You Don't Have Sciatica.
It's a symptom, not a sentence.
Sciatica is such a common condition. Like really common. So many people experience it at some point in their lives.
So, naturally, there is a wealth of information available to educate people about the condition and provide helpful advice and treatments.
Sounds great, right...?
WRONG!
Unfortunately, these commonly praised "sciatica treatments" are often useless at best. Trying to understand and treat "sciatica" often just leads to more confusion.
Let me explain.
One of the big issues in understanding and effectively treating back pain is that it is such a non-homogeneous diagnosis.
While we tend to broadly refer to it as "back pain" and say things like "I've got a bad back", what that means can vary greatly.
There is a variety of conditions and injuries that can cause back pain. They can occur in different locations in the spine, cause pain through different mechanisms and overall have different effects on your life and function. In some cases, back pain may not be caused by an issue in the back or spine at all!
As a result, the best way to treat your back pain may be completely different to the best way to treat someone else's. This often makes it horribly confusing for someone who has developed back pain and is trying to figure out what the hell is going on and what they should do about it.
Sciatica suffers from these same problems.
Sciatica is not a diagnosis; it's a symptom.
We need stop diagnosing people with sciatica. Sciatica is not a diagnosis; it's a symptom. We need to diagnose the cause of this symptom, not the symptom itself.
This is like your Doctor diagnosing you with a fever.
Imagine going to see your Doctor because you are feeling unwell, and they diagnose you with a fever. You would be thinking, "NO SH*T SHERLOCK... What's causing it!? What should I do about it!?"
Is it an infection? Do I need antibiotics, or is it viral? Should I medicate the fever, or let it run its course?
And so on...
Beginning to see how insane this is? It's no wonder people with sciatica struggle to get relief.
We need to identify the cause of the sciatica.
I continue to be shocked and disheartened as I repeatedly encounter concerned people that are told they have sciatica and are terrified about what this may mean. There is so much baggage associated with the term now that it has become such a confusing mess, particularly for people who may have just developed this pain for the first time.
I regularly read and hear things like:
"Will this go away? I cannot imagine living the rest of my life like this."
The equation in their heads seems to go something like: sciatica = permanent, incurable nerve damage and pain.
Sciatica does not mean any of these things. The only thing it refers to is radiating pain felt in the sciatic nerve.
While this pain is commonly caused by a lower back injury (such as a disc bulge), it isn't always. And the overwhelming majority of sciatica causes are very treatable without major intervention or lifelong pain and disability.
There is a big difference between telling someone:
You have sciatica... caused by severe spine cord compression that could lead to permanent loss of function if we don't operate immediately, and,
you have sciatica... caused by mild disc bulge, take it easy and it will probably resolve itself in 8 weeks or so.
This is just a ridiculous situation to be putting clients and patients in, and I believe it initially stems from diagnosing people with something that isn't a diagnosis.
Frequently Asked Questions
What is sciatica, exactly?
Sciatica refers to pain that travels along the path of the sciatic nerve — typically from the lower back through the buttock, down the back of the leg, and sometimes into the foot. Importantly, sciatica is a symptom, not a diagnosis. Describing pain as “sciatica” tells you where the pain is felt, but nothing about what’s causing it — which is why treating “sciatica” without identifying the underlying cause so often fails.
What are the most common causes of sciatica?
The most common cause is a lumbar disc bulge or herniation pressing on one of the nerve roots that forms the sciatic nerve, most often at the L4-L5 or L5-S1 levels. Other causes include spinal stenosis (narrowing of the spinal canal), facet joint inflammation, and — less commonly — piriformis syndrome. Identifying the specific cause is essential because the correct treatment is completely different for each one.
Does sciatica go away on its own?
In many cases, yes — particularly when caused by a disc bulge. With appropriate load management and movement modification, the body’s natural healing process often resolves the underlying issue within weeks to months. The important thing is to stop doing the things that are aggravating the nerve and give the injured structure time to heal. Chasing symptom relief without addressing the cause is why so many people struggle with recurring flare-ups.
Is sciatica the same as a pinched nerve?
These terms are often used interchangeably but they’re not identical. A “pinched nerve” broadly refers to any nerve being compressed or irritated. Sciatica is a specific type of pinched nerve symptom involving the sciatic nerve (or the lumbar nerve roots that form it). Calling it a pinched nerve is a slightly more accurate framing than calling it a diagnosis, but it still doesn’t tell you what’s pinching it or why.