Lower back

Sciatica and referred leg pain

Pain travelling from the back or buttock down the leg — sometimes nerve, often muscle, and worth telling apart.

What it typically feels like

  • Pain running from the buttock down the back of the leg
  • Pins and needles or numbness in the leg or foot
  • Worse on sitting, coughing or sneezing
  • A deep ache in one buttock that will not release

“Sciatica” is used for almost any pain going down a leg, but there are two quite different things behind it, and telling them apart matters.

True nerve irritation — the sciatic nerve is compressed or irritated, often at the spine. Typically pins and needles, numbness, or a sharp electric quality, and often worse when sitting, coughing or sneezing.

Referred muscular pain — trigger points in the glutes, and particularly in piriformis deep in the buttock, refer pain down the back of the leg in a pattern that mimics sciatica convincingly. This one responds very well to soft tissue work.

A great many people told they have sciatica have the second. Assessment sorts out which, because treating one as the other wastes everybody’s time.

What treatment involves

For the muscular pattern, treatment is straightforward and often quickly effective — releasing the glutes and piriformis, settling the trigger points, restoring hip movement, and addressing why they got tight.

For genuine nerve irritation, treatment is gentler and focuses on reducing the tension in the surrounding tissue while the nerve settles. It can help, but it is not a substitute for proper diagnosis.

Read the red flags below carefully on this one. Numbness around the groin, any loss of bladder or bowel control, or weakness in both legs is a medical emergency, not something to book a massage for.

The honest next step

This page describes what is common, not what you have. The only way to know is to have it assessed — and your first session includes a full assessment, so you leave knowing what is actually going on.

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