The 4 Causes of All Sciatica… Which Is Causing Your Pain?


If you’re reading this article on Sciatica and sciatic pain, it’s a good bet you have a radiating pain running down the back of your leg that just won’t go away.

If what I’m about to tell you sounds familiar, don’t worry, help is on the way.

I guarantee you that what you are about to read – and listen to – will be far different than what you have read or heard anywhere else!


Follow this simple, step-by-step plan and in days you can finally kiss your sciatic pain goodbye once and for all.
Sciatica pain in back of leg

First, let me tell you why today’s traditional treatment methods for sciatic nerve pain flat out miss the boat.

The medical community remains so conditioned and focused on treating only the symptoms and trying to get in as many patients a day as possible that many are misdiagnosed and/or mistreated.

In order to get rid of your sciatica you must first know what caused your pain. While sciatic pain is simply caused by pressure being placed on the sciatic nerve, one or more of these four causes are almost always the culprit:

Condition 1. – Piriformis Syndrome

This most common cause of sciatic pain occurs when pressure is placed on the sciatic nerve by the piriformis muscle. Muscle imbalances in your lower back, core, hips and thighs pull your hip joints and pelvis out of place. This changes the position of the piriformis muscle, which can touch and irritate the sciatic nerve. Whatever the case, muscle imbalances like these, left uncorrected, almost always cause major problems. That’s why muscle imbalances are the primary underlying cause of sciatica due to piriformis syndrome.

Condition 2. – Herniated Discs

Pressure caused by a herniated or bulging disc may also cause sciatica. When a disc protrudes out from between the vertebrae – whether caused by an event like a car accident or by months of uneven pressure due to muscle imbalances – the slightest pressure on a nerve can create pain. While herniated discs can cause sciatic pain, it’s important to note many people with herniated discs never experience pain or other symptoms. So even if you discover you have a herniated disc, it may or may not be the cause of your sciatica.

Condition 3. – Spinal Stenosis

Pressure caused by spinal stenosis, which is a decrease in the space between the vertebrae, can pinch nerves along the spinal column. This is primarily caused by uneven pressure and compression due to muscle imbalances.

Condition 4. – Isthmic Spondylolisthesis

Pressure caused by isthmic spondylolisthesis, which is simply when a vertebrae slips or moves out of its normal spinal alignment, can sometimes pinch the sciatic nerve. Imbalances in muscle strength often contribute to this condition. Again, like herniated discs, many with this condition have no sciatic pain, symptoms, or even know they have it!

As you can see, there is a trend here…

In nearly every case of sciatica, muscle imbalances are the primary cause of the pressure being placed on the sciatic nerve…

If you are not sure which one of the four is causing your sciatica, I recommend you start with the basics. Most cases of sciatic pain are caused by muscle imbalances, so if you begin correcting any muscle imbalances you have, you should notice improvement right away… and likely eliminate your sciatic pain in a few weeks or less!

There are several self-assessments you can perform to help identify which specific muscle imbalances you have as described on our website and covered in detail in our Lose the Back Pain® System, along with step-by-step instructions on what to do to eliminate your imbalances and sciatic nerve pain.

Another Cause of Sciatic Pain

While muscle imbalances are the most likely cause of sciatica without a known cause, it can also occur from trauma. Or, even more likely, a combination of both…

A traumatic event scenario is the most likely catalyst for sudden onset of sciatic pain. So here’s what happens… when there is undue stress on the piriformis muscle, that stress causes it to go into spasm and then you have pain due to the piriformis muscle putting pressure on the sciatic nerve which runs past the same area and, in some individuals, directly through the muscle.

car accidentIn most cases, people go to physical therapy or minimize their physical activity to break the pain-spasm cycle. In most cases symptoms subside. However, the event could also set you up for a lifetime of sciatic pain if the piriformis muscle does not fully recover in both strength and flexibility.

Following a muscle injury, both strength and flexibility are compromised. If your recovery ends before strength and flexibility return to normal, you will never be 100% and may struggle with the problem for the rest of your life.

Another way sciatic pain creeps into your life is due to your lifestyle and habits. This is what we like to call the process. The process can be described as a prolonged onset of symptoms based on your everyday activities…

However, from a technical standpoint the process really describes the development of the muscle imbalance in your hip. The piriformis muscle is responsible for external rotation (moving your leg so your feet point outward). Over time, that muscle tends to get tight from the positions you put yourself in and weakens from lack of use.

Let me give you some examples of what I mean:

1. If you frequently sit on your chair with your legs separated and feet pointed outward, this posture keeps your piriformis muscle in a shortened and tightened state. Extended periods of sitting in that position without counteracting the position with stretching causes the piriformis muscle to become chronically tight and lose flexibility. Hence the imbalance.

2. Another example would be competing or highly active runners and bikers. While they work hard, they tend to get sciatica because they fail to keep a strength vs. stretch balance in their workouts. Hence the imbalance creates a greater pull toward external rotation and again the result is a tight piriformis muscle and an irritated sciatic nerve.

These are just two examples of how muscle imbalances can affect the piriformis muscle and cause sciatic pain. You may not be a runner or cyclist, but I’ll bet you have muscle imbalances that are contributing to or directly causing your sciatic pain!

So how do you get rid of your sciatic pain?

Could learning one new stretch be enough? It very well may be. However, depending on the severity of your condition, you may need to incorporate new activities that include the use of the hip rotators such as rollerblading, basketball and tennis. Even better, specific corrective exercises and stretches specific to your situation, like those covered in our Lose the Back Pain® System, can help you effectively and quickly relieve muscle imbalance-related sciatica.

As always, learn as much as you can about your condition, so that you can ask the tough questions to your healthcare providers and get the best care possible.

Filed Under: Sciatica
Written By:

Jesse Cannone, CFT, CPRS, MFT

Jesse is the co-founder and visionary CEO of The Healthy Back Institute®, the world-leading source of natural back pain solutions. His mission as a former back pain sufferer is to help others live pain free without surgery and pharmaceuticals.

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20 thoughts on “The 4 Causes of All Sciatica… Which Is Causing Your Pain?”

  1. Keith filter says:

    I had herniated disc back in 2007. I bought the system for muscle imbalance. This is exactly what I needed. This is exactly what everybody needs. No doctor told me this was the way I needed to be fixed. People need to try this for at least a couple of months and dedicate themselves to it. Even if you have an appointment to get surgery, postpone it, you don’t need surgery. 100% of the people I have talked to that have lower back problems get fixed with this system but there is a small percentage of people that don’t believe and get surgery anyway. I have seen too many people get hurt with surgery. I used to walk with a cane for many years. I am 58 years old now and I workout do squats up to 400 pounds. I couldn’t lift 100 pounds 10 years ago. All this because I used lose the back pains method. Thank you lose the back

  2. Bae Hyun says:

    An excellent article. It actually covers all the different aspects of the condition known as sciatica. People are aware of the name, but usually they’re unaware what causes the pain and this article covers the basic reasons and even describes them in detail too. Good Work. Keep it up!

  3. Martha Stammer-Brankline says:

    Thanks so much for all your information, about sciatica, especially the one about the Piriformis muscle imbalance, and the way we sit. Yes I have notices that when I sit with my feet inwards is more confortable, but then my knee started hurting so I started sitting with my feet pointing outwards, but then my sciatica nerve gets really agravated, Any ways I like better when I don’t have to crosssed my legs because I get more pain on my left knee and is better when I can walk.
    Thanks, again. Also about the article about Nails, ‘

  4. Steven Witzer says:

    Thank you for writing such an informative article on Sciatica. I am also having sorts of muscle pain and back pain for quite a few years. As you mentioned, sitting on a chair legs separated and feet stretched outwards is a very common reason. I feel that is the reason behind both muscle and back pain for me. I find your writing very helpful in this case. I have also been trying inversion table for exercise last few months. And it’s working quite well for me. Thanks again for your research and resourceful article.

    1. Adelaide Bugio says:

      I have had a Spinal Fussion surgery. My pain is so bad I’m on medications n I take Spinnal injections

  5. Hyun Bae says:

    A good read. Herniated disc is the leading cause of sciatica. There are special nonsurgical procedures to help sciatica sufferers (such as exercise plans) which must be recommended and administered by a licensed physician. If the nonsurgical measures prove ineffective, a surgery may be required. It is always best to consult a doctor for back pains and getting screening done.

    1. Hi Dr. Bae,

      Appreciate your comment. While a herniated disc may be the most common condition associated with sciatica, we’ve found most herniated discs not caused by direct trauma are caused by a progressive pattern of postural dysfunction associated with muscle imbalances (differences in strength & flexibility between opposing muscles). Unless corrected, this postural dysfunction caused by muscle imbalances places continual stress on the disc until bulging or herniation occurs.

      We agree with your assessment that individuals should consult with their personal physician on exercise plans and other options for pain relief. However, we have also found the majority of individuals we have helped in the past – including our company’s own co-founder, Jesse Cannone – frequently work with doctors who have limited or no knowledge of the role muscle imbalances play in many causes of pain, especially back pain and sciatica, leaving many pursuing more invasive and potentially dangerous options than needed. That’s also why we offer to consult directly with personal physicians at no extra charge for those using our Lose the Back Pain System to help eliminate back pain and sciatica – without surgery.

      Specific to back pain and sciatica caused by herniated discs, many have had great success using spinal decompression therapy for near-instant and lasting pain relief. Several studies have confirmed most cases of back pain and sciatica caused by herniated discs can be effectively relieved by this approach rather than surgery. An optimal approach for most is to combine spinal decompression for relief of pain caused by a herniated discs with muscle balance therapy to eliminate the underlying muscle imbalances which caused the herniated disc in the first place. (Otherwise it’s like similar to replacing a tire worn unevenly on one side without addressing the alignment issue which caused your tires to wear unevenly.)

      Finally, we encourage all readers to remember most pain has multiple sources and a comprehensive approach is needed to address all imbalances associated with pain for maximum lasting relief. Even following initially trauma-caused pain, your body requires proper nutrition to heal. Supplementing with systemic proteolytic enzymes, which reduce and dissolve internal scarring left behind from the healing process, is crucial for most older adults who have a major deficiency of these as our bodies make less of these as we age and obtaining enough in food alone may be impossible. Emotional healing also plays a role as mindset directly influences both healing and pain perception. Addressing all of these areas in addition to the underlying physical mechanics of pain bring lasting pain relief and optimal health for the vast majority of those we’ve helped. Best of all, it frequently eliminates the need for surgery altogether.

      Best wishes,
      Steve Coombes
      Managing Editor – Live Pain Free

  6. Rose Wells says:

    Thank you for sharing this valuable information about sciatica

  7. Matthew says:

    Hi Jesse,
    I am well aware of the grief, pain and symptoms of lower back pain. I would love to say that I got my disc protrusions while rescuing princesses and fighting dragons…. however the reality was that I was crawling under a desk trying to fix the computer cables. It’s taken me more than a year to get back to being vaguely normal. I’ve found that walking, swimming and a stand up desk have helped me. And lots of ice cream. Thanks for a great read to all at 🙂
    (Melbourne, Australia)

  8. Colleen says:

    What about sacroiliac joint dysfunction as a cause for sciatica?
    I read that a small percentage of people’s sciatic nerve runs through the SI joint.

  9. Admin says:

    Hi Colleen,

    To help you understand more about sciatica and backpain we would like to suggest you get yourself a copy of our free back pain book -The 7 Day Back Pain Cure. You can learn more about the book and its contents via the link below

    Thank you
    Admin (The Healthy Back Institute)

  10. Veronica itkin says:

    Thank you

  11. Jerry says:

    What is the difference between a herniated disk and a bulging disk

    1. Admin says:

      Hi Jerry,

      Thank you so much for your question! Please take a look at the link below which details the differences for you :-

      Thank you
      Admin (The Healthy Back Institute)

      1. Marie says:

        Thanks for your advice.

  12. Marie says:

    I thankful for you then your advice will be help me to get body healthy. Thanks.

  13. Christine M Lawler says:

    I have degenerative arthritis. Disc 3 ,4,5 lumbar. What can I do to loss my cane. It is the way I can walk without looking like a pained. hunchback

    1. Steve HBI-Staff says:


      Hi Colleen,

      To help you understand how to address degenerative arthritis, I would like to suggest you get yourself a copy of our free back pain book -The 7 Day Back Pain Cure. You can learn more about the book and its contents via the link below…

      Thank you

  14. Paula Wahr says:

    Jess can you direct me to resources for those who have had total hip replacement. My right hip had to be done and I have to get my left hip done. My joints erode due to OA and psoriatic arthritis. I am 57 female. Also had neck fusion surgery. As my neck was in severe condition . Hadc1through t1fused corrected. Thanks Paula. Michigan.

  15. Dr Jane Little says:

    I have not read all the information, so I do not know if what I am about to write has been covered. I am a Chiropractor. 80% of the world’s population have an anterior ilium. Out of the 80%, 20% are anterior on the left & 80% are anterior on the right. People are born with this. One side rotates forward. This causes severe pain in the knee on that side, affecting the sciatic nerve, & is what drives people to knee replacement surgery. It does not correct the problem, because the ilium is still rotated forward.. I believe the knee could be saved if the hip is adjusted. Every patient who came to me with knee, hip, back pain, headaches, sore stiff neck & the hundreds of symptoms people have, was diagnosed with an anterior ilium. It is a very simple adjustment, using sacro-occipital technique blocks or manual adjustments. It can take a month for every year of the patients life to get the ilium to stay level with the other side. The ilium has to be re-educated along with the muscles. When the ilium is brought level, the sacral base comes level. The sacrum is a Cerebro Spinal Fluid pump & this rocks & pumps CSF when in its correct position between level hips. Fresh CSF is pumped round the brain & up & down the spinal cord. The spine was created to sit in one place. Any deviation leads to pain & arthritic build up so the body can comfortably accommodate the subluxated bone. The anterior ilium causes scoliosis as the body struggles to get the spine back to the central gravity line. Back pain? See a Chiropractor.

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