Not All Leg Pain is Sciatica—And That’s Okay
Let's be honest: everyone visits "Dr. Google" from time to time. And that’s okay as a starting point. But it should never be the last word. Case in point: one common search query is "causes of leg pain". Google often funnels leg pain inquiries straight to "sciatica pain". In fact, “sciatica” is one of the top 20 search queries in the world! One big problem, however, is that Google isn’t a real doctor, even if it plays one on the internet. It can’t personally evaluate your movement patterns, nor does it care enough to ask you how the pain started in the first place!
As Dr. Paula Czapla says, “Many people think they have sciatica—but that’s not always accurate, and that’s okay."
So, is it sciatic nerve pain? Or is it something else? Google really has no idea. But here at A Life in Balance, we will work personally with you to figure out what happened, diagnose the real issues, and create a personalized physical therapy plan to remove the root causes of your leg pain, whether it’s sciatica or something else. Then you can leave those sciatica symptoms behind and go forward stronger, without the leg pain holding you back.
Sciatica 101: What’s Really Going On
First, let’s define what sciatica actually is: it’s a symptom that indicates the pinching, irritation, or compression of the sciatic nerve that travels through the lower (lumbar) spine between the L4 and S3 vertebrae. The sciatic nerve is the longest, thickest nerve in the body. It runs from the extreme lower back down through the buttocks, the back of the thigh and leg, and into the foot. So, genuine sciatica symptoms include problems like:
Sharp pain radiating down through the behind and the back of the leg.
Numbness and tingling going down the leg and into the foot.
The affected muscles may also be unusually weak because the nerve isn’t able to send signals to the muscles properly.
One thing people often wonder about is whether changes in bladder or bowel habits are connected to back or leg pain. In some cases, those issues can come from pelvic floor dysfunction (something we treat often!), and in other cases they may relate to how nerves in the lower back are functioning. Because there are a few different possibilities, it’s always best to get checked out by a qualified medical provider so you know exactly what’s going on.
When Leg Pain Isn’t Sciatica Pain
Some conditions also cause pain in these same areas, but there are usually differences that separate them from true sciatic nerve pain. For example, muscle tightness, muscle spasms, and joint pain in these areas can mimic sciatica symptoms, even if they aren’t sciatica.
“People often think sciatica is whenever pain goes down the leg,” says Dr. Paula. “But a lot of times, what people are feeling is 'referred pain' from other structures or muscle trigger points. Not all leg pain is sciatica—and that’s an important distinction.”
Common Myths About Sciatica
So is it, or isn’t it sciatica? And how can you really tell? We can definitely help you there, but here are a few myths we’d like to bust right now:
Myth 1: Sciatica is a diagnosis.
Truth: Nope. Sciatica is actually a symptom of an underlying issue, not a standalone condition. It’s a symptom that your sciatic nerve is irritated or pinched.
Myth 2: You just need rest and time.
Truth: Also, no! Your time is precious, and you don't want to waste it on the sidelines with any kind of leg pain, sciatica, or not. It is critically important to seek reliable, professional guidance with gentle movement and guided physical therapy to speed your recovery and prevent the pain from coming back.
Myth 3: There’s one best exercise for sciatica.
Truth: Again, no. That’s like saying there’s only one kind of pizza topping that suits everybody. Everybody’s pain pattern is different—personalized care is key.
As Dr. Paula explains, “We listen to each patient's history of how and why they got to my office and then do a thorough orthopedic evaluation.” The key is finding out what the root cause of the pain is—whether it genuinely is sciatica pain or not. Once we know whether it’s muscle trigger points, an old injury rearing its head, arthritis, or an actual pinched nerve, we can create a customized plan for recovery with exercises that address the underlying problem or problems.
“We’re not just picking from a list of ‘sciatica exercises,’” says Dr. Paula. “We’re finding what your body needs to move and heal better and faster.”
How Physical Therapy Helps (and Why It Works)
At ALIB, our advanced physical therapy approach is highly individual and does not rely on “quick fixes” or generic lists of exercises. What works for one patient may not work for you, just like you may have really strong feelings about pineapple on your pizza that differ completely from someone else's! Here at ALIB, we start with a detailed movement assessment to pinpoint the cause of your pain—then create a customized blueprint that helps you overcome the unique injuries and imbalances behind it.
Once we understand the underlying causes of your sciatica symptoms (whether they’re really sciatica or not), your personal recovery blueprint will include the following elements:
Ongoing movement assessments to find and monitor where the irritation starts, and work on pain relief that addresses the problems behind the pain.
Manual therapy to reduce tension and improve range of motion and mobility.
Nerve glides and mobility work to restore healthy nerve movement and response.
Core and hip strengthening to support better alignment, balance, and stability.
Ongoing education and posture training to prevent future flare-ups and help with injury prevention.
The overall goal is to restore healthy, pain-free movement throughout the body. “We don’t just calm the nerve—we calm the whole system,” says Dr. Paula.
Realistic Recovery: What to Expect
Physical therapy is, of course, a process. And depending on what we discover and your individual blueprint for recovery, your healing timeline won’t look like anyone else’s. That said, patients who work consistently on their exercises typically see improvement within a few weeks of beginning PT. Patience and consistency are the two most important things you can add to your blueprint for healing, which doesn’t always take a linear course.
“True healing takes time,” says Dr. Paula. “Physical therapy is an active modality, and the exercises we give you should make you feel better. And if they don’t, we will figure out why!”
So, even if your sciatica symptoms aren’t a true case of sciatica, we will help you address your leg pain effectively, no matter the underlying cause.
It’s Not About Labels, It’s About Solutions
Whether you come to our physical therapy Flemington NJ location, or our Southern Vermont physical therapy office, we care much less about putting a label on your pain than we care about effectively addressing what’s causing the pain so that you can feel better for the long haul. As Dr. Paula says, “It doesn’t matter what we call it—you’re in pain, and we can help you get better."
So, if Dr. Google has you thinking your leg pain is sciatica pain, the main thing is that you should schedule an appointment with us here at A Life in Balance so that we can get you on the road to feeling better and leaving the pain behind!
Ready to find the real cause of your leg pain?
