Condition Guide
Sciatica
Sciatica is a symptom, not a diagnosis. The structural cause is what matters.
What is Sciatica?
Sciatica is the term for pain, numbness, or tingling that follows the path of the sciatic nerve, from the lower back through the glute, down the back of the leg, and sometimes into the foot. It is a symptom produced by compression or irritation of the sciatic nerve roots, not a diagnosis in itself. The two most common structural causes are lumbar disc herniation compressing a nerve root, and piriformis syndrome, where a tight piriformis muscle in the glute compresses the sciatic nerve as it passes beneath or through it.
Common Symptoms
- Shooting or burning pain from the lower back into one leg
- Numbness or tingling down the back of the thigh and calf
- Pain that is worse with sitting, especially on hard surfaces
- Weakness in the affected leg with prolonged symptoms
- Pain that increases with sneezing, coughing, or bowel movements
- Relief when walking compared to sitting or standing still
The Real Root Cause
The structural root cause of most sciatica is anterior pelvic tilt creating lumbar hyperextension that compresses posterior disc margins and narrows the intervertebral foramina through which the nerve roots exit. When the pelvis is anteriorly tilted, the lumbar spine is in chronic extension, a position that progressively compresses the L4-S1 disc levels most responsible for sciatic nerve irritation. Additionally, the piriformis muscle becomes hypertonic as a compensatory stabiliser when the glutes are inhibited by pelvic tilt, directly compressing the sciatic nerve in the glute.
How We Fix It
The approach addresses the structural chain: restoring pelvic neutrality to decompress the lumbar spine, activating the inhibited glutes to relieve piriformis hypertonicity, releasing the hip flexors that maintain the anterior tilt, and progressively restoring lumbar mobility without loading the compressed discs.
Restore pelvic neutrality
Correcting anterior pelvic tilt is the primary intervention, it decompresses the posterior lumbar joints and disc margins that are compressing the nerve roots.
Activate inhibited glutes
When the glutes are inhibited by pelvic tilt, the piriformis compensates, and compresses the sciatic nerve in the process. Glute activation reduces piriformis overactivity directly.
Decompress the lumbar spine
Specific decompression positions, particularly static back, create traction in the lumbar spine that provides immediate symptomatic relief while the structural work progresses.
Release hip flexors
The hip flexors maintain the anterior pelvic tilt that drives the lumbar compression. Releasing them allows the pelvis to return to neutral and removes the ongoing nerve compression.
The Fix It Program
Sciatica Relief
Everything you need to correct sciatica, step-by-step video exercises, structured progressions, and the exact sequence Mike uses with clients.
Frequently Asked Questions
My doctor says my sciatica is caused by a herniated disc. Can exercise help?
Yes, exercise therapy is the first-line treatment for herniated disc sciatica in most clinical guidelines. The goal is not to push the disc back, but to correct the structural environment (anterior pelvic tilt, lumbar hyperextension) that caused the disc to herniate and continues to compress the nerve root. Most lumbar disc herniations resorb significantly within 6–12 months with appropriate conservative management.
Is it safe to exercise with sciatica?
The right movement is not only safe, it is essential. The sciatic nerve needs movement to maintain its gliding function; immobility causes adhesions to form along the nerve pathway. The exercises in the Lower Back Pain Relief program are specifically designed to decompress the lumbar spine rather than load it, making them appropriate for active sciatica.
How do I know if I have piriformis syndrome vs disc herniation sciatica?
Disc herniation sciatica typically produces pain that follows a specific dermatomal pattern (related to which nerve root is compressed), worsens with sitting and sneezing, and may include true neurological deficits. Piriformis syndrome produces more diffuse pain in the glute region that radiates down the leg but is specifically triggered by sitting on hard surfaces and external hip rotation. Both respond to the same structural corrective approach.
Will sciatica go away on its own?
Acute sciatica from a disc herniation often improves within weeks to months as the disc material resorbs. But if the structural cause, anterior pelvic tilt, compressed lumbar discs, is not addressed, the condition recurs. Corrective exercise removes the mechanical driver of the problem, not just the episode.
Written by Mike Boshnack
Certified Egoscue Therapist · Posture Guy Mike
Mike Boshnack grew up skateboarding and surfing, trained MMA, and rode road bikes competitively, before a shoulder injury put him on a path to discover the Egoscue Method. He's since helped thousands of people fix the structural root causes of chronic pain, without surgery or passive treatments.