Sciatica
Sciatica describes pain, numbness or tingling travelling from the low back through the buttock and down the leg, caused by irritation of the sciatic nerve. Assessment establishes where along its course the nerve is being affected, since disc-related and muscular causes respond to different treatment.
Understanding the problem
Sciatica is a description of symptoms, not the cause of them
The sciatic nerve runs from the low back through the buttock and down the back of the leg. Pressure anywhere along that path produces similar symptoms, but the cause determines the treatment. A disc pressing on a nerve root in the low back and a tight piriformis muscle compressing the nerve in the buttock can feel much the same to the patient and need quite different handling.
Two features guide the assessment: how far down the leg symptoms travel, and whether there is weakness as well as pain. Symptoms below the knee, or any loss of strength, point to nerve root involvement and change both the urgency and the approach.
What a first visit involves
How we work through it
We do not begin treatment on first meeting you. The assessment comes first.
- History — we listen firstWhere the pain is, when it started, what makes it worse, previous injuries, and your work and sleep posture. For accident or work injury cases, how the incident happened.
- Physical examinationPalpation, range of motion testing, and a neurological check of reflexes, strength and sensation — to work out whether the problem is structural, neurological or soft tissue.
- Digital X-ray if indicatedTaken on site. Whether it is needed is a clinical judgement, not a default for every patient.
- Findings and plan explainedIn the same visit you are told what was found, the likely cause, what is proposed and roughly how many visits it may take — before anything begins.
At the clinic
Treatment rooms and equipment
What may be used
Combined according to the assessment
Not every patient needs every item. What is used follows from what the examination shows.
- Chiropractic adjustment of the lumbar and sacroiliac region
- Digital X-ray where clinically indicated
- Spinal traction where disc involvement is suspected
- Soft-tissue work on the piriformis and gluteal musculature
- Electrical stimulation and microcurrent
- Ultrasound therapy
- Cold and heat therapy
- Nerve mobilisation and stretching
- Rehabilitation exercise
Fees and insurance
Who usually pays for this
How treatment is funded changes what paperwork you need. Pick the closest to your situation:
Auto accident
The at-fault driver's liability cover, MedPay on your own policy, or on a lien where you are represented.
What you need →Work injury
California workers' compensation — approved treatment is paid by the employer's insurer.
How it works →Private insurance
What PPO plans typically cover, and deductibles.
How to check →Self-pay
Self-pay rates, including initial examination with digital X-ray.
See rates →Why here
A few objective points
1988 — 38 years
Same practitioner, same Oakland Chinatown block since 1988.
Cantonese · Mandarin · Taiwanese · English
From history-taking to explaining the plan, in the language you are most comfortable in.
Digital X-ray, same visit
Where imaging is clinically indicated it is taken here, not at a separate centre.
5 min from Lake Merritt BART
Madison professional building, downtown Oakland. Building and street parking.
FAQ
Frequently asked questions
How is disc-related sciatica different from a muscular cause?
Broadly, disc-related sciatica tends to be worse with sitting, coughing or straining, and more often produces symptoms below the knee. Piriformis-related sciatica is often worse with prolonged sitting on a hard surface and more localised to the buttock and thigh. The examination distinguishes them properly — these are tendencies, not rules.
Is there anything that means I should not wait?
Yes. Loss of bladder or bowel control, numbness in the saddle area, or progressive weakness in the leg need urgent medical attention rather than a routine appointment. Please seek medical care immediately if any of those apply.
Will I need surgery?
Most sciatica resolves without surgery. Conservative care is generally the first approach. Where the examination suggests something that needs a surgical opinion, we say so and refer rather than continuing.
Related
You may also need these
Request a call
Can't call right now? Leave a time and we'll call you
We book by phone. If now isn't a good time, fill in the form below and we'll call you during clinic hours.