Do You Actually Have Sciatica? Here’s How to Tell

Sciatica gets blamed for a lot of leg pain in Winnipeg. A twinge in your glute, some aching down the back of your thigh, or that deep nagging feeling around your hip — and the self-diagnosis is usually the same: “I must have sciatica.” Sometimes that’s right. Often it isn’t.

At Boreal Spine & Sport, Dr. Mike Minenna, DC, sees this regularly. Patients come in convinced they have sciatica — and the first thing he does is figure out whether that’s actually true, because the answer determines everything about how the problem gets treated.

What Sciatica Actually Is — and the Criteria That Matter

The sciatic nerve is the longest nerve in the body, running from your lower back through your hips and glutes and down each leg. When it’s compressed or irritated — typically by a disc, a joint, or soft tissue — you get symptoms along that pathway. That’s true sciatica.

But not every pain in the leg or glute qualifies. Dr. Mike uses a specific set of clinical markers to assess whether someone actually has it: the pain is worse in the leg than in the back, it travels past the knee, and there’s a positive straight leg raise test — or some meaningful combination of those findings. Without those, the diagnosis is in question.

“It’s really unlikely to be sciatica unless it’s worse in the leg than the back, it goes past the knee, and there’s a positive straight leg raise,” says Dr. Mike. That might sound like splitting hairs, but it matters enormously for treatment. If you’re treating pain that isn’t being driven by sciatic nerve compression, you’re going to get limited results no matter how good the therapy is.

The Most Common Misconception: Leg Pain Isn’t Always Sciatica

The single biggest misconception Dr. Mike corrects is this: anytime someone has pain in their leg or glute, they assume they have sciatica. It’s an understandable leap — sciatica is one of the most Googled pain conditions, and the symptoms people describe are genuinely uncomfortable and disruptive. But leg pain has a lot of potential sources.

Piriformis irritation, hip joint referral, SI joint dysfunction, lumbar facet irritation, and tight posterior chain musculature can all send pain down the leg in ways that feel similar to true sciatic nerve involvement — but respond to completely different treatment. Treating all of these as sciatica is how people end up in a cycle of appointments without real progress.

This is exactly why the assessment at Boreal doesn’t start with a treatment plan. It starts with figuring out what’s actually happening.

Sciatica Is an Umbrella Term — the Driver Is What Matters

Even when the diagnosis is confirmed, sciatica treatment in Winnipeg isn’t one-size-fits-all. “Sciatica is an umbrella term,” says Dr. Mike. “There are so many reasons for it — so it depends on what the driver of the sciatica is.”

A disc herniation compressing the nerve root calls for a different approach than a tight piriformis muscle pressing on the nerve as it exits the pelvis. Lumbar stenosis narrowing the spinal canal is different again. The nerve might be irritated at multiple points along its path. The treatment has to follow the findings.

At Boreal, that means the combination of adjustments, soft tissue work, and rehabilitation exercises varies from patient to patient. For some, the primary driver is a restricted lumbar joint, and chiropractic adjustments are the anchor of care. For others, the soft tissue around the hip and glute is the main problem, and that’s where treatment is focused. For many, it’s both — and care is sequenced to address each layer.

What to Expect If You Come In with Leg Pain

If you’re dealing with leg pain, glute pain, or what you suspect is sciatica in Winnipeg, your first appointment at Boreal starts with a thorough history and physical assessment. Dr. Mike will test your movement, check your neurological signs, and apply the clinical criteria to determine whether the sciatic nerve is actually involved and, if so, where and why.

From there, care is built around what the assessment reveals. That might include lumbar adjustments, targeted soft tissue work in the hip and glute region, nerve mobilization techniques, or specific exercises to reduce compression and restore movement. What it won’t include is a generic protocol applied before anyone has figured out what’s driving your symptoms.

If you’ve been told you have sciatica and haven’t gotten better, or if you’re not sure what’s causing your leg pain in the first place, it’s worth getting a proper assessment before assuming more of the same treatment will do the trick.

Get Assessed, Not Just Treated

Sciatica treatment in Winnipeg works when it’s matched to the actual cause. That starts with a clear diagnosis — not a label applied to any pain that travels down the leg.

Ready to feel better? Book your appointment at Boreal Spine & Sport in Winnipeg — call us or visit borealspine.com today.