Sciatica treatment

Available at Lake Forest, San Diego, and Spring Valley

Sciatica is pain, tingling or numbness that travels from the low back or hip down one leg because the sciatic nerve is irritated or compressed. Chiropractic care may help by finding what is irritating the nerve, then easing pressure on it with gentle adjustments, soft tissue work, stretching and changes to how you sit and drive.

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When to seek urgent care

Sciatica can occasionally signal a serious nerve problem. Go to an emergency room straight away if you have:

  • Loss of bladder or bowel control
  • Numbness in the groin or inner thighs
  • Sudden weakness in a leg

These need emergency medical care. Do not wait for a chiropractic appointment.

Living with sciatica

Sciatica can be frustrating, exhausting and limiting. When pain shoots from your low back into your leg, even simple movements can feel overwhelming. Many people come to us unsure why the pain started or why it keeps coming back.

Our chiropractors take the time to understand what is irritating your sciatic nerve and how it is affecting your daily life. Care is gentle and aims to improve movement and help you get back to normal activities with confidence. Your first visit is about listening, understanding your symptoms and making a clear plan.

What sciatica is

Sciatica is pain from irritation or compression of the sciatic nerve. It usually starts in the low back or hip and travels down one leg. It can change with your posture, movement and activity.

In some people the pain reaches only the buttock. In more involved cases it travels all the way down the leg into the foot. Where the pain goes tells us how much the nerve is involved and guides both the exam and the treatment plan.

How we find the cause

Your exam starts with how you move: your range of motion, how you sit down and stand up, how you get on and off the table, and whether you favor one side when you walk. We also check whether your hips are level.

Next is a neurological exam of the sensation, reflexes and strength in your legs. Reduced sensation, weaker reflexes or weakness in certain muscles point to nerve involvement. This helps tell whether the pain comes from a pinched nerve in the spine or from a very tight piriformis muscle in the buttock, another common cause of sciatic pain.

X-rays are taken when clinically needed. An MRI is not usually the first step. If leg symptoms are still present after several weeks of care, your chiropractor may refer you for an MRI.

How we treat sciatica

Care is based on the cause. It may combine gentle adjustments, trigger point therapy, soft tissue work, hip and buttock stretches and massage. Some people respond better to soft tissue work and others to adjustments, so your plan is adjusted as you go.

Flexion-distraction is a gentle table technique that rhythmically stretches the low back to ease pressure on the disc and nerve and to counter the effects of long hours sitting. Dr. Ron Merriel, DC uses Cox flexion-distraction at our San Diego office. At Lake Forest, motorized spinal decompression is also available for disc-related leg symptoms. Stretching comes first, then strengthening as you improve.

If you sit a lot, which loads the discs, easing that pressure becomes a key part of care. We also look at your chair, desk and car seat.

When a disc is involved

Some sciatic pain comes from a disc bulge or herniation. Each disc has tough outer rings around a gel-like center. As a disc wears or after an injury, that center can push into the rings. If it breaks through them, it can leak into the spinal canal and press on a nerve. This is a disc herniation.

Disc bulges take time to settle, and herniations take longer, often many months. We explain this at the start so you have realistic expectations and can stay with the plan.

What sciatica can feel like

Sciatica feels different from person to person. Some people describe a deep ache in the buttock, others a burning or electric pain down the back of the thigh and calf. It usually affects one side. Pain may be worse when you sit, cough, sneeze or bend forward, and may ease when you walk or lie down.

Tingling, pins and needles or numbness in the leg or foot are common. Weakness, such as a foot that catches when you walk, is a sign of more nerve involvement and should always be examined.

Self-care between visits

  • Avoid sitting for long stretches; stand up and walk every 30 to 45 minutes
  • Use a lumbar support in your chair and car
  • Keep gently active with short walks rather than resting in bed
  • Do the stretches your chiropractor gives you, slowly and without forcing
  • Try ice on the low back for 15 to 20 minutes if it is inflamed
  • Sleep on your side with a pillow between your knees, or on your back with a pillow under your knees

If any self-care makes leg symptoms spread further down the leg, stop and tell your chiropractor.

Patient case studies

Sciatica from long hours sitting and driving

Patient
A woman who sat for most of her working day and drove a lot during the week.
Symptoms
Nagging sciatic pain and low back pain. More than 25 to 30 minutes in traffic brought on severe pain.
Findings
A disc herniation, with long hours of sitting and driving keeping pressure on the disc and making it harder to heal.
Care
She followed her plan closely and did her stretching and strengthening exercises. She switched to a more supportive chair at home, used a sit-stand desk, took walking breaks, and rested one foot on a small step when standing. The change that helped most was a lumbar cushion with a sacral cutout in her car, which let her drive without triggering the sciatica.
Outcome
After about four months of care she was doing significantly better. Because of the herniation, progress was gradual, and she chose to continue conservative care.

Individual results vary.

Care that may be part of your plan

Your chiropractor recommends care after your exam. Some therapies are offered only at certain offices.

From the blog

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Sciatica is treated at all 3 Greenlight offices.

Your questions,
answered

About sciatica care at Greenlight.

Can sciatica go away without treatment?

Mild cases may settle, but sciatica that lasts or keeps returning often needs care that addresses the cause. Having it checked early gives you the best chance of getting back to normal activities sooner.

How long does sciatica treatment take?

It depends on the cause, how severe it is and how you respond. A disc bulge takes longer to settle, and a herniation can take many months. One patient with a herniation was doing significantly better after about four months of care. Individual results vary.

Can chiropractic care help sciatica?

For many people it can. Care aims to ease pressure on the nerve with gentle adjustments, flexion-distraction or decompression where offered, soft tissue work and stretching, and to change daily habits such as how you sit and drive. People who follow their plan and make those changes tend to do best.

Does sciatica treatment hurt?

Care is gentle. We ease muscle tension before each adjustment, which makes treatment more comfortable and helps the adjustment hold.

Will sciatica come back after treatment?

Exercises, posture guidance and occasional check-ups can help lower the chance of it returning. Catching a flare early makes it easier to address.

What are the common causes of sciatica?

The causes we see most are a pinched nerve in the low back, often from a disc problem, and a very tight piriformis muscle. Long periods of sitting and regular driving are two of the biggest contributors.

What happens if sciatica is ignored?

Sciatica that is left alone can lead to ongoing leg and back pain, muscle weakness, reduced mobility and changes in how you walk. Loss of bladder or bowel control, numbness in the groin or sudden leg weakness needs emergency care.

What are the symptoms of sciatica?

Low back pain that spreads, buttock or leg pain, muscle spasms, sharp or burning pain, a mild ache, electric-like jolts, pain when coughing or sneezing, tingling, numbness and leg weakness.

What raises the risk of sciatica?

Disc herniation, bone spurs, older age, extra body weight, long periods of sitting, physically demanding work and heavy lifting. Regular exercise, a healthy weight, good posture and careful lifting help lower the risk.

Should I rest in bed with sciatica?

Long bed rest usually is not helpful. Gentle movement such as short walks tends to help more, while avoiding the positions that clearly make your leg pain worse.

Is it better to use heat or ice?

Ice is often more comfortable when pain is new or inflamed. Some people prefer heat for muscle tightness in the buttock. Your chiropractor can suggest which suits you.

Do I need an MRI before I start care?

Not usually. Many people start with an exam and conservative care. If leg symptoms do not settle, get worse, or you develop weakness, your chiropractor may refer you for an MRI.