Sciatica

Sciatica isn't a diagnosis — it's a symptom. The sharp, shooting, burning pain that travels from the lower back through the buttock and into the leg is the sciatic nerve being compressed or irritated. The question is what's compressing it, and that's where proper assessment makes all the difference.

What's Actually Causing Your Sciatica

The sciatic nerve is the longest and largest nerve in the body. It forms from nerve roots at L4, L5, and S1 in the lower spine, passes through the pelvis, and runs down through the back of the leg to the foot. Compression anywhere along that path can produce sciatic symptoms.

Common sources include:

• Lumbar disc herniation — the most common cause; a bulging disc presses on a nerve root
• Piriformis syndrome — the piriformis muscle in the buttock impinges the nerve
• Lumbar facet joint dysfunction — joint irritation refers pain in a sciatic pattern
• Sacroiliac joint dysfunction — often mimics disc-related sciatica
• Spinal stenosis — narrowing of the spinal canal, more common with age

The treatment for each of these is different. Treating piriformis syndrome like a disc herniation won't work — and vice versa. This is why Dr. Britt's SFMA assessment matters: it identifies the actual source before any treatment begins.

What Treatment Looks Like

For most sciatic patients, a combination of lumbar and pelvic adjustments, soft-tissue work to the piriformis and hip rotators, nerve flossing exercises, and movement retraining produces significant relief within a few weeks of consistent care. The goal is not just pain reduction — it's restoring the movement patterns that allowed the compression to develop in the first place.

Surgery for sciatica has a much lower success rate than most patients are told, and most surgical candidates improve equally well with conservative care given enough time. We'll be honest with you about when conservative care isn't the right choice — but that's genuinely rare.

Red Flags That Need Immediate Attention

Most sciatica is not an emergency. However, if you experience progressive leg weakness, numbness in the groin or inner thighs, or loss of bladder or bowel control, seek care immediately — these can indicate cauda equina syndrome, which is a surgical emergency.