If you have ever felt a sharp, electric-like jolt shooting from your lower back down into your leg, you likely know exactly why people dread sciatica. It is not just a back ache; it is a distinct, often debilitating sensation that can make sitting, driving, or even walking feels like an impossible task.

In our clinics across Wolli Creek, Miranda, Hurstville, and Kareela, sciatica is one of the most frequent reasons patients walk through our doors. Yet, there is often confusion about what it actually is. Many people use the word “sciatica” to describe any leg pain, but medically, it refers to a specific set of symptoms caused by irritation or compression of the sciatic nerve.

The sciatic nerve is the longest and thickest nerve in your body. It starts from nerve roots in your lower spine (lumbar) and travels through your hips and buttocks, branching down each leg. When something pinches or irritates this nerve at the source, the alarm bells ring all the way down the line.

Understanding the root cause is the first step toward relief. Because sciatica is a symptom of an underlying issue—not a diagnosis in itself—identifying why the nerve is irritated is crucial for creating a management plan that actually works.

Quick answer: What causes sciatica?

In short, sciatica occurs when the sciatic nerve or its nerve roots are compressed, irritated, or inflamed. The most common culprit is a herniated disc (sometimes called a slipped or bulging disc) in the lower spine, specifically at the L4, L5, or S1 levels. When the soft inner material of the disc pushes out, it can press directly on the sensitive nerve root.

However, discs aren’t the only cause. Sciatica can also stem from lumbar spinal stenosis (a narrowing of the spinal canal due to wear and tear), spondylolisthesis (where one vertebra slips forward over another), or muscular issues like piriformis syndrome, where a tight muscle in the buttock traps the nerve. Effective management relies on determining which of these factors is driving your pain.

Common causes of sciatica

While the sensation of sciatica feels similar for many people, the biological drivers can be quite different. Here is a detailed look at the most common reasons the sciatic nerve becomes irritated.

Disc irritation or bulges

Your spinal discs act as shock absorbers between your vertebrae. They have a tough outer layer and a gel-like centre. Due to wear and tear, injury, or sustained pressure, the inner gel can push against or break through the outer layer. If this bulge happens in the lower lumbar spine, it often presses directly onto the nerve roots that form the sciatic nerve. This is widely considered the most frequent cause of acute sciatica, particularly in people aged 30 to 50. The pain from a disc issue is often sharp and may worsen when you bend forward, cough, or sneeze.

Lumbar spinal stenosis

As we age, our spines undergo natural changes. The channel that houses the spinal cord and nerve roots (the spinal canal) can narrow due to the thickening of ligaments or the formation of bony overgrowths (bone spurs) caused by osteoarthritis. This narrowing is called stenosis. Unlike a sudden disc injury, this tends to develop gradually. If you have stenosis, you might find that standing or walking for long periods triggers heaviness or pain in the legs, which often improves when you sit or lean forward (like leaning on a shopping trolley).

Piriformis syndrome and muscle compression

Sometimes, the issue isn’t in the spine at all. The piriformis is a small muscle located deep in the buttock, right near the top of the hip joint. The sciatic nerve runs directly beneath (and in some people, through) this muscle. If the piriformis becomes tight, spasmed, or inflamed—often due to overuse in runners or prolonged sitting in office workers—it can compress the nerve. This mimics the symptoms of a spinal disc issue but requires a different treatment approach focused on soft tissue release and hip mobility.

Joint stiffness and inflammation

The joints in your lower back (facet joints) and pelvis (sacroiliac joints) are designed to move. However, if they become stiff or locked up due to injury or poor posture, the surrounding tissues can become inflamed. This inflammation can chemically irritate the nearby nerve roots, leading to sciatic-like pain. We often see this in patients who have a history of lower back stiffness that was ignored until it “suddenly” became leg pain.

Prolonged sitting and sedentary habits

Our bodies are designed for movement, yet modern life often demands the opposite. Many professionals commuting from suburbs like Hurstville or Miranda spend an hour in the car, followed by eight hours at a desk. Prolonged sitting places significant compressive load on the lumbar discs and keeps the hip flexors in a shortened position. Over time, this weakens the gluteal muscles and core stabilisers, transferring more stress to the spine and increasing the risk of nerve entrapment.

Training load spikes and lifting strain

On the other end of the spectrum, sudden increases in physical activity can trigger sciatica. This is common among “weekend warriors” who might spend the work week sedentary but engage in heavy gardening, renovation work, or high-intensity gym sessions on the weekend. Lifting heavy objects without proper bracing, or twisting while carrying a load, can shear the disc or strain the lower back structures, leading to acute inflammation around the nerve root.

What sciatica pain feels like

Sciatica manifests differently for everyone, but there is a distinct pattern that differentiates it from standard muscle soreness. If you are unsure if your pain is sciatica, look for these common signs:

• Radiating pain: The hallmark sign is pain that travels. It usually starts in the lower back or buttock and shoots down the back of the thigh, calf, and sometimes into the foot.
• Electric sensations: Unlike the dull throb of a muscle ache, nerve pain often feels sharp, burning, or like an electric shock.
• Pins and needles: You may experience tingling, numbness, or a “crawling” sensation in the leg or foot.
• Positional triggers: The pain often changes with position. For many, sitting worsens the pain, while walking provides relief. For others (especially with stenosis), walking is painful and sitting offers relief.
• One-sided symptoms: Sciatica typically affects only one leg at a time, although rare cases can affect both.

For more detailed information on symptoms and management strategies, you can visit the Healthdirect sciatica page.

Common triggers that can flare sciatica

Once the nerve is sensitised, certain activities or environments can act as triggers, causing a flare-up of symptoms. Identifying these in your daily routine is a key part of recovery.

• The “Commuter’s Back”: Long periods of driving or sitting on public transport without lumbar support can aggravate the nerve. The vibration of a car combined with a static posture is a common irritant.
• Repetitive bending: Activities that involve repeated flexion of the spine—like weeding the garden, loading the dishwasher, or picking up children—can increase disc pressure.
• Poor sleep hygiene: Sleeping on a mattress that lacks support, or sleeping on your stomach, can twist the lumbar spine and keep the nerve under tension throughout the night.
• Stress: High stress levels often lead to physical tension in the back and gluteal muscles, which can further compress an already irritated nerve.
• Cold weather: Some patients report that cold, damp weather increases joint stiffness and muscle guarding, making nerve pain feel more acute.

Sciatica vs back pain: what is the difference?

It is easy to confuse general back pain with sciatica, especially since they often happen at the same time. However, the distinction is important for how you manage it.

General Lower Back Pain is usually “axial,” meaning it stays in the trunk area. It might be an ache across the belt line or stiffness in the central spine. This is often caused by muscle strain, ligament sprain, or joint irritation that hasn’t involved the nerve root.

Sciatica is “radicular,” meaning the problem originates in the back but the pain is felt elsewhere along the nerve pathway. You can have sciatica with very little back pain, or you can have severe back pain accompanied by leg symptoms. Think of the spine as the fuse box and your leg as the lightbulb. If the fuse blows (nerve compression in the back), the light goes out (pain/numbness in the leg). Treating the leg won’t fix the issue; you have to look at the fuse box.

How long does sciatica last?

The timeline for recovery varies significantly depending on the cause and severity of the nerve compression. The good news is that for many people, sciatica is temporary.

According to clinical guidelines, most cases of acute sciatica improve significantly within 4 to 6 weeks. However, “improve” doesn’t always mean “disappear completely.” The initial sharp pain often settles first, leaving behind some stiffness or mild tingling that takes longer to resolve.

Recovery can be slower if the cause is structural (like stenosis in older adults) or if the condition has become chronic (lasting more than 3 months). Factors that can delay recovery include continuing to lift heavy loads, high stress, poor sleep, and avoiding movement entirely. Fear of movement often leads to deconditioning, which can paradoxically make the recovery longer.

How chiropractors approach sciatica

At our clinics, we take an evidence-informed approach to sciatica. We understand that no two cases are the same, and what works for a disc bulge might not work for piriformis syndrome.

Assessment comes first: We don’t guess. We start with a thorough history and physical examination. We look at your posture, your range of motion, and perform neurological tests (checking reflexes and muscle strength) to locate exactly where the nerve irritation is coming from.

Restoring motion: If the cause is joint restriction or spinal misalignment contributing to nerve pressure, we may use specific chiropractic adjustments. These are designed to restore normal motion to the spine and pelvis, which can help reduce the mechanical stress on the nerve.

Soft tissue therapy: If muscle tightness (like the piriformis) is a factor, we utilise massage therapy or trigger point techniques to relax the muscles compressing the nerve.

Activity modification: We help you identify the habits that are keeping you in pain. This might mean adjusting your car seat, changing how you sit at your desk, or modifying your gym routine while you heal.

Rehabilitation: Passive care (what we do to you) is only part of the solution. We prescribe specific exercises to mobilise the nerve (nerve flossing) and strengthen the core and glutes to support the spine long-term.

We do not promise “cures” or quick fixes, but rather a structured pathway to reduce pain and restore function. If your case is complex or not responding to care, we are trained to recognise this and can refer you for imaging or to a GP. You can learn more about our specific approach on our Sciatica page.

What you can do at home

While professional care is important, what you do in the 165 hours a week you aren’t in the clinic matters most.

• Keep moving: Bed rest was once the standard advice, but we now know it can slow recovery. Try to take short, frequent walks within your pain tolerance. Motion helps flush inflammation and prevents stiffness.
• Find a relief position: Lying on your back with your legs elevated on a chair or a stack of pillows can take the pressure off the lumbar discs and give the nerve a break.
• Heat and Ice: Ice can help numb the area during a sharp flare-up, while heat is generally better for relaxing tight muscles and stiffness.
• Pillow support: If you sleep on your side, place a pillow between your knees to keep your hips square. If you sleep on your back, a pillow under your knees helps flatten the lower back.
• Don’t push through pain: “No pain, no gain” does not apply to nerve pain. If an activity causes the pain to shoot down your leg, stop and modify.

When to see a GP or seek urgent care (Red Flags)

Most cases of sciatica are painful but not dangerous. However, there are rare situations where nerve compression is severe and requires immediate medical attention.

Please seek urgent care or visit the emergency department if you experience:

• Sudden loss of bowel or bladder control (incontinence or inability to go).
• Numbness in the “saddle” area (groin, buttocks, and inner thighs).
• Severe or progressive weakness in the leg (e.g., you cannot lift your foot).
• Sciatica following a severe trauma, like a car accident or fall.
• Unexplained weight loss, fever, or feeling generally unwell alongside your back pain.

FAQs

What causes sciatica most commonly?

The most common cause is a herniated or bulging disc in the lower spine pressing on the nerve roots. However, it can also be caused by spinal stenosis (narrowing of the canal), tight muscles (piriformis syndrome), or joint inflammation.

What are the first signs of sciatica?

The first signs are usually pain radiating from the lower back into the buttock and down the back of the leg. This may be accompanied by tingling, numbness, or a sensation of heat or electric shocks in the leg.

Can sciatica go away on its own?

Yes, many cases of acute sciatica resolve on their own within 4 to 6 weeks with proper rest and gentle movement. However, treatment can often speed up recovery and prevent the issue from becoming chronic or recurring.

Is walking good for sciatica?

Generally, yes. Short, gentle walks are beneficial as they reduce inflammation and keep muscles working. However, if walking significantly increases your leg pain (which can happen with spinal stenosis), you should stop and seek advice.

What makes sciatica worse?

Prolonged sitting, heavy lifting, twisting movements, and coughing or sneezing can increase pressure on the disc and worsen symptoms. Sleeping on your stomach or on a mattress that is too soft can also aggravate it.

Should I rest or keep moving?

Active rest is best. Avoid bed rest for more than a day or two. Focus on gentle movements that don’t spike your pain. Complete inactivity often leads to more stiffness and a longer recovery time.

Can a chiropractor help sciatica?

Yes, chiropractors are trained to assess and manage sciatica. Through spinal adjustments, soft tissue therapy, and exercise prescription, they aim to improve spinal function and relieve pressure on the irritated nerve roots.

Do I need scans for sciatica?

Not always. In most cases, a diagnosis can be made via physical exam. Scans like MRIs are usually reserved for severe cases, those that aren’t improving after conservative care, or if “red flag” symptoms are present.

How long does sciatica usually last?

Acute episodes often last 4 to 6 weeks. However, without addressing the underlying cause (like posture or weakness), it can recur. Chronic sciatica can last months but can still be managed effectively with the right plan.

When should I see a doctor urgently?

Seek urgent help if you lose bladder/bowel control, have numbness in the saddle area, experience severe leg weakness (foot drop), or if the pain follows a significant trauma.

Taking the next step

Sciatica can be frustrating, interrupting your work, sleep, and family life. But you do not have to just wait it out. By understanding the cause—whether it is a disc, a tight muscle, or a joint issue—you can take control of your recovery.

If you are struggling with radiating leg pain and want a clear assessment of what is causing it, we are here to help. Our team can guide you through a personalised plan to get you moving freely again. You can learn more about our Chiropractic Services or contact us to book an appointment.