It is one of the most over-used words in back pain.
It runs down the back of your thigh. Or it sits deep in one buttock and will not be stretched out. Or your calf goes numb on a long drive and you shift in the seat to get rid of it.
Some people describe it as electrical. Others describe a heaviness, like the leg belongs to someone else by the end of the day.
Whatever it feels like, someone has almost certainly called it sciatica by now. A friend, a colleague, or the internet.
The word is doing more work than it should
Used properly, the word describes pain generated by irritation of the sciatic nerve or the nerve roots that form it. Used the way most people use it, it means any pain that travels down a leg, which is a much larger category with a lot of different things in it.
That matters because the treatment for one is not the treatment for another, and because a word that feels like an answer stops people asking the next question.
What can refer pain into a leg
These are the broad categories, not a list to sort yourself into.
The nerves that form the sciatic nerve exit the lower spine, and they can be irritated where they exit. This is the version that genuinely earns the word.
Joints in the lower back and pelvis refer pain into the buttock and thigh without any nerve being involved. It can feel very similar and it is a different problem.
Muscles have their own referral patterns, and some of the deep hip muscles refer into territory that overlaps almost exactly with where people expect sciatica.
Hip problems often present as groin, thigh or buttock pain, and are regularly mistaken for a back problem.
The nerve can be irritated at points well below the spine, which produces symptoms in a smaller and more specific area.
Some leg pain comes from blood vessels rather than nerves or joints. That group matters and it is covered at the bottom of this page.
We are deliberately not telling you how to tell these apart. Every version of that advice on the internet produces people who have confidently sorted themselves into the wrong category and then spent months treating it. The distinction is made through examination, not through reading.
Why the difference matters
If a nerve root is irritated, the questions are about what is irritating it and how the surrounding structures are behaving. If a joint is referring, the nerve is not the issue at all. If it is the hip, you can work on a lower back for months without touching the problem.
This is the single most common reason people arrive having already tried things that did not work. The things were not necessarily wrong. They were aimed at the wrong place.
If you would rather skip ahead and have someone look at it, that is a reasonable place to start.
Book an assessmentWhy your capacity was thin
Your body is built to adapt. Load arrives, tissue responds, you recover, you carry on. We describe what happens when recovery falls behind in three stages: adapting, borrowing and overloaded. The line between them is not how much you carry. It is how much you clear.
Leg symptoms often appear late in that sequence, which is why so many people can trace a history of back stiffness or one-sided tightness going back years before the leg ever got involved.
Read how your body carries loadWhat we check
That is not us avoiding the question. It is the reason the assessment exists.
How far the symptoms travel, what brings them on, what settles them, what the nerve is doing, and what the surrounding structures are doing all narrow it down. Those are observations made in a room, not conclusions drawn from a description.
What you do, how you sleep, what your body has already been through, and what has changed recently.
How far the region moves, how it moves, and what the surrounding structures are doing to compensate.
Reflexes, sensation and strength, to understand how well the system is communicating.
Where we need to understand structure before making a decision, we say so and explain why.
We tell you what we found, what it means in plain English, and what we think is worth doing about it. You decide from there.
Go to an emergency department immediately, the same day, if you have numbness around your groin, inner thighs or buttocks, or any change in bladder or bowel control, or weakness in both legs.
Seek urgent medical assessment if you have calf pain with swelling, warmth or redness, particularly after a long flight, surgery or a period of immobility. That combination can indicate a clot and it is not a musculoskeletal problem.
See your GP or go to an emergency department if you have progressive weakness in the leg or foot, if your leg pain follows a significant fall or impact, or if it comes with fever or unexplained weight loss.
If you are not sure, ask us. We would rather send you to the right person than be the wrong one.
Possibly, and the word gets applied to a lot of leg pain that is not. That is the thing an assessment sorts out, and it changes what is worth doing next.
Not necessarily. Disc-related nerve irritation is one cause among several, and it has a recognisable presentation. Plenty of leg pain has nothing to do with a disc.
That is common, and it is often information rather than failure. A stretch that does nothing may be aimed at a structure that is not the source.
Not usually first. Imaging helps when something in the history or examination points to a reason for it, which is a decision made after an assessment rather than before one.
An assessment at Wild Chiropractic in Shenton Park starts with a history, a look at how you move, and a conversation about what we found.
Book an assessmentWhat happens first
