Sciatica

Sciatica or Something Else? Common Causes of Leg Pain From Your Back

Reviewed by Dr. Dustin Dukart, DC — September 20, 2026

“Sciatica” gets used as a catch-all for pain running down the leg — it’s actually a symptom, not a diagnosis on its own. Here’s what’s usually behind it, and the small number of signs that mean it’s time to see a doctor first.

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Reassuring context: a large retrospective cohort study found no increased association between chiropractic spinal manipulation and cauda equina syndrome. The red flags below are signs that mean “see a doctor first” — not evidence that care itself creates them.

What “Sciatica” Actually Means

Sciatica describes pain — sharp, shooting, or burning — that radiates from the low back or buttock down the back of one leg, often with numbness, tingling, or weakness. It happens when something is irritating or compressing the sciatic nerve or its nerve roots. The most common cause is a herniated disc pressing on a nerve root; spinal stenosis (narrowing around the nerve) is another common one, especially as we get older.

Why the Distinction Matters

Both causes can produce very similar leg pain, but they respond differently to different approaches, and they’re identified differently on exam — which is why “I have sciatica” is a useful starting description but not the end of the workup.

The Signs That Mean See a Doctor First

The large majority of sciatica is not an emergency. A small number of cases involve pressure on multiple nerve roots at once (cauda equina syndrome), and those need prompt medical evaluation rather than a chiropractic visit. Get seen right away — same-day, at urgent care or the ER — if you notice any of these along with your leg pain:

New numbness in the groin or inner thighs (“saddle” area)
New difficulty controlling your bladder or bowels
Progressive weakness in one or both legs
Leg pain that started right after a significant trauma (a fall, a car accident)

To be clear about where manipulation fits into this picture: a large retrospective cohort study looking specifically at chiropractic spinal manipulation and cauda equina syndrome found no increased association between the two — this isn’t a reason to avoid care, it’s a short list of signs that mean the next step is a doctor visit, not a diagnosis chiropractic care itself creates.

How We Approach It

Every new patient with leg pain gets screened for these signs before anything else. If none are present, the exam narrows down what’s actually driving your specific pain, and we build the plan around that. See our sciatica page → for how that exam and care plan work.

Ready to Get an Actual Answer?

Most new patients are seen within a few days.