Sciatica

Sciatica — when the pain shoots all the way down your leg

It starts somewhere in your lower back or deep in your buttock or hip, then travels — down the back of your thigh, past the knee, sometimes all the way to your foot. It might feel like a sharp electric shock, a burning ache, or a persistent numbness that makes your leg feel heavy and unreliable. Sometimes it flares when you stand up from a chair. Sometimes it wakes you up at night. If this sounds familiar, you're dealing with sciatica — and you don't have to wait it out.

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How do I know if I have sciatica?

Sciatica isn't a diagnosis in itself — it's a description of what the sciatic nerve does when something is irritating it. The sciatic nerve is the longest in the human body, running from the lower spine through the buttock and down the back of each leg to the foot. When it's compressed, irritated or inflamed anywhere along that route, you feel it.

The hallmark signs of sciatica:

Pain radiating from the lower back or buttock into one leg — almost always one-sided
Tingling, numbness, or weakness in the leg, calf, or foot
Pain that worsens when sitting and may ease slightly when walking
Sharp pain when coughing, sneezing, or standing up quickly
A feeling that the leg doesn't quite respond the way it should

When to seek emergency care:

If you experience numbness or tingling in the groin or inner thighs, loss of bladder or bowel control, or weakness in both legs simultaneously, go to an emergency room immediately. These can be signs of cauda equina syndrome, a rare but serious spinal emergency.

What you can do about sciatica — right now

Call your chiropractor if you think you're suffering from sciatica; it is best to be examined and treated by a professional. Before your appointment, there are things you can do today to get some relief. Here's what actually works and some things to avoid.

What tends to help:

The 90/90 position: Lie on your back and rest both legs at a right angle on a chair or couch, hips and knees each at 90 degrees. This takes pressure off the lumbar spine and decompresses the nerve roots. Even 10–15 minutes can reduce the intensity of symptoms.
Heat — especially on the buttock/hip: Most people put heat on their lower back. If the piriformis muscle is involved (and it often is), placing a heat pack directly on the buttock is more effective. Heat relaxes the muscle tissue pressing on the nerve. Important note: 20 minutes is enough. Avoid excessive, deep, or very hot methods as they can make inflammation worse and create more pain when the heat is removed.
The piriformis stretch: Lying on your back, cross the ankle of the affected leg over the knee of the other leg, then gently pull both legs toward your chest. Hold for 30–60 seconds. This reaches deep into the gluteal muscles where much sciatic irritation originates.
Keep moving: Short, slow walks are far better than bed rest. Lying still for hours causes the surrounding muscles to tighten further into spasm and the nerve to remain under tension.

What usually doesn't solve it:

Painkillers tend not to be helpful for nerve pain unless there is inflammation. TENS devices (electrotherapy), and specialist pillows can make living with sciatica more manageable — but they don't address compression or nerve irritation at its source. Avoid using massage guns for extended periods of time, as they can bruise the tissue around the nerve and make it even more sensitive to pain. Deep, excessive heat can also cause rebound pain, especially if inflammation is present. If pain persists beyond two to three weeks, or worsens, professional assessment is the next step.

What causes sciatica?

The irritation has to come from somewhere. Finding that source and making the correct diagnosis is the key to successful treatment. As the body's longest nerve, there are many places where it can become trapped or irritated, and therefore there are many causes for sciatica, but the most common culprits are:

Disc herniation — A bulging, prolapsed or ruptured disc in the lumbar spine can press directly on one of the nerve roots that form the sciatic nerve. This is the most common structural cause in people under 50, and often shows clearly on MRI [1].

Lumbar vertebral restrictions/blockages — When individual vertebrae lose their normal range of motion, the surrounding structures (small muscles and ligaments) spasm and come under pressure. Desk workers, drivers, and people with sedentary lifestyles are especially prone to this.

Piriformis syndrome — The piriformis muscle sits deep in the buttock, running almost directly over the sciatic nerve. When it's in spasm or chronically tight, it can compress the nerve from outside the spine entirely. This is frequently missed in conventional orthopaedic workups and is a common cause of "MRI-negative" sciatica.

Sacroiliac joint dysfunction — The joint between the sacrum and the pelvis can generate referred pain that mimics sciatica and radiates into the leg.

Spinal stenosis — A narrowing of the spinal canal that reduces space for the nerve roots, more common in people over 60. There can be many reasons for this narrowing that can only be conclusively diagnosed with medical imaging (MRI), but because of this narrowing there is often a coinciding compression of the surrounding structures, like nerve roots that make up the sciatic nerve.

Spondylolisthesis — A slippage of one or more vertebrae that causes a spinal canal narrowing. Most people know they have this medical condition because they have had occurances of pain and subsequent imaging already, but orthopedic tests in-office can help determine whether it is causing sciatic pain.

Important to note: there is often a combination of factors that can cause irritation of the sciatic nerve.

How does a chiropractor treat sciatica?

The first step is always assessment — not assumption. Before any treatment begins, we need to identify exactly where the problem originates. Is it the lumbar spine? A specific disc? The sacroiliac joint? The piriformis? The answer shapes everything that follows.

Chiropractic treatment for sciatica is not one-size-fits-all. Depending on what we find, treatment typically combines:

Targeted chiropractic adjustments — When a restricted or misaligned lumbar vertebra is contributing to nerve compression, a precise adjustment restores normal movement and reduces pressure on the nerve root. This is often what produces rapid relief in the early sessions.

Soft tissue therapy for the piriformis — When muscle tension is the primary driver, we work directly on the piriformis and surrounding gluteal muscles using manual techniques and specific stretching protocols that reach this deep structure. For many patients, this is painful, but satisfying.

DNS (Dynamic Neuromuscular Stabilisation) or other Exercise Therapy — A rehabilitation approach that reactivates the deep stabilising muscles of the lumbar spine and pelvis. For patients with recurrent sciatica, DNS or other targeted exercises addresses the underlying motor control deficit that makes relapses so common.

Sciatic nerve mobilisation (nerve flossing) — Gentle techniques designed to help the nerve move freely through the tissues around it, reducing the sensitivity and "stickiness" that prolonged irritation creates.

Many patients notice a significant reduction in radiating leg pain after the first or second session, but it is common to do a course of care over 4 to 6 visits due to the high rate of reoccurance. The goal isn't just pain relief — it's making sure the sciatica doesn't keep coming back.

When to see a chiropractor for sciatica in Munich

The sooner, the better.

Sciatica that goes untreated tends to progress — what starts as an intermittent ache can, over weeks and months, become a chronic, sensitised pain state that's harder to resolve.

You do not need a referral to see us. No GP visit first, no waiting for an orthopaedic appointment, no navigating a referral system. We offer short-notice appointments because we know sciatica doesn't schedule itself conveniently.

See a doctor or go to the hospital if you notice:

Increasing weakness or numbness in the leg (inability to pick up your foot or "foot drop")
Any changes to bladder or bowel control, or loss of control
Symptoms in both legs at the same time

An MRI can be helpful for identifying disc involvement — but in most cases, it's not required before starting chiropractic care. If there is no improvement after 6–8 weeks of conservative treatment, it is standard, evidence-based practice to perform imaging (MRT).

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Sciatica FAQ

How long does sciatica last? It depends on the cause and how long it's been there. Acute sciatica from a lumbar restriction or mild disc bulge often responds well within a few weeks of targeted treatment. Chronic sciatica that has been present for months takes longer and requires more consistency. What's almost universally true: without addressing the underlying cause, sciatica rarely resolves permanently on its own.

How can I tell if it's sciatica or something else? The defining feature of sciatica is radiation into the leg. Back pain that stays in the lower back, without any leg involvement, is not sciatica. If you feel tingling, burning, numbness, or weakness traveling down the back of your thigh — especially on one side — sciatica is likely. Sciatica and a "slipped disc" are often confused: a herniated disc is a cause; sciatica is the symptom it produces.

What makes sciatica worse? Long periods of sitting, especially on hard surfaces or with a wallet in the back pocket, tend to flare it. Prolonged driving, forward-bent desk posture, coughing and sneezing, and high stress levels are common aggravators. Morning is often the worst time, as the discs re-hydrate overnight and may be slightly more bulged.

Can sciatica cause bladder problems? When multiple nerve roots are severely compressed — a condition called cauda equina syndrome — can affect bladder and bowel function. This is a medical emergency. Single-nerve sciatica affecting one leg does not typically cause bladder symptoms.

Is sciatica visible on an MRI? You cannot see sciatica itself on a picture, but a disc herniation compressing a nerve root is usually visible on MRI. However, piriformis syndrome and facet joint restrictions frequently produce no MRI findings at all. This does not mean there's nothing to treat - simply that the "red flag" conditions have been ruled out. Many patients with entirely normal MRIs have a clear and very treatable mechanical cause for their sciatica.

Which vitamin deficiency is linked to sciatica? Vitamin B12 deficiency can impair nerve function and produce symptoms that mimic or worsen sciatica. Vitamin D also plays a role in muscle and nerve health. A blood test with your doctor can clarify this — nutritional factors are worth addressing alongside structural treatment, but they don't replace it.

Do I need an MRI or a doctor's referral to see you in Munich? No. You can book directly with us — no GP letter, no MRI, no waiting list, no referral required. We also offer same-week and short-notice appointments for patients in acute pain.