Sciatica is pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. It is a symptom, not a diagnosis. The underlying cause is usually a lumbar disc bulge, piriformis muscle compression, or spinal stenosis irritating the nerve root.

How long does sciatica last without treatment?

Mild sciatica can resolve on its own in 4 to 6 weeks. Moderate to severe sciatica often persists for months or becomes chronic if untreated. Studies referenced by the National Institute of Neurological Disorders and Stroke show that early conservative care produces better long-term outcomes than waiting it out.

Can a chiropractor fix sciatica?

In most cases yes. Chiropractic care addresses the mechanical causes of sciatica: lumbar joint dysfunction, disc bulges, and muscle imbalance. A 2010 study in JMPT found that 60% of patients who had failed other treatments responded to chiropractic care. Severe or progressive cases may need surgical consultation.

When should I get an MRI for sciatica?

An MRI is warranted if you have progressive leg weakness, loss of reflexes, severe pain that does not respond to 4 to 6 weeks of conservative care, or any red flag symptoms like loss of bladder or bowel control. Most cases of sciatica do not need imaging to start treatment.

What is the difference between sciatica and piriformis syndrome?

True sciatica originates at the lumbar spine, usually from a disc or nerve root compression. Piriformis syndrome mimics sciatica but is caused by the piriformis muscle in the buttock compressing the nerve. Both produce leg pain. Treatment differs, which is why a thorough exam matters before starting care.

Will I need surgery for sciatica?

Most patients do not. According to multiple published guidelines, 80 to 90% of sciatica cases resolve with conservative care including chiropractic, exercise, and time. Surgery is reserved for severe cases with progressive neurologic deficit or for patients who have failed 6 to 12 weeks of high-quality conservative treatment.

Does Valley Chiropractic treat sciatica at all four locations?

Yes. We see sciatica patients at our Tracy, Mountain House, Manteca, and Ripon offices. All four locations use the same evaluation and treatment protocols, and our doctors rotate across sites. Pick the office most convenient to your home or work.

The Complete Sciatica Relief Guide for Valley Chiropractic Patients

Sciatica is sharp, burning, or shooting pain that travels from the lower back down through the buttock and into the leg. Most cases are caused by a lumbar disc bulge, a tight piriformis muscle, or spinal stenosis irritating the sciatic nerve. The vast majority of sciatica responds to conservative chiropractic care without surgery or long-term medication.

I am Dr. Johannes Garrido, a chiropractor with Valley Chiropractic Center. I see sciatica patients across our four San Joaquin County offices in Tracy, Mountain House, Manteca, and Ripon. This guide is the same explanation I give every new sciatica patient. It covers what sciatica actually is, how we diagnose it, the realistic treatment options, and what you can do at home.

What sciatica actually is

The sciatic nerve is the longest and thickest nerve in the body. It originates from the L4 through S3 nerve roots in the lower spine, exits the pelvis, runs through the buttock and the back of the thigh, then splits behind the knee into the tibial and common fibular nerves that supply the lower leg and foot.

“Sciatica” is the term for any pain that follows that path. It is a symptom, not a diagnosis. Saying you have sciatica is a bit like saying you have a fever. It tells you something is wrong, but not what.

The common causes we see in San Joaquin County

When a new sciatica patient walks into one of our offices, the underlying cause is usually one of these:

Cause	What it does	Who gets it
Lumbar disc bulge	Disc material presses on nerve root	30 to 55 age range, sitters and lifters
Lumbar stenosis	Bony narrowing of the spinal canal	55+ age range, worse with standing/walking
Piriformis syndrome	Buttock muscle compresses the nerve	Long sitters, drivers, runners
Spondylolisthesis	Vertebra slips forward, narrowing space	History of injury or arthritis
SI joint dysfunction	Mimics sciatica from the pelvis	Pregnancy, asymmetric loads, falls

Among the commuter-heavy population in Tracy and Mountain House, lumbar disc bulges from long driving combined with piriformis compression are the most common pattern. In agricultural communities like Ripon and Manteca, we see more spondylolisthesis and stenosis cases from years of physical labor.

Symptoms: how to tell sciatica from regular back pain

Sciatica has a distinct pattern. Typical signs include:

Pain that starts in the lower back or buttock and shoots into the leg
Pain that follows a specific path (back of thigh, side of calf, foot)
Numbness or tingling in part of the leg, foot, or toes
Weakness in the leg or foot (such as a foot that drags or slaps)
Pain that gets worse with sitting, sneezing, or coughing
Pain that eases with walking or lying flat

If your pain stays in the lower back and does not travel below the knee, it is probably mechanical low back pain rather than true sciatica. Both respond well to chiropractic care, but the treatment plan differs.

When sciatica needs immediate medical attention

A small percentage of sciatica is an emergency. Go to the ER, not our office, if any of these apply:

Loss of bladder or bowel control
Saddle anesthesia (numbness in the groin or inner thighs)
Progressive weakness in the leg
Sciatica after a major fall or crash

These can indicate cauda equina syndrome, a rare but urgent condition that requires immediate surgical evaluation. Everything else is appropriate for a conservative-first approach.

How we evaluate sciatica at Valley Chiropractic

A first visit for sciatica at any of our offices runs about 45 to 60 minutes. The exam covers:

History: when and how the pain started, what makes it worse, what makes it better
Orthopedic tests: straight leg raise, slump test, Bragard’s, Faber, and Gaenslen’s
Neurologic exam: reflexes, sensation testing, muscle strength in the legs
Range of motion: lumbar flexion, extension, lateral bend, rotation
Palpation: identifying restricted joints, trigger points, and tender areas
Gait analysis: how you walk and stand reveals compensation patterns
Imaging review: we order or review X-ray or MRI when warranted

The goal is to identify which structure is causing the symptoms. Treatment for a disc bulge is different from treatment for piriformis syndrome, and getting it right matters.

Treatment options compared

This is the honest treatment-comparison table I show every sciatica patient.

Treatment	How it works	Best for	Time to relief
Chiropractic care	Restores joint motion, decompresses nerve	Most mechanical sciatica	2 to 6 weeks
Physical therapy	Strengthens core and hips	Long-term prevention, post-surgery	4 to 12 weeks
NSAIDs	Reduces inflammation	Short-term flare control	Days
Oral steroids	Strong anti-inflammatory	Severe acute flare	Days
Epidural injection	Direct anti-inflammatory at nerve root	Failed conservative care	Weeks
Surgery (discectomy)	Removes disc fragment	Severe progressive cases	Days to weeks

The American College of Physicians’ 2017 low back pain guideline lists spinal manipulation, exercise, and time as first-line interventions for both acute and chronic cases. Surgery is reserved for the small percentage of patients who fail conservative care or have progressive neurologic deficit.

The Valley Chiropractic sciatica protocol

Our sciatica treatment plan combines several elements, all delivered in-house at any of our four offices:

Specific chiropractic adjustments to restore lumbar and sacroiliac joint motion
Spinal decompression or flexion-distraction for disc-related cases
Soft tissue and trigger-point work on the piriformis, gluteus medius, and lumbar paraspinals
Targeted exercise: McKenzie protocol, nerve glides, glute activation, and core stabilization
Ergonomic coaching: car, desk, and lifting mechanics
Lifestyle adjustments: sleep position, weight management, hydration

Most patients see meaningful relief in the first 2 to 4 visits and full resolution in 6 to 12 visits over 4 to 8 weeks. Visit our sciatica service page for the deeper clinical breakdown.

A typical patient story

Names and details below are anonymized for privacy.

“Maria” is a 42-year-old Mountain House resident who works remotely for a Bay Area tech company. She came in with 4 months of right-sided buttock and leg pain that started after a long weekend of yard work. She had tried ibuprofen, two physical therapy sessions, and stretching from YouTube videos. Pain was 7 out of 10 with prolonged sitting.

Exam showed positive straight leg raise on the right at 45 degrees, decreased lumbar flexion, and significant trigger points in the right piriformis. She had no neurologic deficit. We diagnosed lumbar disc irritation with secondary piriformis involvement.

Plan: 3 visits per week for 2 weeks, then 2 per week for 2 weeks, then 1 per week for 2 weeks. Each visit included adjustment, flexion-distraction, soft tissue work, and progressive exercise. By visit 6 her pain was 3 out of 10. By visit 12 it was 1 out of 10. By visit 14 she was discharged to monthly maintenance. Total time from start to discharge: 7 weeks.

This is a typical timeline. Some patients are faster, some are slower, but the trajectory is consistent.

What location should you pick?

We treat sciatica with the same protocol at every office, so pick the one most convenient to your home or work.

Tracy HQ: 438 W Beverly Pl #101. Our largest office. Best for west-side Tracy and downtown commuters.
Mountain House: 583 Wicklund Crossing. Convenient for Mountain House residents and east-side I-205 commuters.
Manteca: 130 N Grant Ave. Downtown Manteca, easy access from CA-99 and Yosemite Avenue.
Ripon: 1444 W Main St. Our newest office, serving Ripon, Salida, and Escalon.

All four offices accept the same insurance plans and use the same electronic health records, so you can switch between them mid-treatment if your schedule changes.

What you can do at home today

While you wait for your first appointment, these are safe and helpful:

Avoid prolonged sitting: stand and walk for 2 minutes every 30 minutes
Try the McKenzie press-up: lying face down, push up on your forearms or hands, hold 10 seconds, 10 reps, twice a day
Walk: 10 to 20 minutes once or twice a day is one of the best things for sciatica
Ice the lower back: 15 minutes on, 1 hour off, for acute flares
Sleep on your back with a pillow under your knees, or on your side with a pillow between your knees
Skip the heavy stretching: aggressive hamstring stretches often worsen sciatica

Avoid heavy lifting, deep forward bending, and high-impact exercise until you have been evaluated.

Book your sciatica evaluation

If your sciatica has lasted more than 2 weeks, is interfering with sleep or work, or is getting worse, do not wait. The earlier conservative care starts, the faster recovery happens. Request an appointment online at any of our four offices.

For more on lower back pain in general, see our Mountain House lower back pain guide. For a complete walkthrough of what your first visit looks like, see our first chiropractic visit post. To learn about our doctors, visit the meet the doctors page.

Sciatica is one of the most treatable causes of severe pain we see. With the right exam, the right plan, and consistent follow-through, almost everyone recovers.