Sciatica

Sciatica is irritation of the nerve roots that form the sciatic nerve. We assess the spine, hips, and nervous system, calm inflammation, and build a graded plan guided by how your symptoms behave.

What you may be noticing

A sharp, burning, or electric pain that travels from your buttock down the back of your leg, sometimes to the foot. Numbness or tingling. Sitting and coughing make it worse. You may limp, struggle to sleep, or avoid bending entirely.

Loss of bladder or bowel control, numbness in the saddle area, symptoms in both legs, or rapidly worsening leg weakness or foot drop is a medical emergency. Seek care immediately.

Why it is rarely one thing

Sciatica describes a symptom, not a cause. It usually reflects irritation of a lumbar or sacral nerve root, most often from a disc herniation, and sometimes from narrowing of the spinal canal or foramen. Less often, the sciatic nerve is irritated near the piriformis muscle in the buttock.

Mechanical pressure is only part of the picture. Disc material triggers an inflammatory response around the nerve root, and inflammation itself drives much of the pain. Many disc herniations shrink over time as the body resorbs them. Chronic inflammation, poor recovery, disrupted sleep and circadian rhythm, and unstable blood sugar make nerves more vulnerable and slow that process.

The brain shapes the experience too. Brainstem circuits that receive balance and posture information also help regulate how strongly pain signals are felt, and a nervous system held on alert amplifies them. Restoring precise input through balance and vestibular work supports both spinal stability and pain modulation, which is why I treat sciatica as an inflamed, sensitized nerve within a whole system.

Patterns we look for

• Nerve root signs: reflexes, sensation, strength, and nerve tension tests.
• Directional preference: which movements centralize or spread the pain.
• Disc and joint involvement in the lumbar spine.
• Hip mobility and piriformis involvement.
• Core stability, gait, and balance.
• Inflammation and blood sugar regulation.
• Vitamin D, B12, and magnesium status.
• Sleep, circadian rhythm, and central sensitization.

How I evaluate it

The comprehensive functional neurological exam maps which nerve root is involved through reflexes, dermatomes, myotomes, and nerve tension tests, and screens bowel and bladder function. It assesses balance, gait, vestibular input, and movement control, which often change with leg pain.

Functional labs may include inflammatory markers, fasting glucose and HbA1c, B12, vitamin D, and magnesium. Imaging is ordered when red flags are present, when weakness progresses, or when symptoms persist despite care.

How we address it

• Rule out emergencies and coordinate with your physicians and, when needed, a spine specialist.
• Calm inflammation with nutrition, sleep, circadian anchoring, and gentle positions of relief.
• Find the directional movements that centralize the pain, use them regularly, and treat spreading pain as a signal to step back.
• Progress by how your symptoms respond over the following day, one change at a time.
• Use nerve gliding, functional chiropractic care, and soft tissue work to restore nerve and joint mobility.
• Retrain core stability, hips, balance, and vestibular control with functional neurology.
• Support nerve health with blood sugar balance and nerve-supporting nutrients.

When the pain retreats from the foot toward the back, that is usually a good sign. Centralization tells us the nerve is calming even before the back itself feels better.

Most sciatica improves with a clear, graded plan. The nerve heals best when it is protected, not immobilized.

Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.