When someone walks into my Thunder Bay office and tells me they have sciatica, my first thought isn’t about their leg. It’s about whether they actually have sciatica at all.
The term gets thrown around so often that it’s become a catch-all for any pain radiating down the leg. But true sciatica has a very specific signature. It runs along the sciatic nerve, all the way to the foot.
If your pain stops at the knee, you’re likely dealing with something else entirely. SI joint dysfunction, piriformis syndrome, or general low back pain can all masquerade as sciatica. They cause leg pain, sometimes intense leg pain, but they’re not the same condition.
This distinction matters because the approach to care changes based on what’s actually happening in your body.
The Damage You Don’t See Coming
Here’s what most people get wrong about how sciatica develops. They often think it was the one time they lifted something heavy or that awkward movement getting out of the car. They remember a specific moment and assume that’s when the damage happened.
It almost never works that way.
What you’re experiencing is usually the result of accumulated strain. Years of sitting too much, lifting with poor form, slouching at your desk, and repetitive loading of the spine all add up silently until your body can’t compensate anymore.
The pain you feel is the breakdown of mechanics that have been deteriorating for years.
When true sciatica develops, it’s because spinal misalignment or disc changes are creating pressure on the bundle of nerves in your lower back that forms the sciatic nerve. This can result from repetitive strain, wear and tear, or inflammation. The nerve itself, up to two centimeters in diameter, is the largest in your body. When it’s irritated or compressed, the pain can be excruciating.
Why Your Back Hurting Is Actually Good News
This is the part that confuses people most. You come in with pain shooting down your leg to your foot. We begin care, and within a few weeks your leg feels better, but now your back hurts.
Many patients think they’re getting worse. They’re not.
What’s happening is called centralization. As we gradually reduce pressure on the nerve through adjustments and movement, the pain walks itself back up the leg toward the source.
Research shows that most people with true sciatica experience this process, and those who do typically achieve better long-term outcomes. The pain is returning to where the problem actually is: your lower back.
Many people with sciatica have no back pain when they first come in because the irritation has traveled along the nerve and settled in the leg. As healing progresses, it reverses course.
The farther down your leg the pain goes initially, the more inflamed the source tends to be. When it starts moving back up, that’s your body’s way of signaling improvement.
This is why communication from day one matters so much. If you don’t understand this process, you might panic when your back starts hurting and assume your care isn’t working.
The Timeline Nobody Wants to Hear
I’ll be honest with you about how long this takes. There’s no single quick fix for sciatica. If it took years for the problem to develop, it takes time and repetition to change how your body moves and adapts.
With consistent chiropractic care, you should start noticing improvements within four to six weeks. But stabilizing those changes in your spine can take several months.
For the spine to reach its best possible function, it can take years.
Each adjustment helps relieve nerve pressure gradually. It takes time to retrain joint and muscle memory, and for inflammation to settle.
While about 90% of sciatica cases resolve naturally within six weeks, early chiropractic care often helps shorten recovery time and improve mobility, especially when combined with movement and postural strategies.
What You Actually Need to Do
Recovery happens in phases, and each one serves a purpose.
First comes pain control. We make sure you’re not pushing through too much too soon. This includes limiting sitting, moving gently in short bursts, and using ice or heat to keep your spine more comfortable.
As your movement improves, we add simple exercises. The McKenzie Protocol for sciatica and radicular pain often becomes part of the plan.
Timing matters. If you begin strengthening too early, you can aggravate the condition. Wait too long and you miss the opportunity to rebuild proper mechanics.
Activity modification is key throughout recovery. Take short, frequent walks instead of long sessions. Stand more, sit less, and use the right exercises at the right time.
At Santin Chiropractic, we often work with our laser therapy and physiotherapy teams to help speed this process. Laser therapy uses specific light frequencies to support cellular function, reduce inflammation, and promote tissue repair.
The foundation, however, remains the same: gradual pressure relief, restored movement, and progressive strengthening to help your body hold and perform in a healthier way.
When You Need Medical Attention Instead
There are certain red flags that require immediate medical attention.
If you experience any loss of bowel or bladder control, or numbness in the area where you would sit on a saddle, this may indicate cauda equina syndrome and needs urgent hospital evaluation.
Every case is different. A consultation helps determine whether chiropractic care is appropriate for your situation. We review your health history, discuss what you’ve tried before, and examine imaging if available. The goal is to understand what’s really causing your pain and whether our approach can help.
Why Waiting Makes Everything Harder
Here’s what I wish everyone understood from the start. The sooner you seek help, the better your outcomes. Chiropractic care can be very effective at reducing pain and improving movement for sciatica, but it works best when started early.
The longer you wait, the more your body compensates, the more inflammation sets in, and the more your movement patterns deteriorate.
What could have been a few weeks of recovery can easily turn into months of work undoing avoidable damage.
I see it often. Someone suffers for weeks or months, hoping it will resolve on its own. By the time they come in, their body has been compensating for so long that the path back to normal function is longer and harder.
Your body is incredibly resilient, but it’s not indestructible. Give it the support it needs when it needs it. That’s how you get back to doing the things you love.
Take the First Step Toward Lasting Relief
If you’ve been struggling with leg pain or suspect sciatica, don’t wait to find out what’s really going on. Schedule a consultation to get clear answers, personalized guidance, and a plan to help your body move and feel its best again.