Conditions We Treat
Sciatica
Radiating pain, numbness, or tingling down the leg is often traced to nerve compression in the lumbar spine or piriformis syndrome. Identifying the actual source matters — treatment is different depending on where the compression is.
Sciatica is not a diagnosis — it’s a symptom. The burning, shooting, or tingling sensation that travels from the lower back through the buttock and down the leg is the sciatic nerve signaling compression or irritation somewhere along its path. Where that compression is happening determines everything about how it should be treated.
The two most common sources are lumbar disc herniation (compression of the L4, L5, or S1 nerve root at the spine) and piriformis syndrome (the sciatic nerve irritated by the piriformis muscle deep in the gluteal region). These require different treatment approaches. Treating one when you have the other doesn’t work.
At Spine Bar, sciatic presentations are assessed carefully: orthopedic provocation tests (straight leg raise, Slump, FAIR test), lumbar and sacral motion palpation, and neurological screening for motor or sensory deficit. Once the source is identified, treatment is targeted — lumbar decompressive adjustment, soft tissue work to the piriformis and hip external rotators, or a combination of both.
Common causes
- L4–L5 or L5–S1 disc herniation
- Lumbar facet joint compression
- Piriformis muscle tightness or spasm
- Sacroiliac joint dysfunction
- Spinal stenosis
- Prolonged sitting or hip flexor tightness
What to Expect
Your first visit for sciatica
Diagnosis is clinical — we use orthopedic and neurological testing to identify the source. If imaging is needed, we’ll tell you. Treatment begins same visit once the source is confirmed. Sciatic cases typically require a multi-visit plan; improvement is usually measurable within 2–4 visits.
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