Sciatica

Evidence-Informed Chiropractic Care


Sciatica is not a diagnosis on its own. It is a pattern of symptoms that signals irritation or dysfunction affecting the nerves that travel from the lower spine into the hip, leg, and foot.


For many people, sciatica becomes persistent, unpredictable, and frustrating — often returning despite medication, rest, or imaging that shows “nothing serious.”


Understanding what sciatica actually is and how it responds to care is essential to recovery.

What Is Sciatica?


Sciatica refers to pain, numbness, tingling, or weakness that follows the path of the sciatic nerve.
Symptoms may include:


  • Sharp or burning pain down one leg
  • Pins and needles or numbness in the foot
  • Weakness when standing, walking, or lifting
  • Pain that worsens with sitting or bending


Importantly, sciatica is not always caused by disc herniation.
Research shows that nerve irritation may also arise from:


  • Reduced spinal movement
  • Segmental joint dysfunction
  • Altered nervous system signalling
  • Chronic inflammation around spinal structures


Imaging often rules out serious pathology but does not assess nerve function or spinal movement,
which are critical contributors to sciatic symptoms.

What the Research Says About Chiropractic Care for Sciatica

Spinal Manipulation and Nerve-Related Pain


Spinal Manipulative Therapy (SMT) has been shown to reduce pain and improve function in patients with lumbar radiculopathy and sciatica-related symptoms (Bronfort et al., 2008; Heliövaara et al., 2013).


Clinical trials demonstrate that Chiropractic care:


  • Improves pain intensity
  • Enhances mobility and daily function
  • Reduces reliance on medication


These improvements are linked not only to mechanical changes, but also to neurological modulation and improved sensorimotor integration (Niazi et al., 2024; Haavik and Murphy, 2012).

Dose and Structure Matter


Sciatica rarely resolves with one-off treatment.



Studies consistently show that structured, repeated care produces better outcomes than sporadic intervention (Haas et al., 2014). This aligns with what we know about nerve healing, inflammation resolution, and central nervous system adaptation.


Short-term or under-dosed care often leads to:

  • Temporary relief
  • Symptom recurrence
  • Incomplete neurological recovery


This is why sciatica requires a planned approach, not guesswork.

Chiropractic vs Medical Management for Sciatica


Medication-based management for sciatica often focuses on symptom suppression through:


  • NSAIDs
  • Muscle relaxants
  • Opioids


However, systematic reviews have shown that these medications offer limited benefit for nerve-related low back pain, with increased risk when used long-term (Chou et al., 2017; Enthoven et al., 2016).


In contrast, patients receiving Chiropractic care demonstrate:


  • Lower medication use
  • Reduced progression to surgery
  • Better functional outcomes over time
    (Cifuentes et al., 2011; Goertz et al., 2018)


Importantly, research has also shown that spinal surgery for nerve-related lower back conditions carries:


  • Higher complication rates
  • Increased disability risk
  • Poor long-term return-to-work outcomes
    (Nguyen et al., 2011; Don and Carragee, 2008)


This is why conservative, movement-based care is recommended before invasive options.

Safety and Appropriateness


When delivered by registered Chiropractors following proper assessment, Chiropractic care has a strong safety profile for sciatica-related presentations (Cassidy et al., 2008; Whedon et al., 2022).


At Adjusting to Health, care is only provided after:


  • Thorough neurological examination
  • Orthopaedic testing
  • Review of imaging when indicated


If findings suggest progressive neurological deficit, infection, fracture, or systemic disease, immediate referral is made.

The Health Blueprint™ Process for Sciatica


Through the Health Blueprint™ Process, we:


  • Identify whether symptoms are mechanical, neurological, or systemic
  • Assess spinal movement and nerve sensitivity
  • Track objective change through progress examinations
  • Modify care based on response, not assumption


This ensures care remains Appropriate, Measured, and Evidence-Informed.

Why Many GPs Refer Sciatic Patients to Chiropractic


As evidence has evolved, many GPs now refer patients with sciatica for Chiropractic assessment, particularly when:


  • Imaging is inconclusive
  • Medication has not resolved symptoms
  • Surgery is not clearly indicated



This reflects growing recognition that addressing spinal movement and nervous system function leads to better long-term outcomes (Bishop et al., 2010; Goertz et al., 2018).

Next Steps


If you are experiencing sciatic pain and want:


  • Clarity rather than assumptions
  • Conservative care before invasive options
  • A structured, evidence-informed plan


Your next step is a comprehensive assessment using our Health Blueprint™ Process

References


Bishop, P.B., et al. (2010) The Chiropractic Hospital-Based Interventions Research Outcomes (CHIRO) Study. The Spine Journal, 10(12), pp.1055–1064.


Bronfort, G., et al. (2008) Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. The Spine Journal, 8(1), pp.213–225.


Cassidy, J.D., et al. (2008) Risk of vertebrobasilar stroke and chiropractic care. Spine, 33(4), pp.S176–S183.


Chou, R., et al. (2017) Systemic pharmacologic therapies for low back pain. Annals of Internal Medicine, 166(7), pp.480–492.


Cifuentes, M., et al. (2011) Health maintenance care and disability recurrence in work-related low back pain. Journal of Occupational and Enviro Medicine, 53(2), pp.190–198.


Don, A.S. and Carragee, E.J. (2008) Evidence-informed management of chronic low back pain with surgery. The Spine Journal, 8(1), pp.258–265.


Enthoven, W.T.M., et al. (2016) NSAIDs for chronic low back pain. Cochrane Database of Systematic Reviews.


Goertz, C.M., et al. (2018) Effect of usual medical care plus chiropractic care vs usual medical care alone. JAMA Network Open, 1(1).


Haas, M., et al. (2014) Dose-response and efficacy of spinal manipulation for chronic low back pain. The Spine Journal, 14(7), pp.1106–1116.


Haavik, H. and Murphy, B. (2012) The role of spinal manipulation in addressing CNS dysfunction. Journal of Electromyography and Kinesiology, 22(5), pp.768–776.


Heliövaara, M., et al. (2013) Lumbar disc herniation and sciatica. BMJ, 347.


Nguyen, T.H., et al. (2011) Long-term outcomes of lumbar fusion. Spine, 36(4), pp.320–331.


Niazi, I.K., et al. (2024) Neuroplastic responses to chiropractic care. Scientific Reports, 14.


Whedon, J.M., et al. (2022) Risk of adverse events following spinal manipulation. Journal of Manipulative and Physiological Therapeutics, 45(2).