Sciatica and pain radiating down the leg
Sciatica is the term used when pain starts in the lower back or buttock and travels down the leg, sometimes as far as the foot. It may come with numbness, tingling or a burning sensation.
The word describes where the pain travels rather than a specific cause. Irritation of a nerve root in the lower back, for example by a herniated disc, can produce it, but other structures of the lower back, pelvis or hip can cause similar pain. Telling these situations apart is the purpose of the assessment.
Some episodes improve over a few weeks. Others persist or come back. In either case, knowing what is involved helps you make informed decisions.
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When to see a doctor without waiting
Some signs call for prompt medical assessment rather than a chiropractic appointment. See a doctor right away, or go to the emergency department, if leg pain comes with any of the following:
- Loss of bladder or bowel control, or difficulty urinating
- Numbness in the genital area, inner thighs or around the anus
- Weakness in the leg or foot that is getting worse, for example a foot that catches or drops when walking
- Symptoms in both legs at once
- Fever, unexplained weight loss, a history of cancer, or pain following a fall or significant accident
What an assessment involves
Screening for warning signs
Before anything else, the examination aims to rule out signs that may point to a condition requiring medical investigation. If one is present, you will be referred to a doctor.
The history of your pain
How it began, the path it follows, what aggravates and relieves it (sitting, walking, coughing, bending), and what has already been tried.
The neurological examination
Strength, reflexes and sensation in the leg and foot, and nerve tension tests.
The lower back, pelvis and hip
Examining these regions helps distinguish pain coming from a nerve root from pain produced by other structures that can follow a similar path.
A plan discussed with you
If chiropractic care is indicated, your chiropractor explains the options and the reasoning behind them, and gives you an estimate of how long care should last and how many visits to expect. If it is not, he will tell you and direct you to the appropriate professional.
Care, when indicated
Depending on what the assessment shows and on your preferences, care may include manual techniques, spinal mobilisation or manipulation, and an exercise programme adapted to your situation. Advice on positions, daily activities and returning to work is also part of it.
Progress is reassessed at planned intervals. If your condition does not evolve as expected, or if further tests such as imaging appear necessary, your chiropractor will refer you to your doctor.
When leg or back pain has lasted several months, the page on chronic pain and complex conditions describes the approach to persistent pain.
Common questions
Do I need an X-ray or MRI?
Imaging is not requested routinely. It is considered when clinical signs warrant it or when the condition does not evolve as expected. If you already have imaging results or reports, bring them to your first visit.
Do I need a medical referral?
No. You can book an appointment directly.
How many visits will I need?
It depends on your situation. After the assessment, your chiropractor will give you an estimate of how long care should last and how many visits to expect.
Talk to us about your pain
Reach our team directly. No online form needed.