Sciatica Is a Symptom — Not a Diagnosis
Sciatica is one of the most commonly used — and most commonly misunderstood — terms in musculoskeletal medicine. Strictly speaking, sciatica refers to pain that travels along the path of the sciatic nerve — from the lower back through the buttock and down the leg, sometimes reaching the foot. But sciatica is not a diagnosis. It is a description of a symptom pattern that can have several different underlying causes — and the treatment approach depends entirely on which cause is driving it.
When sciatica is treated as a uniform condition rather than a symptom with a specific underlying driver, results are inconsistent. Patients receive the same treatment regardless of whether their pain is coming from a lumbar disc, a tight piriformis, a sacroiliac joint, or a peripheral nerve entrapment — and when the treatment doesn't match the cause, the pain persists.
At Bray Chiropractic & Wellness in Glastonbury, nerve pain is evaluated with the goal of identifying the specific source and mechanism — so treatment can be directed at the actual problem.
What Is the Sciatic Nerve?
The sciatic nerve is the largest nerve in the body. It originates from nerve roots at the L4, L5, S1, S2, and S3 levels of the lumbar spine and sacrum, travels through the pelvis, passes through or near the piriformis muscle in the buttock, and continues down the back of the leg to the foot. Because of its size and length, it can be irritated or compressed at multiple points along its course — and the location of irritation significantly affects the character and distribution of symptoms.
Common Causes of Sciatica and Nerve Pain
Lumbar disc herniation
The most commonly cited cause of sciatica. When a disc herniates, the displaced disc material can compress or irritate the adjacent nerve root — producing pain, numbness, tingling, or weakness in the distribution of that nerve. The specific nerve root affected determines the pattern of symptoms. Disc-related sciatica often responds well to directional movement strategies and chiropractic care when properly assessed.
Lumbar spinal stenosis
Narrowing of the spinal canal or intervertebral foramina that compresses the nerve roots. More common in older patients. Often produces bilateral leg symptoms that worsen with prolonged standing or walking and improve with sitting or flexion.
Piriformis syndrome
A condition in which the sciatic nerve is irritated by the piriformis muscle in the buttock — either because the piriformis is hypertonic and compressing the nerve, or because of an anatomical variant in which the nerve passes through the muscle rather than beneath it. Piriformis syndrome is frequently misdiagnosed as lumbar disc pathology because the symptom pattern is similar. The key distinction is that lumbar provocation tests are typically negative, while piriformis and hip provocation tests are positive.
Sacroiliac joint referred pain
SI joint dysfunction can refer pain into the buttock and posterior thigh in a pattern that mimics sciatica. This is one of the most common sources of diagnostic confusion in low back and leg pain. Learn more about SI Joint Dysfunction.
Peripheral nerve entrapment
The sciatic nerve and its branches — including the common peroneal nerve, tibial nerve, and sural nerve — can be entrapped at multiple points along the lower extremity. Peripheral entrapments produce symptoms that follow the distribution of the entrapped nerve and are frequently missed when assessment focuses exclusively on the lumbar spine.
Multiple crush syndrome
A condition in which a nerve is compressed or irritated at more than one point along its course simultaneously — for example, at the lumbar spine and at the piriformis. Each individual compression may be subclinical, but the combination produces significant symptoms. Identifying and addressing all points of irritation is essential for resolution. This is a presentation Dr. Bray has presented on clinically, having delivered a Grand Rounds case study on sciatic nerve entrapment and multiple crush syndrome at the University of Bridgeport School of Chiropractic.
Symptoms of Sciatica and Nerve Pain
Sciatic and lower extremity nerve pain can present in a variety of ways depending on the underlying cause and the nerve involved:
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Sharp, shooting, or burning pain traveling from the low back or buttock into the leg
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Numbness or tingling in the leg, foot, or toes
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Weakness in the leg or foot
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Pain that worsens with sitting, standing, bending forward, or coughing and sneezing
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Pain that is relieved by certain positions or movements — and worsened by others
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Symptoms that are primarily in the buttock without significant low back pain
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Symptoms that change in character or distribution over time
The specific pattern of symptoms provides important diagnostic information. A careful assessment of symptom behavior — what makes it better, what makes it worse, how it has changed over time — is one of the most important parts of the evaluation process.
How Sciatica Is Evaluated at This Practice
Assessment of sciatica and nerve pain at Bray Chiropractic & Wellness includes:
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Detailed health history — onset, mechanism, symptom distribution, behavior, and prior treatment history
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Full neurological examination — assessing sensation, reflexes, and motor strength in the lower extremities
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Orthopedic provocation testing — lumbar, SI joint, hip, and piriformis specific tests to identify the source of nerve irritation
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Neurodynamic assessment — evaluating the mobility and sensitivity of the neural tissue along its full course
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Functional movement assessment — identifying positions and movements that centralize versus peripheralize symptoms
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Peripheral nerve assessment — evaluating entrapment points along the lower extremity when indicated
How Sciatica Is Treated at This Practice
Treatment for sciatica and nerve pain at Bray Chiropractic & Wellness is directed at the specific source identified in the assessment. Treatment may include:
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Chiropractic manipulation and mobilization for lumbar and SI joint contributions
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Soft tissue therapy and orthopedic massage for piriformis, deep hip rotator, and surrounding muscular contributors
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Dry needling for piriformis syndrome, trigger point contributions, and neuromuscular components
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Neurodynamic mobilization — gentle movement techniques designed to restore mobility of the nerve along its course
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Rehabilitative exercise targeting the specific movement and loading factors contributing to nerve irritation
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Clinical nutrition guidance when systemic inflammation is contributing to nerve sensitivity
Learn more about Chiropractic Care, Dry Needling, and Rehabilitative Exercise at this practice.
Sciatica & Nerve Pain Treatment in Glastonbury, CT
Patients with sciatica, lumbar radiculopathy, and lower extremity nerve pain in Glastonbury, South Glastonbury, Hebron, Marlborough, East Hartford, Manchester, and the surrounding Hartford County area will find a thorough, source-specific approach to nerve pain care at Bray Chiropractic & Wellness.
No referral is required. New patients can schedule directly online or by calling or texting (203) 303-4760. Bray Chiropractic & Wellness is in-network with Aetna, Anthem BCBS, Cigna (ASH), and CT Medicaid (Husky). Self-pay and HSA/FSA options are also available.