What is “sciatica”?

“Sciatica” is often applied to any radiating low back pain, regardless of whether true sciatic nerve compression is happening.

True sciatica is pain that radiates along the sciatic nerve from the lower back through the buttock and down the back of one leg. It is usually caused by nerve compression from a herniated disc, bone spur, or spinal stenosis. True sciatica will include some level of numbness, tingling, or weakness in the affected leg. It is horrible! If you have it, I am really sorry.

However… most sciatica resolves with conservative care — physical therapy, activity modification, and pain management. Surgery is reserved for severe, progressive neurological deficits or cases of prolonged failed conservative treatment.

When it comes to low back pain, here’s the annoying part: somewhere between 90–95% of back pain is actually from unknown origin.^1

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What helps low back pain?

Exercise is the gold standard

The evidence is overwhelming: exercise reduces low back pain and improves function. There is stronger evidence for this than for any drug or medication — ibuprofen, narcotics, all of it. It works better than anything else for low back pain.^2

Resistance training specifically

Resistance training decreases low back pain, improves quality of life, and decreases disability. A program works best when it is structured, progressive, and at least 12 weeks long.^3 ^4

Even imperfect form isn’t the enemy

Even doing “bad” squats isn’t strongly correlated with increased low back pain.^5. So don’t worry about your squats. If you can’t take that advice and absolutely insist on worrying, come see me and we can work it through–either with personal training (if you’re not hurting) or physical therapy (if you are).

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What about squats specifically?

There are only a few studies about squats specifically. They show that heavy resistance training including squats and deadlifts decreases low back pain.^6 ^7

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References

1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. The Lancet. 2017;389(10070):736–747.
2. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. 2021;CD009790.
3. Rodríguez-Domínguez ÁJ, et al. Does resistance training improve pain intensity, quality of life, and disability in people with chronic nonspecific low back pain? Disability and Rehabilitation. 2026;48(6):1532–1545.
4. Owen PJ, Miller CT, Mundell NL, et al. Which specific modes of exercise training are most effective for treating low back pain? Br J Sports Med. 2020.
5. Saraceni N, Kent P, Ng L, et al. To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? Scandinavian Journal of Pain. 2020.
6. Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport & Exercise Medicine. 2015;1:e000050.
7. Aasa B, Berglund L, Michaelson P, Aasa U. Individualized, heavy resistance training in patients with chronic low back pain: a feasibility study. BMC Sports Science, Medicine and Rehabilitation. 2020;12:21.