Sciatica: Nerve Pain or Tight Muscle? Signs, Self-Care and When to Get It Checked
That sharp, burning or electric pain that runs from your buttock down the back of your leg has a name most people have heard: sciatica. It can make sitting, driving or even putting on your socks feel like a project. But not every pain in the back of the leg is actually sciatica, and knowing the difference can help you get the right care sooner.
What is sciatica?
Your sciatic nerve is the largest nerve in the body. It starts from several nerve roots in your lower back, travels through the buttock and runs down the back of each leg to the foot. “Sciatica” describes pain that follows the path of that nerve because something is irritating or pressing on it.
Common causes include:
- A bulging or herniated disc in the lower back pressing on a nerve root
- Narrowing around the nerves (spinal stenosis), more common as we get older
- Tight or irritated muscles in the buttock, such as the piriformis, which the sciatic nerve runs close to
- Long hours of sitting, heavy lifting or sudden twisting that aggravate an already sensitive back
Nerve pain or muscle pain?
Here’s where it gets tricky. Tight muscles and irritated joints in the low back and hips can also send pain into the leg. This is called referred pain, and it often gets mistaken for sciatica. The two can feel similar, but there are some clues:
| More likely nerve-related | More likely muscle or joint | |
|---|---|---|
| How it feels | Sharp, shooting, burning or electric | Deep, dull, achy |
| How far it goes | Often below the knee, sometimes into the foot | Usually stays above the knee |
| Other sensations | Pins and needles, numbness or weakness | Stiffness and tender spots |
| What aggravates it | Coughing, sneezing, bending or sitting | Certain movements or positions, pressing on the sore area |
These are only clues, not a diagnosis. Many people have a bit of both. A hands-on assessment is the best way to find out what’s driving your symptoms, and that shapes which treatment makes sense. If you suspect your pain starts deep in the buttock, our older post on piriformis syndrome is worth a read.
What can I do at home?
- Stay gently active. Short, regular walks are usually better than lying in bed. Move within what’s comfortable.
- Break up sitting. Sitting is a common aggravator. Stand up and move every 20 to 30 minutes, and try a small rolled towel behind your lower back when you do sit.
- Find your position of relief. Many people are more comfortable lying on their side with a pillow between the knees, or on their back with their knees supported.
- Go easy on hard stretching. Irritated nerves don’t like being pulled on. If a stretch makes the leg pain sharper or spread further, back off.
- Try heat or cold. Either can ease pain. Use whichever feels better for you.
The encouraging news is that many cases of sciatica improve over a period of weeks with the right care and activity.
When should I get it checked?
Book an assessment if leg pain lasts more than a week or two, keeps coming back, comes with numbness or tingling, or is getting in the way of work or sleep.
Get medical care right away (see your doctor, or go to emergency) if you have:
- Loss of bladder or bowel control, or trouble passing urine
- Numbness in the groin, genitals, buttocks or inner thighs
- Leg weakness that’s getting worse, or a foot that drags or slaps when you walk
- Symptoms in both legs at once
- Fever, unexplained weight loss, or a history of cancer along with new back pain
- Pain after a serious fall or accident
How we help with sciatica
Because leg pain can come from a disc, a joint, a muscle or a combination, having several disciplines under one roof helps. If another approach would suit you better, we can refer you in-house. Learn more on our sciatica and nerve pain page.
Chiropractic
Our chiropractors assess how your lower back, pelvis and hips are moving, check nerve function, and use care such as spinal manipulation and mobilization, soft tissue work and exercise to ease pain and improve movement. Dr. Tessa Bryan, DC uses soft tissue therapies, manipulation and nerve flossing as part of her care. Dr. Alexia Grelson, DC blends manual, instrument-assisted and drop-table techniques tailored to each patient’s comfort level. Dr. Matthew Bryan, DC takes a collaborative, multidisciplinary approach and has a special interest in working with athletes. Dr. Krisjan Gustavson, DC has been practising since 1986.
Spinal decompression
When sciatica is related to a bulging or herniated disc, or hasn’t settled with other care, spinal decompression is a non-surgical, drug-free option. A computer-controlled table gently and gradually reduces pressure on the discs of the lower back. Your practitioner will let you know whether it’s a good fit.
Physiotherapy and IMS
Our physiotherapists use manual therapy, education and a graded exercise plan to calm irritated nerves and build strength and confidence in movement. When tight, shortened muscles are adding to the problem, IMS (intramuscular stimulation) may help release them. IMS uses very fine needles placed in tight muscle bands or near the spine where a nerve root may be irritated.
Kanu Priya, MPT has over 10 years of experience, works with people with persistent pain and complex musculoskeletal conditions, and includes dry needling (IMS) in her care. Ivy Elling-Quaintance, MPT has training in AN-IMS dry needling and an interest in chronic pain management. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy and patient education.
Book an appointment
If leg pain is slowing you down, we’d be glad to help you figure out what’s behind it. We bill most insurance plans directly, so you can focus on getting better.
Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.
This article is general information and isn’t a substitute for an assessment by a qualified health professional.
