If you’ve ever had severe sciatica, you’re not likely to forget it. The condition can be excruciating, with burning or stabbing pain shooting down the buttock and leg. But sciatica’s not always like that. Sometimes, people have weird symptoms in a leg or foot and don’t link it to sciatica.

The nerve path

The sciatic nerve is the longest in the body. It starts in the low back, travels through the buttocks, and goes down the back of the leg to the foot. Specifically, its path includes the:

• Two lowest vertebrae in spine
• Piriformis muscle (in butt)
• Hamstrings
• Back and side of calf (nerve splits behind knee)
• Foot and toes

So, what goes wrong?

If this nerve gets pinched, you can get pain or symptoms anywhere along its path. The two main places it gets pinched are at the low back, usually when a bulging disc presses on a nerve root, or in the buttocks, when a tight piriformis muscle squeezes the nerve.

How this shows up

I’ve seen clients with severe sciatica who could hardly get on my table without excruciating pain. But I’ve also seen people with more “mysterious” leg or foot symptoms that they don’t connect to their back or pelvis. For instance, imagine that:

• Your hamstring and upper calf keep cramping
• Your leg is numb in one area and tingly or painful in another
• Your foot hurts or won’t lift when you walk (drop foot)
• One leg feels weaker than the other

What can help?

Most sciatica will clear up on its own in a few weeks. So unless there are red flags, doctors typically advise home care like heat or cold, pain relievers, and gentle exercise.

In my experience, massage may be helpful if the pain is caused by a tight piriformis. Craniosacral therapy, however, is nearly always helpful. It can relieve pressure on the nerve by releasing restrictions, reducing inflammation, and correcting alignment issues in the vertebrae and sacrum. Often, the relief is swift.

You may also be able to relieve some pressure yourself. For a tight piriformis muscle, try these stretches. If the problem is your low back, try this flat-back resting position.

Know these red flags:

• Sudden, severe low back or leg pain (especially after injury)
• Extreme numbness or weakness in a leg or foot
• Trouble controlling your bladder or bowel

If you have any ref flags, see a doctor right away. Don’t mess around with nerve damage.