Condition We Treat

Sciatica

Shooting pain that travels down the leg from the lower back.

Medically reviewed by Dr. Jason Bang, DC, FNP

|Last updated: April 2, 2026

Understanding Sciatica

Sciatica is not a diagnosis in itself — it's a description of symptoms produced when the sciatic nerve, the longest and largest nerve in the human body, is compressed or irritated somewhere along its path from the lower spine through the buttock and down the leg. The burning, shooting, or electric pain that travels from the lower back into the leg is one of the most recognizable and disabling pain patterns in musculoskeletal medicine.

What makes sciatica particularly difficult to manage with conventional approaches is that the pain location — the leg — is not the source of the problem. Anti-inflammatory medications and steroid injections may quiet symptoms temporarily, but unless the compression at the nerve root is relieved, the underlying problem remains and symptoms reliably return.

At Chiropractic Unlimited, we specialize in identifying the exact site and mechanism of sciatic nerve compression. Whether the cause is a herniated lumbar disc, spinal stenosis, sacroiliac joint dysfunction, or piriformis syndrome — each requires a distinctly different treatment approach. Dr. Bang's comprehensive clinical evaluation determines the precise cause of your sciatica before treatment begins, ensuring the approach is targeted and effective rather than generic.

Root Causes

What Causes Sciatica?

The sciatic nerve is formed from several nerve roots that exit the lumbar spine and merge in the pelvis before traveling down the back of the thigh. Compression or irritation at any point along this path can produce sciatic symptoms. The most common causes we evaluate and treat include:

Lumbar Disc Herniation: When an intervertebral disc in the lower back — most commonly at L4-L5 or L5-S1 — bulges or herniates, it can press directly against the nerve root that forms part of the sciatic nerve. This produces characteristic radiating pain that travels down the back of the leg, often to the calf or foot, along with potential numbness and weakness.

Spinal Stenosis: Narrowing of the spinal canal or the nerve root channels due to degenerative changes, bone spurs, or thickened ligaments can compress sciatic nerve roots. This type of sciatica often worsens with standing or walking and is more common in patients over 50.

Sacroiliac Joint Dysfunction: Misalignment or inflammation of the sacroiliac joint — which connects the spine to the pelvis — can directly compress or irritate the sciatic nerve as it exits the pelvis. SI joint sciatica is frequently misdiagnosed as disc herniation.

Piriformis Syndrome: The piriformis muscle sits deep in the buttock, directly above the sciatic nerve. When this muscle becomes tight or goes into spasm — often from prolonged sitting, overuse, or hip imbalance — it can compress the sciatic nerve, producing buttock and leg pain that mimics disc-related sciatica.

Lumbar Misalignment: Even without disc herniation, vertebral misalignment in the lower spine can narrow nerve root channels and create chronic mechanical irritation of the sciatic nerve roots.

Recognize the Signs

Common Symptoms

Shooting pain down the leg

Burning or tingling sensation

Numbness in the foot or toes

Lower back tightness

Leg weakness

Pain worsening when sitting

Take Action

When to See a Chiropractor

Sciatica that goes untreated tends to worsen, not improve. Prolonged nerve compression can lead to chronic changes in nerve function — including persistent numbness, muscle weakness, and reduced reflexes — that become increasingly difficult to reverse the longer they are left unaddressed.

You should seek evaluation promptly if you have pain that radiates from your lower back into your buttock or leg, if you're experiencing numbness or tingling in your lower extremity, or if you notice any weakness in your leg or foot. Sciatica that worsens with sitting, improves slightly with walking, or that disturbs your sleep is a sign of significant nerve root compression that requires prompt clinical attention.

If you experience sudden, severe sciatica with loss of bowel or bladder function, this is a medical emergency requiring immediate emergency room care. For all other presentations, Dr. Bang's approach offers a highly effective, non-surgical path to recovery. Early intervention significantly improves outcomes and reduces the risk of transitioning from acute to chronic sciatica.

How We Help

Our Treatment Approach

Effective sciatica treatment requires precise identification of where and why the sciatic nerve is being compressed — and our approach is built on exactly that diagnostic foundation. Before treatment begins, Dr. Bang performs a thorough evaluation including orthopedic nerve tension tests, lumbar and sacral assessment, and a detailed history to determine whether the source of compression is discal, articular, muscular, or some combination. For disc-related sciatica, the primary treatment is spinal decompression combined with lumbar adjustment. Spinal decompression creates gentle traction in the lumbar spine that reduces intradiscal pressure, encourages herniated disc material to retract, and facilitates the rehydration and healing of damaged disc tissue. For sacroiliac joint dysfunction, we use specific SI joint mobilization techniques to restore proper pelvic alignment and reduce the joint irritation that is compressing the sciatic nerve. Many patients with SI-driven sciatica respond very quickly to this targeted approach — often experiencing dramatic relief within the first few visits. For piriformis syndrome, treatment focuses on soft tissue release of the piriformis muscle combined with hip and sacral correction to address the underlying biomechanical cause. All sciatica patients also receive a rehabilitative exercise component — specific movements designed to decompress the lumbar spine and maintain the corrections achieved through treatment. Dr. Bang's FNP background adds a critical clinical layer: the ability to identify when sciatica has inflammatory or systemic contributions that require co-management beyond structural chiropractic care. For patients currently managing sciatica pain with medication, the 2025 research on chiropractic vs medication for pain shows that chiropractic care can significantly reduce or eliminate the need for opioids.

Got Questions?

Frequently Asked Questions

How do I know if it's sciatica or just back pain?

The defining feature of sciatica is pain that travels from the lower back or buttock into the leg — typically following the path of the sciatic nerve down the back of the thigh, into the calf, and sometimes to the foot. Numbness, tingling, or weakness in the leg are additional signs of nerve involvement. Pure back pain, without leg symptoms, is more likely a local structural problem rather than sciatic nerve compression. Dr. Bang's evaluation can precisely distinguish between these presentations.

Can sciatica go away on its own?

Mild sciatica from minor disc irritation may resolve with rest, but the structural issue driving it — misalignment, disc herniation, SI dysfunction — often persists and predisposes you to recurrent episodes. Without addressing the mechanical cause, sciatica reliably returns, often more severely. Chiropractic care aims to correct the underlying structural problem so that recovery is complete and durable, not just temporary.

Is chiropractic better than surgery for sciatica?

For the large majority of sciatica cases, conservative care — including chiropractic, decompression, and rehabilitation — achieves outcomes equivalent to or better than surgery, without the risks of operative intervention. Surgery is generally reserved for cases involving severe neurological deficit or for patients who have failed comprehensive conservative management. Dr. Bang will be straightforward about whether your case is appropriate for conservative care or requires surgical referral.

How quickly will I feel relief?

Many patients experience meaningful improvement within the first 3-6 visits as we begin decompressing the affected nerve root. The full course of treatment — aimed at correcting the underlying structural problem rather than just relieving symptoms — typically spans several weeks depending on the severity and chronicity of the condition.

I've had sciatica for years. Can you still help?

Yes, though chronic sciatica typically requires a more extended treatment protocol than acute presentations. Long-standing nerve compression often involves disc changes, muscle atrophy, and adaptation patterns that take time to correct. The important thing is that with a proper diagnosis and consistent treatment, even chronic sciatica cases frequently achieve significant, lasting improvement.

Will I need X-rays or an MRI?

Diagnostic imaging is not always necessary, but for complex or severe presentations, Dr. Bang may recommend imaging to confirm the diagnosis or rule out conditions that require a different management approach. His FNP training gives him the clinical background to evaluate when imaging is warranted and to properly interpret the findings in the context of your full clinical picture.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for medical concerns. Dr. Jason Bang holds both Doctor of Chiropractic (DC) and Family Nurse Practitioner (FNP) credentials. Learn more about Dr. Bang's qualifications.