What Is Sciatica? Symptoms, Causes & Treatment Options in Los Angeles

Short answer: Sciatica is not a diagnosis on its own — it is a set of symptoms (pain, numbness, tingling, or weakness travelling from the low back or buttock down the back of one leg) caused by irritation or compression somewhere along the sciatic nerve. Most cases improve within 4 to 12 weeks with conservative, non-surgical care, and only a small minority ever need surgery.

This guide was written by Dr. Matthew Gloin, D.C., who has treated low back and leg pain in Los Angeles since opening Live Well Chiropractic and Pilates Center on West Pico Boulevard in 2006. It is educational information, not a substitute for an in-person examination.

What is sciatica?

The sciatic nerve is the thickest and longest nerve in the human body. It is formed from nerve roots that exit the lower spine (roughly L4 through S3), merges deep in the buttock, travels behind the hip and down the back of the thigh, then branches below the knee to supply the calf, shin, and foot.

That nerve carries both movement signals and sensation — touch, temperature, pressure, and pain. When any point along its path is compressed, stretched, or chemically irritated, the signal misfires. Think of a damaged lamp cord: the bulb flickers, dims, or goes out entirely, even though the bulb itself is fine. That is why sciatica is usually felt in the leg even though the source is often in the low back or hip.

Because sciatica is a symptom pattern rather than a diagnosis, effective treatment depends entirely on finding which structure is irritating the nerve.

What does sciatica feel like?

Patients describe it very differently depending on the cause and severity. Common descriptions include:

• A sharp, electric, or shooting pain running from the buttock down the back of the thigh
• A deep ache in one buttock that worsens with prolonged sitting or driving
• Burning or hot-wire sensations along the back of the leg
• Pins and needles, numbness, or a "dead leg" feeling in the calf or foot
• Weakness when pushing off the toes or lifting the front of the foot
• Pain that spikes with coughing, sneezing, or straining

Two features are typical: sciatica is usually one-sided, and the leg symptoms are often worse than the back symptoms. Pain that stays in both legs, or that comes with fever or bladder changes, deserves prompt medical evaluation — see the warning signs below.

What causes sciatica?

In our Los Angeles practice, the great majority of sciatica cases trace back to one of these five sources.

1. Lumbar disc bulge or herniation

The most common cause, especially in adults between 30 and 50. The soft inner material of a spinal disc pushes outward and presses on — or chemically inflames — a nearby nerve root. Our page on herniated disc care in Los Angeles explains what this looks like on examination and how we manage it.

2. Lumbar spinal stenosis and arthritic narrowing

With age, discs thin, joints thicken, and the openings the nerve roots pass through narrow. Classic pattern: leg symptoms that worsen with walking or standing upright and ease when sitting or leaning forward over a shopping cart.

3. Piriformis and deep hip muscle irritation

The sciatic nerve passes directly beside (and in some people, through) the piriformis muscle deep in the buttock. A tight, guarded piriformis can compress the nerve and produce true sciatic symptoms without any disc involvement. We cover this in detail in 3 best piriformis stretches for sciatica and lower back pain relief.

4. Spondylolisthesis and segmental instability

When one vertebra slips slightly forward on the one below it, the nerve pathway narrows. This often responds well to targeted core and hip stabilization rather than manipulation alone.

5. Trauma — including car accidents

A rear-end collision on the 10 freeway can injure discs and joints in the low back that only produce leg symptoms days later. If your sciatica started after a crash, review our auto accident injury care in Los Angeles page — documentation matters for both your recovery and your claim.

Everyday factors that make it worse

Long commutes, desk work without breaks, sleeping positions that twist the pelvis, carrying a wallet in a back pocket, sudden increases in training load, and prolonged sitting after an injury all tend to prolong symptoms.

How long does sciatica last?

Most acute episodes settle substantially within 4 to 6 weeks, and the majority resolve within about 12 weeks with conservative care. Symptoms that persist beyond three months are considered chronic and usually indicate that the underlying driver — a mechanical, postural, or strength issue — has not been addressed.

Recovery is rarely a straight line. Good days followed by a flare-up after a long drive is normal early on. What matters is the trend: leg symptoms pulling back toward the spine (a pattern clinicians call centralization) is a favorable sign.

Warning signs that need urgent medical care

Go to an emergency room or contact a physician immediately — do not wait for a chiropractic appointment — if you have any of the following:

• Loss of bladder or bowel control, or difficulty starting urination
• Numbness in the inner thighs, groin, or saddle region
• Progressive or severe weakness in one or both legs, or a foot that drags
• Sciatica in both legs at once following an injury
• Unexplained fever, night sweats, or unexplained weight loss with back pain
• Severe back pain after significant trauma, or a history of cancer

These can signal cauda equina syndrome, infection, or fracture, which are medical emergencies. Everything else in this article assumes those have been ruled out.

What to do in the first 72 hours

1. Keep moving gently. Prolonged bed rest slows recovery. Short, frequent walks are better than sitting still.
2. Break up sitting. Stand and change position every 20–30 minutes, especially in the car.
3. Use ice or heat by comfort. Ice tends to help sharp, recent flare-ups; heat helps muscular tightness. Neither one is a cure — use whichever lets you move more.
4. Avoid deep forward-bending with rotation — the classic disc-aggravating movement (think loading a heavy bag into a low trunk).
5. Track your symptoms. Note what makes leg pain travel further down, and what pulls it back up toward the spine. That information shapes an accurate diagnosis.

How chiropractic care treats sciatica

Chiropractic care for sciatica is not simply "cracking the back." At Live Well, a first visit begins with history and a physical examination — orthopedic and neurological testing, reflexes, muscle strength, sensation, and movement patterns — to identify the specific source of nerve irritation. Imaging is ordered only when findings warrant it, and cases outside the scope of conservative care are referred out.

Depending on what the examination shows, a treatment plan may combine:

• Spinal manipulation or gentle mobilization to restore motion in restricted lumbar and pelvic joints
• Flexion-distraction and positional techniques that reduce pressure on an irritated disc without forceful thrusting
• Soft tissue therapy for the piriformis, deep hip rotators, hamstrings, and lumbar musculature
• Specific, progressive rehabilitation — nerve glides, hip hinge patterning, and core endurance work
• Ergonomic and activity coaching for your actual desk, car, and workout

Clinical guidelines from major U.S. bodies, including the American College of Physicians, recommend non-drug approaches such as manipulation, exercise, and massage as first-line care for low back pain before medication or surgery. Background on the evidence is also available from the National Center for Complementary and Integrative Health (NIH) and the National Institute of Neurological Disorders and Stroke.

Why a combined approach works better — and what makes our office different

Most Los Angeles clinics offer one service and refer out for the rest. Live Well was built the other way around: chiropractic, Pilates, massage, and acupuncture operate in the same building on West Pico, so a sciatica plan can be coordinated rather than fragmented.

How each service supports sciatica recovery at Live Well

Service	Role in sciatica recovery	Typical stage
Chiropractic care	Diagnosis, restoring joint motion, reducing nerve irritation, guiding the overall plan	From day one
Pilates (reformer and mat)	Rebuilding deep core and hip strength so the low back is supported and flare-ups become less frequent	Once acute pain settles
Massage and soft tissue therapy	Releasing the piriformis, glutes, and hamstrings that keep tension on the nerve	Early and ongoing
Acupuncture	Additional pain modulation for patients who prefer or respond well to it	Any stage

In practice, the patients who stay better longest are the ones who move from pain relief into strengthening. That handoff — from the adjusting table to a Pilates instructor who already knows the clinical findings — is the part that is hard to replicate across separate offices.

What to expect at your first visit

Plan for roughly 45 minutes. You will complete intake paperwork, discuss your history, and go through an examination before any treatment is performed. You will leave with a working diagnosis, an explanation of what is driving your symptoms, and a plan with an expected timeframe. Full details are on our what to expect page, and coverage questions are answered on our chiropractic insurance page.

Our office is at 5553 W Pico Blvd, Los Angeles, CA 90019 — in Mid-City, minutes from Miracle Mile, Beverly Grove, Carthay Circle, Mid-Wilshire, Culver City, and West Hollywood. Hours are Monday, Wednesday, and Friday 9:00 am to 2:00 pm, and Saturday 8:00 am to 4:00 pm. Convenient street parking is available, but there is no onsite lot. The entrance at the front of the building is accessible.

To be evaluated, book an appointment or send us a question, or call (323) 930-9355. For a deeper look at our approach to this condition, see our sciatica treatment in Los Angeles page.

Frequently asked questions about sciatica

Should I see a chiropractor or a medical doctor for sciatica?

For typical mechanical sciatica without red-flag signs, either is a reasonable starting point, and guidelines favor non-drug care first. If you have progressive weakness, bladder or bowel changes, saddle numbness, fever, or a history of cancer, see a physician or emergency department first.

Can sciatica go away on its own?

Often, yes — many episodes resolve within several weeks. Care matters because it usually shortens the episode, reduces the chance of it becoming chronic, and addresses the underlying cause so it recurs less often.

Is walking good for sciatica?

Usually. Short, frequent walks at a comfortable pace are generally better than rest. If walking makes leg symptoms travel further down the leg, shorten the distance and have it evaluated.

What sleeping position is best for sciatica?

Most people are most comfortable on their side with a pillow between the knees, or on their back with a pillow under the knees. Stomach sleeping tends to aggravate symptoms.

Does sciatica require an MRI?

Not routinely. Imaging is indicated when there are red flags, significant or progressive neurological deficits, or when symptoms are not improving as expected with conservative care.

Is Pilates safe when I have sciatica?

Modified, supervised Pilates is often extremely helpful once acute symptoms have calmed. It should be programmed around your diagnosis — some flexion-heavy movements aggravate disc-related sciatica, which is exactly why we coordinate it with your chiropractic findings.

Does insurance cover chiropractic care for sciatica?

Many plans do. Coverage varies by plan; we verify benefits before care begins — details are on our insurance page.

How many visits will I need?

It depends on the cause, how long it has been present, and your goals. Many uncomplicated cases improve meaningfully within a handful of visits over 2 to 4 weeks; longstanding or disc-related cases take longer. You should receive an estimate at your first visit and a reassessment along the way.

Key takeaways

• Sciatica is a symptom of nerve irritation, not a diagnosis — identifying the source is the whole job.
• Disc herniation, arthritic narrowing, piriformis compression, vertebral slippage, and trauma cause most cases.
• Most episodes improve in 4 to 12 weeks with conservative care; surgery is rarely required.
• Bladder or bowel changes, saddle numbness, or progressive weakness are emergencies.
• Combining chiropractic, soft tissue work, and progressive Pilates-based strengthening reduces recurrence.

Medical disclaimer: this article is for general education and does not create a doctor-patient relationship or constitute medical advice. Individual results vary. Please consult a licensed healthcare provider about your specific condition.