Sciatica.
A word people use loosely. A condition that deserves more precision than it usually gets.
A symptom, not a diagnosis.
Sciatica refers to pain, tingling, numbness, or weakness that travels along the path of the sciatic nerve, typically from the lower back through the glute, down the back of the leg, and sometimes into the foot. It's a symptom, not a diagnosis. The actual source can vary.
Find the source, not just the sensation.
The sciatic nerve is the longest in the body. There are multiple points along its path where it can be irritated or compressed, and identifying which one matters enormously. Common contributing factors include disc bulges or protrusions at the lower lumbar levels, restricted movement in the hip or sacroiliac joint, tightness in the piriformis muscle, and altered load distribution through the pelvis caused by longstanding postural habits or previous injuries. Sedentary work patterns, prolonged sitting, and sudden changes in training load can all be associated with the onset or worsening of sciatic symptoms.
The nerve pain itself is not the cause. It's the output of an irritated or compressed system.
Relief without a reason rarely lasts.
Stretching the hamstring or piriformis may provide temporary relief. Anti-inflammatory approaches can reduce irritation short-term. But if the reason the nerve is under load hasn't been identified, whether that's a disc issue, a movement restriction, or a biomechanical pattern, the symptoms are likely to persist or recur.
Addressing the sensation without understanding the structure keeping it there is a short-term strategy.
The whole picture, not just the leg.
Our initial assessment includes a detailed history, how the symptoms started, what aggravates and eases them, and what previous management has looked like. Postural and movement assessment helps identify how load is being distributed through the lumbar spine, pelvis, and hips. Neurological screening is conducted where clinically appropriate.
We look at the whole picture, not just the leg that hurts. Where clinically appropriate, surface EMG provides additional data on how the nervous system is responding. Care plans are built on what we actually find, and reassessed as the picture changes.