Sciatica Is More Than Just a Pinched Nerve: Why We Treat the Whole Body
Sciatica is one of the most common complaints I see in clinic—often described as pain radiating from the lower back or glute down the leg, sometimes as far as the foot. While many people assume the problem lies solely in pressure on the sciatic nerve, it’s often more complex than that.
In osteopathy, we look beyond the site of pain to understand how the whole body is contributing to the issue. Because the nervous system functions as a continuous loop from head to toe, what happens in the neck, spine, feet, or even diaphragm can influence how the lower back and hips are functioning.
The Source May Be Above or Below
True sciatic nerve compression is just one cause of sciatic-like pain. Sometimes, the discomfort comes from tension in the pelvis or glutes, or from a shift in posture due to dysfunction higher up, like in the thoracic spine or neck.
For example, a forward head posture or a stiff upper back can change the way your pelvis aligns, shifting weight unevenly and irritating the sciatic pathway. On the other end, foot and ankle mechanics affect how forces travel upward through the legs and hips. If there’s stiffness or instability below, the pelvis and spine are forced to compensate, and over time this can cause irritation along the nerve's path.
Proprioception and Postural Feedback Loops
Your body’s proprioceptive system—its ability to sense position, pressure, and movement—relies on a network of spinal tracts and sensory input that run through the whole spine and body. If certain joints or tissues aren’t moving well, the brain receives altered signals, which can lead to faulty posture and muscle recruitment patterns.
This is why we don’t just release the area around the sciatic nerve. We also:
Improve spinal mobility, especially in the thoracic and cervical regions
Address diaphragmatic function and breathing patterns, which influence spinal stability
Restore balance and equal weight-bearing through the feet and hips
Improve how your nervous system communicates with your body through better movement
Over time, this helps the body self-correct, reducing strain on the sciatic pathway and restoring functional alignment.
Treating the Whole System, Not Just the Symptoms
Osteopathic treatment for sciatica involves more than addressing inflammation or tight muscles. We look at:
How the pelvis moves during walking
Whether there’s compensation in the spine or shoulders
If one leg is loading differently than the other
How the nervous system is regulating movement and tone
Even if your pain is one-sided or localized, the source of dysfunction may lie far from where it hurts.
The body is interconnected. When we treat the whole system—nervous, muscular, joint, and fascial—we create lasting change that helps relieve sciatica and prevent it from coming back.
If you're experiencing sciatic symptoms, or if you've tried stretches and treatments that haven’t worked, let’s look deeper. Your body has a reason for every signal it sends. My job is to help interpret those signals and support your system in getting back to ease.
— Leah Garrett, OMP
Leah Garrett Osteopathy