It’s a pain in the B*tt… or behind the leg, or all the way to the toes.
Sciatica: one of those syndromes we all seem to know someone who’s affected by. It often has an insidious onset—slow and sneaky—and can become insanely debilitating. I frequently hear about people being “down for the count” during a flare-up. Others live with the pain daily, long after the acute phase is over. Their lives are often shaped by the fear of aggravating the sciatic nerve again. Dealing with sciatica can be frustrating—not just for the people experiencing it, but also for the doctors trying to help manage it. There are many contributing factors that can both cause sciatica and make it harder to resolve.
So, what exactly is sciatica? It’s the irritation or pinching of the sciatic nerve, which can result in pain, altered sensation in the back of the leg, or changes in muscular function—like reflexes or strength. The nerve can be compressed in several different areas, which is why it’s important to consult a specialist who can help identify where the impingement is coming from.
The sciatic nerve is most commonly affected in the spine at the L4-S1 levels, around the sacroiliac joint (video below for help), at the piriformis muscle, or in the popliteal fossa behind the knee. When the nerve is functioning properly, it carries motor and sensory information to the hamstrings and most of the lower leg, including the calves and feet. It assists with movements like hip extension (think donkey kicks) and knee flexion (bending your knee).
The real challenge lies in how to resolve sciatica—how to manage the pain and, ideally, eliminate it entirely. Maybe you’ve heard chiropractic success stories where someone got adjusted once and felt immediate relief. Or maybe you’ve heard horror stories of adjustments making things worse. Both scenarios are valid—but neither should be seen as the whole picture. Sciatic pain often requires long-term commitment and collaboration between the doctor and the patient. Consistent at-home care and working closely with a chiropractor who understands the why behind your symptoms is key.
Think of it like braces: just as teeth need time and consistent effort to shift into a healthier alignment, your sciatic nerve may need time and repeated care to function freely again. Chiropractic adjustments and targeted muscle work can help restore spinal mobility and reduce nerve compression—like freeing up a dam in the river of your nervous system.
The ways people manage sciatica pain are as varied as the causes. When pain persists, some feel hopeless and turn to more aggressive measures for relief. I’ve heard of people undergoing surgeries like laminectomies (removing part of the vertebra) or microdiscectomies (removing part of a spinal disc that’s pressing on the nerve). Ouch!
Others find relief through corticosteroid injections or by taking high doses of pain medication. While these approaches can be effective in the short term, they often don't address the root cause—so the pain tends to come back. Without active care to correct the underlying issue, the problem can get worse over time, leading to even more nerve compression and pain.
So, how do you deal with sciatica—and how do you avoid it in the first place? The answers aren’t always straightforward, and they can feel overwhelming. Sciatica often develops from wear and tear on the spine or from certain lifestyle factors. Here are a few common culprits:
Herniated discs – When a spinal disc bulges and presses on the sciatic nerve.
Degenerative disc disease – Wear and tear over time, often from repetitive movements like lifting, bending, or sports that stress the spine.
Spondylolisthesis – The slipping of one vertebra over another, usually from repetitive strain or a traumatic injury like a car accident.
Cool thoughts on your spine’s health
Think of your spinal discs like water balloons wrapped in reinforced packing tape (seriously). The tape represents the fibrous outer layer of the disc. Over time, stress wears down the tape. If it gets too thin, the water balloon (disc) can bulge or rupture through the damaged area. That’s what we call a bulging disc. If it’s in the wrong spot, it can press right into the sciatic nerve.
The same factors that wear down your discs can also lead to sciatica:
Prolonged sitting – Causes spinal flexion and compression of the discs.
Repetitive lifting and bending – Adds more strain and pressure to the spine and discs.
Weak core muscles – A weak core leads to poor posture, forcing the spine and discs to absorb forces your core should be handling.
Obesity – More body weight means more pressure on the spine, which can accelerate degeneration or cause nerve pinching in multiple areas like the pelvis or behind the leg.
People will spend thousands on dollars on corrective surgery or pain management shots and also on top of that they will spend so much time and emotional energy on dealing with the syndrome after they get it
My simple chart I created just for y’all
Final Thoughts
Sciatica sucks—there’s no way around it. But understanding why it happens gives you power over it. Whether you’re battling a flare-up or trying to avoid one altogether, know that there are ways to support your body and your spine. You don’t have to accept pain as your norm, and you definitely don’t have to figure it out alone.
Work with someone who listens, investigates, and helps you get to the root cause. Be consistent, stay curious, and give your sciatic nerve the space it needs to breathe, move, and chill out. Your spine (and your sanity) will thank you.