis. The key to long-term relief is identifying what is irritating the nerve and creating a clear plan to reduce irritation, restore movement, and rebuild strength.

At Elevate Chiropractic we assess the spine, pelvis, and nervous system to determine the likely cause of your sciatica and guide you through the right treatment and recovery approach. This includes:

• Thorough assessment and diagnosis
• Chiropractic care to improve spinal function
• Simple things you can do at home to help manage symptoms
• Advice on sitting, lifting, and daily movements
• Rehab exercises to help prevent flare-ups

​If you’d like help with your sciatica, you can book online by clicking on the button below, or feel free to contact the clinic with any questions here.

Book online now

Common Sciatica FAQs

Can sciatica heal on its own?

Yes, in many cases sciatica can improve on its own over time, especially if the irritation is mild and you avoid aggravating movements. However, if symptoms are severe, worsening, or lasting more than a few weeks, it’s a good idea to have it assessed by your health professional so the underlying cause can be identified and treated appropriately.

Is walking good for sciatica?

Walking is often one of the best activities for sciatica because it promotes circulation, gentle spinal movement, and helps reduce stiffness. That said, walking should not increase symptoms, and if it does, stop and have it assessed. Short, frequent walks are often better than long walks during the acute stage. You also may note that walking uphill or downhill may aggravate the symptoms depending on where the nerve irritation is.

Should I rest or keep moving with sciatica?

In most cases, a balanced approach is best. Complete bed rest is rarely helpful long-term. Gentle movement (like walking) can support recovery, but it’s important to avoid positions and activities that aggravate symptoms. The goal is to stay active without repeatedly irritating the nerve.

What positions make sciatica worse?

Sciatica is often aggravated by positions that increase pressure on the nerve. This will depend on where the nerve is irritated, but common culprits are:

• Prolonged sitting (especially slouching)
• Bending forward repeatedly
• Twisting under load
• Lifting with poor technique (Or being distracted whilst lifting)
• Coughing or sneezing can also increase symptoms in some cases, particularly if a disc bulge is involved.

What is the fastest way to relieve sciatica pain?

There is no single “fastest” solution, because sciatica is a symptom and the cause varies. However, many people find relief by:

• Avoiding aggravating positions (especially slouched sitting), Sitting in an up right chair is often better than a couch
• Using heat or ice appropriately
• Using restful positions like the Static Back position. This blog post linked below shows how to do this
• Gentle walking
• Gentle movements like the Yoga exercise “The cat/cow”, or our circle exercises (see blog post linked below)
• Receiving appropriate manual therapy or chiropractic care
• In some cases, pain medication may also be warranted

​If pain is severe, medical pain relief may be needed to help calm symptoms so healing can begin.

Blog Post: Lower back pain relief: Try these 4 simple moves

Can a disc bulge cause sciatica?

Yes. A disc bulge or disc herniation in the lower back (commonly at L4-L5 or L5-S1) is one of the most common causes of sciatica. If the disc irritates or compresses a nerve root, it can cause pain, tingling, numbness, or weakness down the leg.

How do I know if my sciatica is serious?

Sciatica may be serious if it is associated with:

• Significant or worsening weakness in the leg or foot
• Numbness around the groin or saddle area
• Loss of bowel or bladder control

​These symptoms may indicate a medical emergency and require urgent medical attention.

How long does sciatica usually last?

Sciatica can last anywhere from a few days to several weeks depending on the cause. Many cases improve within 4–6 weeks, especially with appropriate treatment and movement modifications. If symptoms persist longer than this, further assessment and investigation may be needed.

What exercises are best for sciatica?

The best exercises depend on what is causing the sciatica. In many cases, gentle walking, core stability exercises, glute strengthening, and mobility work can be helpful. However, some stretches and exercises can make symptoms worse if the nerve is irritated. It’s best to be assessed and given exercises specific to your condition.

Can stretching make sciatica worse?

Yes, stretching can sometimes worsen sciatica, especially aggressive hamstring stretching or deep forward bending. If the sciatic nerve is irritated, stretching may increase tension on the nerve and aggravate your symptoms. If stretching increases leg pain, tingling, or numbness, it may not be appropriate at that stage.  Stop and seek medical advice.

Can chiropractic help sciatica?

Chiropractic care may help cases of sciatica by improving spinal joint function, reducing irritation, restoring movement, and supporting the nervous system. Chiropractic treatment is often combined with movement advice and rehabilitation exercises to help improve long-term recovery and reduce the risk of recurrence.