Lifestyle

5 Signs of Sciatica Most People Blame on a Bad Back

By Erica Coleman · August 14, 2026

Your back hurts. Your leg aches. You’ve been stretching, taking ibuprofen, and waiting for it to go away. It hasn’t — because the problem isn’t your muscles. It’s a nerve.

Sciatica affects up to 40% of adults at some point in their lives, and the telltale sign is pain that starts in the lower back and shoots down one leg. But because the pain begins near the spine, most people treat it as a back problem — and miss the signals that distinguish a compressed nerve from a strained muscle.

The pain travels past your knee. Ordinary lower back pain stays in the lower back. Sciatica radiates from the buttock down the back of the thigh and into the calf, sometimes reaching the foot. If your pain follows a line from your hip to your ankle — especially on one side — it’s following the sciatic nerve, not a muscle group.

You feel numbness, tingling, or “pins and needles” in your leg. Back muscle pain doesn’t cause neurological symptoms. Sciatica does — numbness, tingling, burning, or electric-shock sensations along the nerve path are hallmarks. If your leg tingles or goes numb along with the pain, the signal is coming from a compressed nerve, not a sore muscle.

The pain gets worse when you sit — not when you move. Muscle strain improves with rest and worsens with activity. Sciatica often does the opposite — sitting compresses the nerve further, which intensifies the pain. If long car rides, desk work, or sitting on a couch makes your leg hurt more than walking does, the mechanism is nerve compression.

Coughing or sneezing sends a jolt down your leg. This is one of the most specific sciatica indicators. Coughing, sneezing, or straining increases pressure in the spinal canal, which pushes against an already-compressed nerve. A back muscle sprain doesn’t produce referred pain down the leg when you sneeze. A herniated disc pressing on the sciatic nerve does.

One leg feels weaker than the other. As nerve compression progresses, the muscles served by that nerve begin to lose strength. You may notice difficulty lifting the front of your foot, stumbling when walking, or a sense that one leg gives out under you. This weakness isn’t from deconditioning — it’s from a nerve that’s no longer transmitting signals properly.

Most sciatica resolves within six to twelve weeks with physical therapy, anti-inflammatory medication, and activity modification. But cases involving progressive weakness, numbness in both legs, or bladder and bowel dysfunction require urgent evaluation — these symptoms can indicate a condition called cauda equina syndrome, which is a surgical emergency. If your “bad back” has been getting worse for months and the pain is now in your leg, it’s time to see a provider who will evaluate the nerve, not just the muscle.