Sciatica

Sciatica isn't a diagnosis — it's a symptom. Pain, tingling, or weakness that travels along the sciatic nerve from the lower back through the buttock and down the leg. The right fix depends on what's compressing the nerve.

Common causes

• Herniated lumbar disc (usually L4–L5 or L5–S1)
• Piriformis syndrome — a tight buttock muscle pressing on the nerve
• Spinal stenosis — canal narrowing (more common after 50)
• Isthmic spondylolisthesis — a vertebra slipping forward

What the research supports

• Active movement and directional exercises (e.g., McKenzie extensions for disc-type sciatica).
• Spinal manipulation for acute sciatica of disc origin.
• Nerve-glide (neural mobilization) drills.
• Progressive walking — quiet, consistent, effective.

Red flags — go to the ER

• Loss of bowel or bladder control
• Progressive foot weakness ("foot drop")
• Numbness in the saddle region

These may indicate cauda equina syndrome and are a medical emergency.

A sensible starting plan

1. Keep moving — walk daily, break up sitting.
2. Try the McKenzie press-up: face down, prop up on forearms, then hands. 10 reps, 3–5× per day. Stop if leg pain worsens.
3. Get evaluated by a chiropractor if pain persists past a week.
4. Imaging is rarely needed in the first 4–6 weeks without red flags.

For a deep dive, read our long-form guide: Sciatica — what actually works.

Educational information only — not medical advice. Consult a licensed chiropractor or physician for care.