Sciatica, Arlington Texas
Sciatica: What Is Actually Causing The Pain Down Your Leg
The short answer
Sciatica is pain or altered sensation along the path of the sciatic nerve, which is made up of the nerve roots L4 through S3. The most common cause is a herniated or bulging lumbar disc pressing on or irritating one of those roots. Most cases settle within four to six weeks. The job of an examination is to find which root is involved, and to catch the small number of cases that need a hospital instead.
Read This First
When Sciatica Is An Emergency
If You Notice Any of These Warning Signs, Please Seek Emergency Room Care Right Away.
These features can indicate cauda equina syndrome, a progressive neurological problem or an infection. They need a hospital the same day.
- Loss of bowel or bladder function
- Urinary retention, meaning you cannot pass urine
- Numbness through the saddle area or the inner thighs
- Weakness in both legs, or weakness that is getting worse day by day
- Fevers, night sweats or chills alongside the pain
- Back pain after a significant fall or collision, or a suspected fracture
- New back pain with a history of cancer, or with a compromised immune system
Do not wait for an appointment and do not drive across town for one. If you are unsure, call 817-800-7136 and describe it, and you will be told plainly where to go.
Sciatica, StatPearls, NCBI Bookshelf (National Institutes of Health): names loss of bowel or bladder function, urinary retention and lower extremity weakness as indicators of cauda equina syndrome, and notes that fevers, night sweats and chills are atypical for simple sciatica.
Full text: Sciatica, StatPearls.
The Mechanism
Why It Travels Down The Leg
Sciatica is not a diagnosis. It is a description of where you feel something, and the useful question is always which structure is producing it.
The sciatic nerve is not a single cable leaving the spine. It is formed from the nerve roots L4 through S3, which exit between the vertebrae of the lower back and the sacrum. Anything that narrows the space a root passes through can irritate or compress it, and the root that is affected decides where you feel it.
The most common cause is a herniated or bulging lumbar intervertebral disc. In older patients, narrowing of the spinal canal itself is also common. That is why the same complaint, pain down the back of the leg, can have quite different causes at 30 and at 70.
Why which root matters
Different roots produce different patterns. Involvement at L5 is associated with weakness of hip abduction and of lifting the big toe. Involvement at S1 is associated with a reduced or absent ankle reflex. Those are examination findings rather than things you can check yourself, and they are the reason an examination is not a formality.
This is where applied kinesiology earns its place. Dr. Monet is certified in it, and manual muscle testing lets her assess how your body responds under load, muscle by muscle and joint by joint. It is a skill she trained for specifically, and very few clinics in Arlington offer it. The site of pain and the site of the problem are frequently not the same.
What To Expect
Most Sciatica Gets Better On Its Own
Most cases resolve in less than four to six weeks with no long-term complications, even if no treatment is sought at all.
Sciatica, StatPearls, NCBI Bookshelf (National Institutes of Health): "Most cases of sciatica resolve in less than 4 to 6 weeks with no long-term complications, even if no medical therapy is sought."
The same reference notes that patients with pain lasting more than six months have poorer surgical outcomes than those with pain of less than six months.
Full text: Sciatica, StatPearls.
That figure is on this page on purpose, and it is not a reason to do nothing. It sets an honest expectation, and it makes two things clearer. Care during that window is about comfort and about keeping you moving. And a case that is not following that pattern is the one worth examining properly rather than waiting out.
Annals of Internal Medicine, 2017 (Qaseem et al.), American College of Physicians: the ACP guideline on low back pain recommends non-drug treatment first, and names spinal manipulation among the recommended options for subacute and chronic low back pain.
Guideline: Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain, 166(7):514-530.
The StatPearls reference lists spinal manipulation among conservative management options alongside physical therapy and core strengthening, hot and cold packs, activity modification, and medication. Whether manipulation suits your case is a question the examination answers, not something a web page can promise.
At The Clinic
What Happens When You Come In
You describe the pattern
Where it starts, how far down it travels, what makes it worse, and whether there is numbness, burning or pins and needles. The pattern is diagnostic information, not small talk.
An examination, including muscle testing
Movement, reflexes, strength and manual muscle testing, to work out which root or structure is involved rather than guessing from the location of the ache.
You get told what she found
In plain language, including what she is not sure about. If the finding calls for an image or a medical opinion, you get referred out rather than adjusted anyway.
Treatment, if it fits
Care aimed at the mechanical problem behind the symptom. No promises about the outcome, no contract, and a straight answer if it is not working.
Two honest limits
There is no imaging in this building, so an X ray or MRI means a referral. And there are no walk-ins, so a visit has to be booked, which is what keeps the appointment time yours.
Common Questions
Sciatica, Asked And Answered
How long does sciatica last?
Most cases resolve in less than four to six weeks with no long-term complications, even without treatment, per the StatPearls clinical reference hosted by the National Center for Biotechnology Information. Care during that window is about comfort and function, and about identifying the cases that are not following that pattern.
Is sciatica the same as low back pain?
No. Sciatica is pain or altered sensation in the distribution of the sciatic nerve or an associated lumbosacral nerve root. Low back pain that stays in the back is a different problem, and the two get confused constantly.
Do I need an MRI?
Usually not, and there is no imaging in this building either way. If your examination points at something that needs an image, you get referred for one rather than adjusted anyway.
Can a chiropractor help sciatica?
Spinal manipulation is named among the conservative management options in the StatPearls reference, and the American College of Physicians guideline names it among recommended options for subacute and chronic low back pain. Whether it suits your case depends on what the examination finds, and you will be told if it does not.
When is sciatica an emergency?
Loss of bowel or bladder function, urinary retention, weakness in both legs, or fevers with night sweats and chills need a hospital the same day rather than a chiropractor. Those can indicate cauda equina syndrome or an infection.
Do you take walk-ins?
No. Every visit is booked. Call 817-800-7136 and describe what is happening, and you will be told whether this is the right clinic for it.
Sources
Where The Numbers On This Page Come From
- Sciatica. StatPearls, NCBI Bookshelf, National Institutes of Health. Definition, the L4 through S3 anatomy, disc herniation as the most common cause, the four to six week natural history, the cauda equina features, and the conservative management options.
- Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Qaseem A, Wilt TJ, McLean RM, Forciea MA, and the ACP Clinical Guidelines Committee. Annals of Internal Medicine, 4 April 2017, 166(7):514-530. PMID 28192789.
- A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Supporting reference for the radiculopathy framing.
Get It Examined Properly
Call and describe the pattern, or book online and pick a time.
3825 W Green Oaks Blvd, Suite 710, Arlington, TX 76016. Appointments only.