Areas of Treatment

Sciatica

Pain down the leg is a signal, not a diagnosis.

Sciatica describes pain that travels along the path of the sciatic nerve — from the lower back through the buttock and down the leg, sometimes as far as the foot. It can present as sharp pain, burning, tingling, numbness, or weakness. For some people it's occasional and manageable; for others it's constant and severely limiting.

The word sciatica tells you where the pain is going. It doesn't tell you why. And that distinction matters a great deal for how it's treated.

What's actually driving it

The sciatic nerve can be compressed or irritated at several points along its path — at the lumbar spine (disc herniation, joint inflammation, spinal stenosis), at the piriformis muscle in the buttock, or through tension in the surrounding soft tissue. Each of these has a different presentation and a different treatment approach.

Disc-related sciatica and piriformis syndrome, for example, are commonly confused — and treating them the same way produces poor results. Accurate assessment of where the nerve is being irritated, and why, is the starting point for effective treatment.

Research noteA Cochrane review (2020) examining treatments for sciatica found that spinal manipulative therapy produced short-term improvements in pain and function comparable to other recommended treatments, with a good safety profile. The authors noted that multi-modal approaches addressing both the spine and surrounding soft tissue consistently outperformed single-modality treatment.Dowell et al. (2020). Treatments for sciatica: an overview of systematic reviews. Cochrane Database of Systematic Reviews.

How Dr Chase approaches it

Assessment identifies where along the nerve pathway the irritation is occurring, and what's driving it — whether that's disc pressure, joint inflammation, muscular compression, or a combination. The pelvis, sacroiliac joints and hip are all examined, as dysfunction in these areas frequently contributes to sciatic irritation even when the primary issue appears lumbar.

Treatment typically combines lumbar and sacroiliac joint mobilisation, targeted soft tissue work through the piriformis and deep hip rotators, and where relevant, visceral techniques addressing the psoas — a muscle with deep connections to both the lumbar spine and the nervous system. Rehabilitation guidance is provided where appropriate to support recovery and reduce the risk of recurrence.

Research noteResearch published in the Journal of Orthopaedic & Sports Physical Therapy (2018) found that combining manual therapy with targeted exercise produced significantly better outcomes for lumbar radiculopathy (nerve root pain) than exercise alone, with greater reductions in leg pain, disability and return-to-work time.Cleland et al. (2018). Manual therapy and exercise for lumbar radiculopathy. Journal of Orthopaedic & Sports Physical Therapy, 48(1).

Sciatica tends to worsen with time when the underlying cause isn't addressed. Early, accurate treatment makes a significant difference to outcomes.

Ready to take the next step?

Dr Chase sees patients across the Sunshine Coast from his clinic in Yaroomba.

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