Condition
Sciatica
Sciatica is sharp or burning pain that radiates from the lower back through the buttock and down the leg, caused by compression or irritation of the sciatic nerve. The nerve can be compressed at the lumbar spine (disc-related), at the piriformis muscle (piriformis syndrome), or at both. The kinetic chain framework finds which segment is actually responsible and resolves the compression at the source.
Where it actually starts
The sciatic nerve runs from the lumbar spine, through the deep glute (passing under or sometimes through the piriformis muscle), and down the back of the leg. Compression can happen at any point along that path. Disc-related sciatica originates at the spine; piriformis syndrome originates at the deep glute; sometimes both contribute. The compensation pattern that drives most sciatica involves a hip that stopped extending, a thoracic spine that stopped rotating, and a piriformis locked in chronic protective tension as a result.
Common symptoms
- Sharp or burning pain radiating from low back into buttock and leg
- Tingling, numbness, or weakness in the leg or foot
- Pain that worsens with prolonged sitting
- Pain that intensifies with bending forward or twisting
- Symptoms typically on one side, sometimes both
How we treat it
Treatment depends on where the compression originates. Dry needling into the piriformis often produces dramatic same-session relief when the deep glute is the driver. Manual therapy and RX2600 work on the lumbar paraspinals and posterior hip address spine-driven compression. The plan also addresses the hip extension and thoracic rotation deficits that allowed the protective tension pattern to form in the first place.
Modalities we use
The tools behind the treatment.
Dry Needling
Thin filament needles release deep trigger points and restore movement faster than manual work alone.
Read moreManual Therapy
Joint mobilization and myofascial work delivered one-on-one with your therapist. No aides, no handoffs.
Read moreThe RX2600 Therapeutic Robot
Sustained pressure, targeted heat, and controlled vibration that hands cannot replicate. The only RX2600 Therapeutic Robot in the region.
Read moreSoft Tissue Mobilization
Hands-on release of trigger points and tight tissue around the joint or chain you’re working on.
Read moreCommon questions
Common questions.
How do I know if my sciatica is from the disc or from the piriformis?
The kinetic chain assessment includes specific tests that differentiate the two. And importantly, identifies when both are contributing. The treatment plan is tailored accordingly.
Should I avoid sitting?
Modified sitting (less time in any one position, better positioning when you do sit) helps. Total avoidance isn’t practical or necessary. The treatment plan includes strategies to manage seated work without aggravating symptoms.
Will I need surgery?
Surgery is rarely the right first step for sciatica. Most cases. Even ones with significant disc findings on imaging. Resolve with kinetic chain treatment. Surgery becomes appropriate when conservative care has failed and there are progressive neurological signs. We’ll be straight with you if that’s where your case is.
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