Chiropractic care for sciatica
Leg pain that starts in the back usually means a nerve is irritated, not that something has slipped out of place.
Sound familiar?
- “shooting pain down my leg”
- “pinched nerve”
- “my leg goes numb”
What it actually is
Sciatica is the name people give to pain that starts in the lower back and travels down the leg. It describes a symptom rather than a diagnosis. The clinical words behind it are radicular pain, meaning pain coming from an irritated nerve root where it leaves the spine, and radiculopathy, when that root stops working properly and the leg goes numb or weak.
The roots of the lower back gather into the sciatic nerve, which runs through the pelvis and down the back of the thigh. At the back of the knee it divides into the nerves that supply the calf, the shin and the foot. A nerve reports trouble along its whole length, so the sorest part of you is often a long way from the part that needs the work.
Most people find the pain has a direction. For many, sitting and bending forward stir it up and a walk brings it down; for others, usually where the openings have narrowed, it is the other way round. Which way it goes for you shapes how you sit at work, how you sleep, and which exercises are worth your time.
What people notice
- pain that runs from the lower back into the buttock, the thigh or the calf
- a sharp, burning or electric quality rather than an ordinary ache
- pins and needles, or numbness, in the leg or the foot
- usually one leg rather than both
- pain that changes with position, worse sitting for some people and worse walking for others
Where it sits in the body
- the nerve roots of the lower back, where they leave the spine
- the sciatic nerve, from the pelvis to the back of the knee, and the nerves it divides into below that
- the lumbar discs and their layered outer wall
- the joints and the deep buttock muscles sitting beside the nerve
What the assessment looks for
The first visit starts with questions rather than with hands: what you were doing when it began, where it sits today and how far down the leg it reaches, what eases it and what stirs it up, and what it is doing to your sleep and your work.
Then it gets tested. How the lower back moves, and what the leg pain does as it moves each way. Strength, reflexes and sensation down the leg and into the foot, which say how the nerve is behaving rather than how it feels. No single test decides it on its own: the picture comes from your history and the examination together.
Screening for the short list of signs that belong with a hospital or a GP is built into that examination every time, rather than added when something sounds unusual.
Imaging is requested when clinically indicated, and on a first visit it usually is not. The Royal Australian College of General Practitioners, in its 2022 guidance for GPs on imaging in adults with acute low back pain, advises that imaging for acute low back pain is only requested after a careful clinical assessment has raised a high suspicion of a serious cause. The same guidance treats nerve pain down the leg on its own terms: imaging is not routine there either, and is considered in the first six weeks only where the symptoms are severe, are not improving, and surgery is being considered. Bring any report you already have: it is read alongside the examination rather than in place of it, and there is more on that in do I need a scan?.
What you leave with is a plain account of what we think is driving the pain in your leg and what we would do about it.
Choosing between professions? Should I see a chiropractor, a physio or an osteopath? compares the three for back and leg pain.
What care involves
Sciatica treatment here is aimed at two things: settling the irritation around the nerve, and getting your back and leg doing ordinary work again. Nothing is pushed back into place, because nothing has slipped out of it.
Early on it is gentle and hands-on: joint mobilisation and soft tissue work to quieten the muscles guarding the area, the positions that ease your symptoms, and a plan for the day that keeps you moving through it. The Low Back Pain Clinical Care Standard, 2022, encourages a person with low back pain to stay active and to continue, or return to, usual activity, including work, as soon as possible or feasible, and that is the direction from the first visit.
As the leg quietens, exercise carries more of the load: movement aimed at how freely the nerve glides, then strengthening so the back is asked to carry load again, then how you sit, how long before you stand up, and how you lift.
The United Kingdom’s National Institute for Health and Care Excellence, in its guideline on low back pain and sciatica in over 16s, NG59, last updated 2026, considers manual therapy, meaning spinal manipulation, mobilisation or soft tissue techniques, for low back pain with or without sciatica, but only as part of a treatment package that includes exercise. That condition is the shape care takes here, which is why the exercise half is not optional.
Technique is matched to how irritable things are rather than applied the same way to everyone: while a nerve is angry the hands-on work is usually slow joint mobilisation, no thrust and no click. An adjustment is never automatic, and you can decline any part of it.
Care here is built for lasting improvement rather than short-term relief, which is why the strengthening half of it is not the half that gets dropped.
How quickly an irritated nerve settles varies, which is why nothing on this page attaches a number to it. How many visits will I need? goes through what is reviewed instead.
Everyone moves through this differently, so the plan is paced to your body, reviewed with you as you progress, not read off a fixed schedule of visits.
What the guidelines say
- Australian Commission on Safety and Quality in Health Care, Low Back Pain Clinical Care Standard, 2022. https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard
- Royal Australian College of General Practitioners, First do no harm: A guide to choosing wisely in general practice. For GPs: Imaging in adults with acute low back pain, 2022. https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/first-do-no-harm/gp-resources/imaging-in-adults-with-acute-low-back-pain
- Royal Australian College of General Practitioners, Handbook of Non-Drug Interventions (HANDI): Advice to stay active for people with acute low back pain, 2019. https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/musculoskeletal/advice-to-stay-active-for-people-with-back-pain
- National Institute for Health and Care Excellence, Low back pain and sciatica in over 16s: assessment and management (NG59), 2026. https://www.nice.org.uk/guidance/ng59
When to get it looked at
Go to a hospital emergency department straight away if you have numbness or altered feeling around the saddle area, meaning the groin, the inner thighs, the buttocks or the genitals; a loss of normal sensation in the genitals, including during sex; trouble starting to pass urine, or any new change in your bladder or bowel control; weakness in both legs, particularly if it is getting worse; new or worsening pain running down both legs; weakness in one leg that is severe or getting worse, or a foot that has started to catch or drag when you walk; or numbness in a leg that is spreading or getting worse quickly. Go to a hospital emergency department straight away for back or neck pain after a serious fall or a high-impact accident, such as a car accident; back or neck pain with a fever or feeling generally unwell; or new back or neck pain if your immune system is weakened, for instance by long-term steroids or chemotherapy, if you inject drugs, or if you have recently had a spinal injection, spinal surgery or a dental procedure. Go to a hospital emergency department the same day if you have new clumsiness in both hands, or new unsteadiness on your feet.
The back signs above go to an emergency department because the Australian guidance on low back pain puts them there: the Low Back Pain Clinical Care Standard, published by the Australian Commission on Safety and Quality in Health Care in 2022, and the Royal Australian College of General Practitioners’ 2022 guidance for GPs on imaging in adults with acute low back pain both send suspected cauda equina syndrome, suspected spinal infection, a fracture after a high-impact injury and severe or rapidly worsening nerve weakness for emergency assessment.
See your GP promptly, before booking here, if you have a history of cancer, unexplained weight loss, pain at night that will not settle in any position, known osteoporosis with new severe pain, numbness that is spreading or getting worse slowly, or new, unexplained back pain as an older adult.
Short of those, the ordinary threshold is simpler than people expect. If leg pain has been there more than a week or two, is disturbing your sleep or your work, or keeps coming back, it is worth having it assessed properly.
Common questions
Can a chiropractor help with sciatica?
The assessment comes before the technique. We examine the back, test the nerve and tell you what we think is driving the pain, and the work from there is aimed at settling the irritation and getting you moving normally. On the evidence, the United Kingdom’s NICE guideline on low back pain and sciatica, last updated 2026, considers manual therapy for low back pain with or without sciatica only as part of a treatment package that includes exercise, which is how care is built here.
Should I rest, or keep moving?
Keep moving, inside what your body will tolerate. For a low back pain episode of less than six weeks, the Royal Australian College of General Practitioners’ Handbook of Non-Drug Interventions entry from 2019 advises staying active, rather than resting in bed, and says staying active means ordinary daily activity, including going to work. That entry is written about the back rather than about nerve pain down the leg. In practice that is short and frequent movement, using the positions that ease things while you build back up.
I sit at a desk in the city all day. Is that why it started?
Sitting is what stirs it up for a lot of people with sciatica, and for others it is what settles it, so it is worth finding out which one you are before you rearrange your desk. What helps a desk-based day is small and repeatable: stand up before the leg asks you to, change position often, and walk part of the way in. This is a city clinic on Macquarie Street, so an assessment does not need a day off, and the consulting hours are on the booking page.
Are there exercises or stretches for sciatica I can do at home?
Which ones suit you depends on which way your pain goes: for some people sitting and bending forward stir it up, and for others it is standing and walking. That direction is found in the examination, which is why the examination comes first. Until then, the answer above on resting or keeping moving is the one to follow. Nerve-gliding movements and strengthening work are chosen once the leg has been examined, and anything you do at home should be gentle. Stop and get it checked if a movement or stretch sends pain further down your leg, if pins and needles or numbness spread, or if your leg or foot feels weaker. Go to a hospital emergency department straight away instead of booking if you have weakness in both legs, particularly if it is getting worse; new or worsening pain running down both legs; weakness in one leg that is severe or getting worse, or a foot that has started to catch or drag when you walk; or numbness in a leg that is spreading or getting worse quickly. The same goes for every other sign in the emergency list on this page.
What sits behind the first of those answers, the evidence and the risks both, is written out in full. Is chiropractic safe, and what does the evidence actually say?
Read next
Nearby: Chiropractic care for lower back pain and Chiropractic care for posture.
The clinic is at Suite 1, Lower Ground Floor, 225 Macquarie Street, Sydney NSW 2000. How to find us, or read all the conditions we see.
Take the first step towards better movement.
Suite 1, Lower Ground Floor, 225 Macquarie Street, Sydney NSW 2000. No referral needed to book.