What’s the Difference Between a Pinched Nerve and Sciatica?

Sciatica and pinched nerves share similarities, but their key difference is location. Sciatica refers to sciatic nerve irritation from the lower back, while a pinched nerve can involve any compressed or irritated nerve anywhere in the spine. A helpful analogy is that a pinched nerve is like having a viral infection, whereas sciatica is like having the flu—both are related, but one is more specific.

Sciatica Occurs When the Sciatic Nerve is Irritated or Inflamed

This can cause pain, numbness, tingling, or burning radiating from the buttock down the back or side of the leg. It typically affects one side but can sometimes impact both legs. The sciatic nerve originates from the lower back and spinal nerve roots (L4-S3), traveling from the lower back and tailbone, underneath the gluteal muscles, and along the back of the leg beneath the hamstrings. It then branches behind the knee, continuing down the calf to the foot. This nerve controls movement in the hamstrings and adductor magnus and provides sensation to the side and back of the leg, heel, and both the top and bottom of the foot.

How Do I know if My Pain is My Sciatic Nerve?

The symptoms often follow a predictable pattern when the sciatic nerve is irritated or compressed. You'll most commonly experience pain or altered sensations, such as numbness, tingling, or burning, radiating from the buttock down the side or back of the leg. In some cases, the pain can extend to the calf or foot. Many of my clients thought they had calf tightness, but in reality, it's sciatica. The pain is usually intermittent and may be triggered by certain positions or movements, such as bending over or sitting for long periods.

Pain or sensory changes are typically the only symptoms in the early stages of sciatica. However, motor changes can occur if the condition becomes chronic—lasting for several months or even years. This means a loss of muscle strength or the ability to recruit specific muscles. Since the sciatic nerve innervates the hamstrings and adductor muscles, weakness or loss of function would most commonly affect these areas. These are some ways you can track your sciatica recovery! 

Sciatic Nerve Pain or Sciatica Is Often Caused By Stenosis or Disc Herniations

Sciatic nerve pain can have a host of different causes. The two leading causes are disc herniations and stenosis. These conditions, in some way or another, occupy space near the sciatic nerve's origin and apply pressure or “pinch” the sciatic nerve. This leads to inflammation and pain.

Sciatica Related to Stenosis You Want to Focus on Flexion

Sciatica from Disc Herniation You Want to Focus on Improving Nerve Mobility and Spine Mobility

Should I Have An MRI If I Have Sciatica?

Although you may want to rush to have imaging done to see what's going on, the research shows that MRIs don't change outcomes and in many cases are unnecessary. Other diagnostic tools include an electromyography test (EMG.) This test can help to pinpoint where the compression is occurring down the leg by using an electrical current to see how well it flows on different points of the nerve. Rest assured that in a vast majority of sciatica or a pinched nerve this isn’t necessary. 

Imaging can cause a great deal of fear related to movement that led to the pain in the first place. I need my patients to know that not only is movement safe, it is encouraged to regain that lost function and to return to a full life. ‍

How To Decompress A Sciatic Nerve At Home

Traction is a technique used to apply a safe and tolerable amount of decompression to a specific region of the spine. For sciatica, we focus on decompressing the lumbar spine, as the nerve roots that feed into the sciatic nerve are located in this area. While traction can be beneficial, it can also aggravate symptoms if used incorrectly, so it's best performed under the supervision of a qualified rehab professional. For home care, I typically recommend other interventions, such as exercise, which can provide significant benefits and are easier to incorporate into your routine.

A Pinched Nerve is a Broader Condition That Refers to Compression or Irritation of Any Nerve in the Body or Spine

The symptoms of a pinched nerve are similar to those of sciatica, with the main difference being the location. A pinched nerve can occur anywhere in the body or spine but is most commonly found in the neck, arm, or leg. One that most people know is carpal tunnel syndrome. The primary symptoms are nerve-related, such as radiating pain along a limb or body region, along with altered sensations like pins and needles, numbness, or burning.

What Causes a Pinched Nerve?

A pinch nerve can result from many things ranging from

• Tight or stiff muscles
• Movement dysfunctions
• Space-occupying conditions such as a disc bulge, herniation, or spinal stenosis.
• Osteophytes (arthritis)
• Cccupational causes

The neck is the most common area for nerve compression in the upper body. Like the sciatic nerve, the nerves that run through the arm and hand originate from the spinal cord in the neck.

Piriformis syndrome is another example of a pinched nerve, similar to sciatica. In this condition, a tight muscle—usually the Piriformis or another hip muscle—compresses or irritates the sciatic nerve.

A Potential Cause of Pinched Nerve is Piriformis Syndrome

In this condition, a muscle, typically the piriformis or other hip muscle, can be tight and is compressing or irritating the sciatic nerve.

Serious Symptoms of a Pinched Nerve or Sciatica Include

• Progressive loss in neurological function (You rapidly are losing strength and sensation in the leg)
• Bowel or bladder dysfunction
• Numbness in the pelvic area
• History of fracture
• Unexplained weight loss or gain

If you are experiencing any of these symptoms be sure to follow up with a doctor or go straight to the ER! Aside from these extreme cases, most pinched nerves ends up resolving in a few days to a month. Knowing this is half the battle! Luckily for you there are some ways that you can decrease the pressure on the nerve through specific exercises!

How do I Decompress or Fix a Pinched Nerve at Home?

A pinched nerve often responds well to the same interventions as sciatica. Hands-on techniques like dry needling and myofascial release have shown good results. However, just like with sciatica, exercise and movement are some of the most effective treatments for a pinched nerve. Nerve glides, for both upper and lower extremities, are especially helpful.

Traction, which involves applying a controlled amount of decompression to a specific region of the spine, is another option. For sciatica, traction should target the lumbar spine. However, traction should be done carefully, as improper use can worsen symptoms. It’s best to perform mechanical traction under the guidance of a qualified rehab professional. There are some self traction techniques for sciatica you can try! 

Foam rolling is another great at-home technique to relieve a pinched nerve—perfect for a quick fix (pun intended 😉).

How to Release a Trapped Sciatic Nerve

If your sciatic pain is caused by muscle or soft-tissue impairments, there two techniques that can help alleviate your symptoms and release the nerve. As a physical therapist, I will use nerve glides move the entire nerve and then a modality such as dry needling to improve pain in the glute and leg.

Nerve Glides

Exercise and movement are key to long-term recovery. I always say, motion is lotion, and this is especially true when it comes to sciatica. Exercises like nerve glides or nerve flossing can be incredibly effective. Nerve glides are a series of movements designed to promote healthy movement of a specific nerve, and just like any other part of your body, nerves need movement to stay healthy and functioning properly.

Dry Needling

For those who aren’t familiar, dry needling uses a needle, similar to an acupuncture needle, but it’s specifically designed to target muscle dysfunction like trigger points.

Summary

Sciatica is a specific type of pinched nerve that affects the sciatic nerve, causing pain, numbness, or tingling from the lower back down the leg. In contrast, a pinched nerve can occur anywhere in the body, leading to similar nerve-related symptoms. Both conditions often improve with targeted exercises, movement, and nerve glides, while severe cases may require medical attention. Download my Sciatica Relief PDF to learn simple, effective exercises to ease your pain at home!