Leg pain and sciatica

What it usually is

Sciatica just means pain that runs along the sciatic nerve, down the back of the leg. Usually a nerve root in the low back is irritated, often by a disc that is bulging and angry. An irritated nerve is a sensitive nerve, a bit like a sunburn on the inside. Leg pain can also come from the hip, the buttock muscles or the blood vessels, so we sort that out first.

What it often feels like

Burning, zapping or a deep toothache in the buttock, the back of the thigh, or all the way to the foot. Pins and needles or numbness in part of the leg or foot. Sitting, coughing or sneezing can make it worse, and it can be miserable at night.

What we look at

Your story, then how your back moves and which movements send pain down the leg. We test strength, reflexes and feeling in your legs and feet, so we know how the nerve is working, not just how it feels. And we do nerve tension tests, which tell me how sensitive the nerve is and how well it is sliding.

What usually helps

Neurodynamics is my favourite tool for this, full stop. Your nerves are meant to slide and glide through the tissues around them every time you move. When a nerve is sensitive it stops liking that, so we use gentle, specific movements to get it used to sliding again, without poking the bear. We add adjusting, soft tissue work and exercise as the leg allows. And understanding pain matters a lot here, because nerve pain is loud and very convincing. Loud does not always mean damaged.

What you can do at home

Keep moving, little and often; walking is usually a friend. Pace yourself: find how long you can sit or walk before it flares, and stay just under that. Change positions often and find a sleeping position that lets the nerve rest. Any home exercise should be the gentle one we worked out together, not a stretch that yanks on the nerve.

When it's not a chiro problem

Go to emergency now for numbness around your bottom or between your legs, new trouble peeing or controlling your bladder or bowels, or weakness in both legs. Get seen urgently if your foot starts to drop or slap when you walk, or leg weakness keeps getting worse. A hot, red, swollen calf needs a medical doctor the same day, it can be a blood clot. Calf pain that comes on walking and goes away with rest, especially if you smoke or have diabetes, can be circulation, so see your doctor.