Sciatica is pain that travels from the lower back through the buttock and down the leg along the sciatic nerve. It most often occurs because a herniated disc or narrowing in the spine is pressing on a nerve root. Most cases improve with conservative care over several weeks. Chiropractic care, spinal decompression, and exercise may be considered before injections or surgery.
Sciatica is one of the most common reasons people visit a chiropractor and one of the most misunderstood. It is a symptom, not a diagnosis. This page explains what is happening, how to distinguish sciatica from ordinary back pain, which warning signs require emergency care, and what treatment realistically involves.
What is sciatica?
Sciatica describes pain along the path of the sciatic nerve—the largest nerve in the body—which runs from the lower spine through the buttock and down the back of each leg. When one of the nerve roots that forms the sciatic nerve becomes irritated or compressed, pain, tingling, numbness, and weakness may travel down the leg.
Because sciatica is a symptom rather than a condition, the important question is what is irritating or compressing the nerve. That answer, rather than the word “sciatica,” determines the appropriate treatment.
What causes sciatica?
The most common cause is a herniated or bulging disc in the lower back pressing on a nerve root. Other common causes include spinal or lateral canal stenosis, which is narrowing of the spinal canal or the opening through which a nerve root leaves the spine and becomes more common with age. Additional causes include degenerative disc changes, spondylolisthesis—when one vertebra slips forward over another—and piriformis syndrome, in which a muscle in the buttock irritates the nerve.
Less commonly, sciatica-like symptoms originate from the sacroiliac joint or another mechanical problem in the pelvis. Identifying the source is the purpose of an examination because disc, stenosis, and muscular problems require different approaches.
How do you know it is sciatica and not just back pain?
Ordinary lower-back pain usually remains in the back. Sciatica travels through the buttock and into the leg, frequently extending below the knee and sometimes reaching the foot or toes. It typically affects one side. Tingling, numbness, aching, or a feeling of weakness in the leg or foot strongly suggests nerve involvement.
The pattern is often recognizable. Sciatic pain may be sharp, burning, electric, aching, or dull. It may worsen when sitting, coughing, sneezing, or bending forward. Back pain accompanied by leg symptoms is managed differently from back pain alone, which is why the distinction matters.
When is sciatica an emergency?
A small number of symptoms occurring with sciatica may indicate cauda equina syndrome or another emergency requiring immediate medical care. Go to an emergency department or call 911 if you experience:
- Loss of bladder or bowel control or difficulty beginning urination
- Numbness in the groin, inner thighs, or around the buttocks, sometimes called saddle numbness
- Progressive or severe weakness in one or both legs
- Sciatica on both sides accompanied by new weakness
- Severe pain following a significant fall or accident
- Sciatica accompanied by fever, unexplained weight loss, or a history of cancer
These symptoms are rare but time-sensitive. We screen for them during every evaluation and refer immediately when they appear.
How does chiropractic care treat sciatica?
Care begins with a thorough history and examination to determine what is irritating or compressing the nerve. This includes neurological testing of strength, reflexes, and sensation. Treatment is then matched to the suspected cause rather than the symptom alone.
Depending on the findings, a treatment plan may include chiropractic adjustments to restore motion and reduce mechanical pressure, non-surgical spinal decompression for disc-related sciatica, soft-tissue work for muscle guarding and piriformis involvement, laser therapy for pain and inflammation, acupuncture for pain management, and specific exercises. Exercises are an important part of treatment because they can help reduce the likelihood of sciatica returning after an acute episode settles.
Clinical guidelines from the American College of Physicians and NICE recommend beginning with conservative, non-drug approaches for many patients with lower-back pain and sciatica.
How long does sciatica last?
Many episodes improve substantially within four to six weeks, and most improve within approximately three months, particularly with early, active care. A minority persist longer or recur, often because the underlying cause has not been addressed.
Gentle activity is usually preferable to bed rest. Prolonged rest may delay recovery, while walking and comfortable movement can support it. If sciatica has not improved after several weeks or if weakness or numbness is increasing, we may evaluate whether additional imaging, such as an MRI or CT scan, or a referral to another specialist is clinically appropriate.
Sciatica treatment in St. Peters, MO
Crosby Chiropractic & Acupuncture Centre has treated sciatica in St. Peters and throughout St. Charles County since 1995. Our doctors bring more than 90 years of combined experience. Because we offer adjustments, decompression, laser therapy, acupuncture, and massage in one office, we can match the treatment plan to the suspected cause instead of relying on a single treatment method.
We are located at 331 Jungermann Road in St. Peters and serve patients from O’Fallon, Dardenne Prairie, St. Charles, Cottleville, and Weldon Spring. Call (636) 928-5588 or request an appointment online.
Frequently asked questions about sciatica
Can a chiropractor help with sciatica?
Chiropractic care can help many people whose sciatica has a mechanical cause and does not involve emergency warning signs. Conservative care is commonly considered before more invasive treatment. The examination helps identify the likely cause and screen for cases that require imaging, medical attention, or a specialist.
Should I rest or stay active with sciatica?
Stay gently active unless a medical provider advises otherwise. Walking and normal movement within your comfort level generally support recovery, while prolonged bed rest may slow it. Avoid movements that clearly worsen the leg pain, and let the examination guide which exercises are appropriate.
Is spinal decompression good for sciatica?
Spinal decompression may be considered for some cases of sciatica, particularly when a herniated or bulging disc is involved. It is designed to reduce pressure on the disc and nerve root. It is less suited to symptoms originating from the piriformis muscle or sacroiliac joint, which is why identifying the likely source comes first.
Do I need an MRI for sciatica?
Generally, an MRI is not needed at first unless symptoms suggest cauda equina syndrome or another urgent condition. If sciatica is worsening or not responding to care as expected, imaging may become clinically necessary. We recommend imaging when the examination and progression of symptoms indicate that it is appropriate.
Why does my sciatica hurt more when I sit?
Sitting can increase pressure within the discs of the lower back, potentially causing a bulging disc to press further against a nerve root. Standing, walking, or changing positions may provide relief. This pattern can be one indication that a disc is involved, although an examination is needed to identify the cause.
Can sciatica come back?
Yes. Sciatica may return, particularly if the underlying cause and contributing movement habits are not addressed. Completing the recommended course of care and continuing prescribed exercises may reduce the risk of recurrence rather than stopping as soon as the leg pain improves.
Reviewed by Dr. Jenny Crosby Wiemann, DC, President, Crosby Chiropractic & Acupuncture Centre. Read Dr. Crosby’s full bio.
Last reviewed: September 2026
This page is for general education and is not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing a medical emergency, call 911.
