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The Science of Sciatica: Why Your Leg Hurts When Your Back Is the Problem

Sciatica affects 40% of people at some point in their lives, yet it remains widely misunderstood. Many patients treat the symptom — leg pain — without addressing the spinal compression causing it.

7 min read
Dr. S. Laroche, DPT
Sciatic nerve anatomy

40%

Adults affected by sciatica

90%

Cases resolve with proper treatment

L4-S1

Most affected spinal levels

2-4 wk

Average recovery with decompression

What Is Sciatica?

Sciatica is not a diagnosis — it's a symptom. The term describes pain, tingling, or numbness that travels along the path of the sciatic nerve, which runs from your lower back through your hips, buttocks, and down each leg.

The pain originates in your spine, specifically when something compresses the sciatic nerve roots at lumbar levels L4 to S1. Understanding this distinction is crucial: treating only the leg where you feel pain ignores the spinal source of the problem.

The 3 Root Causes of Sciatica

Herniated Disc (Most Common)

When the soft centre of a spinal disc bulges out and presses against sciatic nerve roots. Often triggered by sudden movements, heavy lifting, or prolonged poor posture.

Lumbar Spinal Stenosis

Narrowing of the spinal canal, often due to age-related bone spurs or thickened ligaments, which compresses the nerve roots.

Piriformis Syndrome

Spasm or tightening of the piriformis muscle in the buttock, which sits directly over the sciatic nerve. Often misdiagnosed as disc herniation.

Evidence-Based Treatments

The most effective treatments address the underlying spinal compression rather than just managing pain:

  • Lumbar decompression — traction-based relief that creates space between vertebrae
  • Targeted physiotherapy — McKenzie method and nerve mobilisation exercises
  • Anti-inflammatory protocols — reducing disc swelling naturally
  • Postural correction — eliminating the daily habits perpetuating the compression
Back Pain Relief Patches (20 pcs.)

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