Sciatica can look very different from one person to the next.
For one patient, it may begin as low-back pain and travel down the back of the leg. Another person may barely notice their back but experience burning, tingling, or numbness into the calf or foot. Someone else may have deep buttock pain that becomes significantly worse after sitting.
All three may describe what they’re experiencing as sciatica.
The important thing to understand is that sciatica isn’t really a diagnosis by itself.
Sciatica describes symptoms associated with irritation or compression of the sciatic nerve or the nerve roots that eventually form it.
And because there are several potential causes, effective sciatica treatment in Durango shouldn’t begin with applying the exact same treatment to every person who has pain traveling down their leg.
At Animas Chiropractic and Collective, we first try to determine where the symptoms are coming from. Depending on what we find, treatment may include chiropractic adjustments, rehabilitation, neurogenic dry needling, shockwave therapy, or referral for additional medical evaluation.
Dealing with back, buttock, or leg pain?
What Is Sciatica?
The sciatic nerve is the largest nerve in the body.
It is formed from nerve roots in the lower spine and travels through the pelvis and buttock before continuing down the back of the leg. Farther down, it branches into nerves that supply different parts of the lower leg and foot.
When one of the spinal nerve roots contributing to the sciatic nerve becomes irritated, symptoms may travel along that pathway.
Common symptoms include:
- Low-back pain
- Buttock pain
- Pain traveling down the back or side of the leg
- Burning sensations
- Tingling
- Numbness
- Electric or shooting pain
- Weakness in the leg or foot
- Symptoms aggravated by sitting, bending, coughing, or certain movements
Some people experience mostly pain.
Others experience very little pain but significant tingling or numbness.
That variation is one reason an examination matters.
What Causes Sciatica?
Several conditions can create sciatica symptoms due to nerve irritation or inflammation. Additionally, symptoms may range from dull ache to sharp, shooting pain that radiates down the leg. The exact pattern depends on which nerve roots are affected and how long the issue persists.
Some begin at the lumbar spine, where the nerve roots originate.
Others occur farther along the sciatic nerve’s pathway.
The most common possibilities include:
- Lumbar disc herniation or disc irritation
- Degenerative changes in the lumbar spine
- Lumbar spinal stenosis
- Foraminal narrowing
- Spondylolisthesis
- Deep gluteal or piriformis-related sciatic nerve irritation
- Less commonly, other neurological, hip, pelvic, or systemic conditions
Determining which category fits is one of the most important parts of treatment.
Cause #1: Lumbar Disc Herniation or Disc Irritation
One of the best-known causes of sciatica is a lumbar disc problem.
Discs sit between the vertebrae of the spine and help distribute load.
If disc material bulges or herniates, it may irritate a nearby spinal nerve root. Chemical inflammation around the nerve root can also contribute to symptoms.
This can produce:
- Low-back pain
- Pain into the buttock
- Pain traveling below the knee
- Tingling or numbness
- Symptoms worsened by sitting or bending
- Pain with coughing or sneezing
- Weakness in specific muscle groups
The presence of a disc herniation on an MRI does not automatically mean surgery is necessary.
Disc changes are common, and many cases of lumbar radicular pain can improve with conservative management.
Treatment decisions should be based on symptoms, neurological findings, function, and progression—not simply an imaging report.
Cause #2: Lumbar Spinal Stenosis
Another potential cause is lumbar spinal stenosis.
Stenosis means narrowing.
As we age, changes in the discs, joints, and surrounding tissues can reduce the amount of space available for nerves in the lumbar spine.
People with spinal stenosis may notice symptoms such as:
- Leg aching or heaviness
- Tingling or numbness
- Symptoms with prolonged standing or walking
- Relief when sitting
- Relief when leaning forward
- Difficulty walking longer distances
This presentation can behave very differently from an acute disc-related episode.
That’s why simply being told you have “sciatica” doesn’t tell us enough.
Cause #3: Foraminal Narrowing
The spinal nerves exit the spine through small openings called foramina.
Degenerative changes, disc height loss, arthritis, or other structural changes can narrow those openings and irritate the exiting nerve.
Symptoms can resemble other forms of lumbar radiculopathy and may include pain, numbness, tingling, or weakness along a particular nerve distribution.
How those symptoms change with spinal position can provide useful clues during an examination.
Cause #4: Spondylolisthesis
Spondylolisthesis occurs when one vertebra shifts relative to the vertebra below it.
Not everyone with spondylolisthesis has symptoms.
When it does contribute to narrowing or nerve irritation, however, it can produce sciatic-type symptoms.
Treatment depends heavily on severity, stability, symptoms, and neurological findings.
Some cases respond well to conservative management, while others require additional medical evaluation.
Cause #5: Piriformis Syndrome and Deep Gluteal Sciatic Nerve Irritation
Not every case of sciatica begins in the spine.
The sciatic nerve also passes through the deep gluteal region.
In some patients, it may become irritated or compressed by structures in this area. Piriformis syndrome is one commonly used term for this type of presentation, although deep gluteal syndrome can encompass other causes of nerve entrapment as well.
Common features can include:
- Deep buttock pain
- Pain worsened by prolonged sitting
- Pain traveling down the leg
- Tenderness in the deep gluteal region
- Symptoms provoked by positions that tension the piriformis
- Relatively little low-back pain
Piriformis syndrome can mimic sciatica coming from the lumbar spine, so it is generally considered after other causes have been evaluated.
This distinction is particularly important for the treatments we use in our office because dry needling and shockwave therapy may be more relevant when the primary problem is in the deep gluteal region rather than a compressed lumbar nerve root.
Sciatica vs. Piriformis Syndrome: What’s the Difference?
True lumbar radicular sciatica originates from irritation of a nerve root in the lower spine.
Piriformis or deep-gluteal sciatic nerve irritation occurs farther downstream, around the buttock.
Both can cause pain down the leg.
The treatment approach, however, may be quite different.
This is why we don’t want to assume that every patient with leg pain needs their piriformis treated—or that every case automatically requires treatment to the lumbar spine.
We examine both.
How Do We Treat Sciatica?
There isn’t one universal sciatica treatment.
The best treatment depends on what is irritating the nerve.
At our office, conservative care may include some combination of:
- Chiropractic adjustments
- Progressive rehabilitation
- Neurogenic dry needling
- Shockwave therapy in selected cases
- Nerve mobility exercises
- Activity modification
- Hip and core strengthening
- Mobility work
- Referral for imaging or medical evaluation when indicated
Not every patient needs every modality.
The diagnosis guides the treatment.
Chiropractic Adjustments for Sciatica
Chiropractic adjustments can be useful for some patients with low-back and sciatic-type pain, particularly when joint restrictions or mechanical factors are contributing to symptoms.
During the examination, we may evaluate:
- Lumbar spine mobility
- Pelvic and sacroiliac movement
- Hip mobility
- Neurological function
- Which movements improve or worsen symptoms
Adjustments may then be incorporated when appropriate.
It is important to be clear about what adjustments are—and are not—doing.
We aren’t trying to “push a disc back into place.”
And sciatica isn’t necessarily caused by a vertebra simply being “out.”
Instead, manipulation can be one tool for improving motion, modulating pain, and helping patients move more comfortably while the underlying condition recovers.
Research evaluating nonsurgical treatments for sciatica has included spinal manipulation among conservative options, although the overall evidence across sciatica interventions varies in quality.
[Learn more about Chiropractic Adjustments → INTERNAL LINK]
Dry Needling for Sciatica
Dry needling is another tool we may use, but its role depends heavily on where the symptoms are coming from.
At Animas Chiropractic and Collective, we use a neurogenic approach to dry needling.
Rather than simply inserting needles into a tight muscle, we consider the relationship between muscles, peripheral nerves, spinal regions, and the nervous system.
For someone with sciatic-type symptoms, this may involve treating relevant neuromuscular structures around the lumbar spine, gluteal region, or lower extremity depending on examination findings.
Dry needling may be particularly useful when there is significant muscular guarding or a deep-gluteal component to symptoms.
However, it is important not to overstate the evidence.
Research directly studying dry needling for lumbar radicular sciatica remains limited; a scoping review found a gap in direct dry-needling research for sciatica specifically.
The evidence is becoming more interesting for piriformis syndrome, where newer clinical research has compared dry needling with shockwave therapy.
[Learn more about Neurogenic Dry Needling → Home – Animas Chiropractic – Durango, Colorado
Can Shockwave Therapy Help Sciatica?
This requires an important distinction.
Shockwave therapy is not a routine treatment for a lumbar disc herniation or a compressed spinal nerve root.
We would not simply apply shockwave to the lower back because someone has sciatica.
Where shockwave becomes more relevant is when sciatic symptoms appear to involve piriformis syndrome or deep-gluteal muscular dysfunction.
Research in this area is emerging.
A 2026 randomized clinical trial compared extracorporeal shockwave therapy with dry needling in people with piriformis syndrome. Both groups also performed stretching, and both groups showed improvements in pain and function during three months of follow-up, with no significant difference between the two treatments.
Other randomized studies have also reported improvement with shockwave for piriformis syndrome, including comparisons with corticosteroid injections.
This makes shockwave an interesting conservative option in appropriately selected deep-gluteal presentations.
But again:
Shockwave treats the tissue we’re targeting. It doesn’t automatically treat every cause of sciatica.
[Learn more about Shockwave Therapy → INTERNAL LINK]
What Would Shockwave for Piriformis-Related Pain Feel Like?
When shockwave is appropriate, treatment is directed toward the involved gluteal tissues using a handpiece applied externally over the skin.
At our office, we use the Piezowave 2 shockwave system.
Most patients describe treatment as:
- Repetitive tapping
- Pulsing
- Deep pressure
- Temporary tenderness in sensitive areas
Treatment intensity and depth can be adjusted.
Shockwave is generally performed as a series of treatments and is typically combined with movement or rehabilitation rather than used as a stand-alone solution.
[Read: What Does a Shockwave Therapy Session Feel Like? → INTERNAL LINK]
Rehabilitation for Sciatica
No matter which hands-on treatments we use, rehabilitation usually matters.
The exact exercises depend on the cause.
Someone with a disc-related radiculopathy may need a very different program than someone with spinal stenosis or deep-gluteal sciatic nerve irritation.
Treatment may involve:
- Directional spinal movements
- Core stabilization
- Hip strengthening
- Gluteal strengthening
- Nerve mobility exercises
- Gradual exposure to bending or lifting
- Walking progression
- Movement retraining
A major goal is to help the nervous system and surrounding tissues tolerate movement again.
We generally don’t want patients to become afraid of their backs.
Instead, we want to find movements that are appropriate now and gradually build toward the movements life requires.
What Are Nerve Glides?
Nerves need to move relative to surrounding tissues.
A nerve glide or neural-mobility exercise uses controlled movement to change tension along a nerve pathway.
For some sciatic presentations, these exercises can be useful.
However, aggressive stretching of an irritated nerve can sometimes make symptoms worse.
That’s why we prefer controlled nerve mobility rather than simply telling everyone with sciatica to stretch their hamstrings as hard as possible.
Sometimes what feels like a “tight hamstring” is actually a sensitive nervous system telling you it doesn’t want more tension.
Should You Stretch Your Piriformis for Sciatica?
Maybe—but not automatically.
If your symptoms are truly related to piriformis or deep-gluteal irritation, certain mobility exercises may help.
But if the sciatic nerve is highly sensitive, aggressive stretching can sometimes increase symptoms.
And if the problem is actually coming from a lumbar disc or spinal stenosis, repeatedly stretching the piriformis may do very little.
Again, diagnosis matters more than the label “sciatica.”
Should You Rest If You Have Sciatica?
Usually, prolonged bed rest isn’t the goal.
During a particularly painful flare, temporarily reducing aggravating activities can be appropriate.
But gradually returning to movement is generally an important part of recovery.
Depending on the condition, we may modify:
- Sitting duration
- Heavy lifting
- Running
- Cycling
- Repetitive bending
- Long car rides
- Hiking
- Certain gym exercises
The goal is usually activity modification, not permanent activity avoidance.
When Does Sciatica Need Imaging?
Not everyone with sciatica needs an MRI immediately.
Imaging may become more important when symptoms are severe, neurological deficits are progressing, the diagnosis is unclear, significant trauma occurred, or symptoms aren’t improving as expected.
If imaging is warranted, we can help determine the appropriate next step or coordinate referral.
An MRI is a useful tool—but it should support the clinical picture rather than replace an examination.
When Is Sciatica an Emergency?
Most cases of sciatica are painful but not dangerous.
However, certain symptoms require urgent medical evaluation.
Seek immediate care for symptoms such as:
- New loss of bowel or bladder control
- Difficulty initiating urination combined with neurological symptoms
- Numbness around the groin, genitals, or inner thighs
- Rapidly progressing leg weakness
- Significant weakness affecting both legs
- Severe neurological changes
These can be warning signs of serious compression of the nerves at the bottom of the spinal canal, including cauda equina syndrome, which requires urgent evaluation.
You should also seek appropriate medical evaluation for severe pain associated with fever, unexplained weight loss, major trauma, known cancer, or other concerning systemic symptoms.
Treating Sciatica in Durango
Sciatica is one of those conditions where the name alone isn’t enough to determine treatment.
Pain traveling down the leg might come from a lumbar disc.
It might be related to spinal stenosis.
It may involve foraminal narrowing.
Or it may be sciatic nerve irritation occurring farther down in the deep gluteal region.
At Animas Chiropractic and Collective, our first goal is to identify the most likely source.
From there, treatment may include:
Chiropractic adjustments when spinal or pelvic joint mechanics are relevant.
Neurogenic dry needling when neuromuscular and neurogenic factors are contributing.
Shockwave therapy in selected cases involving piriformis or deep-gluteal tissue.
Progressive rehabilitation to restore strength, movement tolerance, and confidence.
And when symptoms don’t fit a conservative musculoskeletal presentation, we refer appropriately.
The goal isn’t to treat “sciatica.”
It’s to figure out why your sciatic nerve is unhappy in the first place.
Home – Animas Chiropractic – Durango, Colorado
Frequently Asked Questions About Sciatica
What is the most common cause of sciatica?
Lumbar disc irritation or herniation is a common cause, particularly in younger and middle-aged adults. Degenerative changes and spinal stenosis become more common causes with age. Sciatic-type symptoms can also arise from irritation farther along the nerve, including the deep gluteal region.
What does sciatica feel like?
Sciatica may cause shooting, burning, aching, tingling, numbness, or electric sensations traveling from the buttock into the leg. Some people also experience weakness.
Can sciatica happen without back pain?
Yes. Some people experience primarily buttock or leg symptoms even when the irritated nerve root originates in the lumbar spine.
Is piriformis syndrome the same as sciatica?
Piriformis syndrome can produce sciatic-type symptoms, but it isn’t the same as lumbar radicular sciatica. In piriformis syndrome, irritation occurs around the sciatic nerve in the deep gluteal region rather than at a spinal nerve root.
Can chiropractic adjustments help sciatica?
Spinal manipulation may be one component of conservative care for some patients with sciatica, depending on the underlying cause and examination findings. It is not appropriate for every presentation.
Can dry needling help sciatica?
Dry needling may be incorporated when muscular or neurogenic factors contribute to symptoms, particularly in deep-gluteal presentations. Direct evidence for dry needling specifically for lumbar radicular sciatica remains limited, so treatment should be based on the individual clinical presentation.
Can shockwave therapy help sciatica?
Shockwave is not generally used to treat a compressed lumbar nerve root. Research has shown promising results for shockwave therapy in piriformis syndrome, which can mimic or produce sciatic-type symptoms.
Can shockwave and dry needling both treat piriformis syndrome?
Potentially. A randomized clinical trial published in 2026 found improvements in pain and function with both dry needling and extracorporeal shockwave therapy combined with stretching for piriformis syndrome.
Is walking good for sciatica?
Walking is often encouraged when tolerated, but the appropriate amount depends on the cause and severity of symptoms. Someone with spinal stenosis may respond differently to walking than someone with a disc-related episode.
Should I stretch if I have sciatica?
Not necessarily. Some mobility exercises can be helpful, but aggressively stretching an irritated sciatic nerve can sometimes increase symptoms. Exercise should be tailored to the underlying condition.
How long does sciatica take to improve?
Recovery varies depending on the cause, severity, neurological involvement, activity demands, and treatment. Many cases improve conservatively, while persistent or progressive symptoms may require further evaluation.
When should I worry about sciatica?
Seek urgent medical attention for new bowel or bladder dysfunction, saddle-region numbness, rapidly progressive weakness, or major neurological changes. These symptoms may indicate significant nerve compression requiring immediate evaluation.
Where can I get treatment for sciatica in Durango?
Animas Chiropractic and Collective provides evaluation and conservative treatment for low-back, buttock, and sciatic-type leg pain in Durango, Colorado. Depending on the cause, treatment may include chiropractic adjustments, rehabilitation, neurogenic dry needling, and shockwave therapy for appropriately selected conditions.
