Sciatica
The pain runs down your leg. That is not where it starts.
Book your first visitBook your first visit online or call (630) 435-0100.
You get a straight answer at visit one: what is causing it, whether I can help, and what it would take. If I am not the right answer, I will tell you who is.
Sciatica is a leg problem with a back-and-hip cause. The sciatic nerve, the largest in your body, starts as a bundle of nerve roots in your lower back, runs through your hip and buttock, and travels down the back of your leg. When something along that route presses on it, the leg is where you feel it, and the lower back or the hip is where the problem lives.
I am Dr. Justin Hunter, a chiropractor in downtown Naperville, and for over 20 years finding where a patient's sciatica actually starts has been the job. Until you know that, treatment is guesswork with a table.
What actually causes it
There are a handful of common culprits, and they do not get treated the same way. Telling them apart is the first job of the first visit.
A disc pushing on a nerve root in the lower back. The most common cause, and the one most people assume they have. The herniated disc page covers that whole story, including why a disc on an MRI is not automatically the answer.
Muscle compression through the hip and buttock, where a tight muscle presses on the nerve as it passes through.
Narrowing in the spinal canal, which tends to hurt more when you stand and walk and ease when you sit or lean forward.
Sacroiliac joint irritation at the base of the spine, which can mimic sciatica closely enough to be mistaken for it for years.
Compensation from somewhere else in the chain, an old injury or years of sitting that changed how you load your back and hips. The back pain page goes deep on how that works.
What happens on your first visit
We talk first. When it started, what makes it worse, what you have already tried, what you do all day. Most of what I need to know comes out of that conversation.
Then I examine you. Orthopedic and neurological testing, movement screening, hands on the areas that are guarding. I am trying to reproduce your pain on purpose, because the position that reproduces it tells me where it is coming from.
By the end of the visit you get the answer: what I found, whether I can help, and roughly what that would take. If I do not think chiropractic care is right for your situation, I will say so and point you somewhere better.
First visits run about an hour.
How I treat sciatica
The treatment depends on which culprit the exam found, which is exactly why the exam comes first.
When the compression is in the hip and buttock, the work happens there: releasing the deep hip rotators that are squeezing the nerve, restoring hip rotation that has been lost, and getting the nerve gliding again along its path.
When the sacroiliac joint is the mimic, it gets treated as a joint problem, which tends to respond quickly once someone finally treats the right thing.
When a disc is driving it, the plan follows what works for discs, positions and loading chosen to pull the symptoms up out of the leg. The full version of that plan lives on the herniated disc page.
In every version, the second half is the same: rebuilding the movement and strength that keep the pressure from coming back, with short, specific work you do at home. No prescriptions, no injections, no surgery, and if your situation needs one of those, I will tell you and refer you to someone I trust.
The first visit is mostly examination, because finding the source is what makes the treatment work.
When sciatica is not something I should treat
Some symptoms mean you need a medical evaluation right away, not an appointment next week. Go to an emergency room if you have any of these:
- Loss of bladder or bowel control, or numbness through the groin and inner thighs.
- Weakness that is getting rapidly worse, or a foot you cannot lift.
- Sciatic pain that started with significant trauma, a fall, or a car accident that has not been medically evaluated.
- Pain with fever, unexplained weight loss, or a history of cancer.
How long this takes
I am not going to hand you a number on a brochure. Some people feel a real difference after the first visit. Some have three problems stacked on top of each other and it takes a few weeks of consistent work to unwind them.
What I will do is give you a realistic timeline at the first visit, based on what I actually find, and tell you honestly if you are not responding the way I expected. That goes for athletes too: if you are trying to stay in your sport while we fix this, say so, because the plan changes and staying active is usually possible.
Ready to find out where your sciatica actually starts?
You get a straight answer at visit one: what is causing it, whether I can help, and what it would take.
Common Questions
Should I rest or keep moving?
Keep moving, within reason. Long bed rest makes most sciatica worse, not better. Walking is usually fine and often helps. What you want to avoid is the specific positions that light it up, and I will tell you which ones those are for you.
Do I need an MRI before I come in?
Not to start. Most sciatica can be sorted out with a good history and a thorough exam. If imaging would actually change what I do, I will tell you exactly what to get and where to go. If you already have recent imaging, bring it.
Can chiropractic make sciatica worse?
The risk is low when the cause has been identified first, which is why the first visit here is mostly examination. The trouble comes from treating every leg pain the same way without figuring out where it is coming from.
What is the difference between sciatica and a pinched nerve?
Sciatica is a pinched nerve, specifically the sciatic nerve and its roots, felt in the leg. Nerves get pinched in the neck, shoulder, and arm too, and that has its own page. Same principle, different location, different plan.
Is this covered by insurance?
Pure Health & Wellness is in network with Blue Cross Blue Shield PPO, Aetna PPO, PHCS PPOs, and United Healthcare PPO. In your insurance directory the practice may be listed as Hunter Family Chiropractic, PC. Same practice, same doctor, same address. Call (630) 435-0100 and I will confirm coverage for your specific plan.
Do I need a referral?
No. You can book a first visit directly. If you already have imaging or records, send them ahead or bring them with you. Helpful, but not required.