Yes. Sciatica is one of the conditions we treat most consistently at Full Swing Healthcare in Jacksonville, and it responds well to chiropractic care when the root cause is identified correctly. The critical first step is distinguishing between disc-driven sciatica and piriformis syndrome, because they require different treatment priorities even though the symptoms feel nearly identical.
Two Different Causes, Same Pain Pattern
Classic disc-driven sciatica comes from a herniated or bulging disc at L4-L5 or L5-S1 pressing on a nerve root. The pain radiates in a specific pattern down the leg and typically worsens with lumbar flexion and prolonged sitting. Piriformis syndrome produces nearly the same sciatic pain pattern, but the source is different: the piriformis muscle in the posterior hip compresses the nerve directly. It worsens with hip internal rotation and with sitting on a hard surface for long periods.
We test for both causes at every sciatica assessment. Most patients arriving at our clinic have never had anyone check the hip before attributing all of their symptoms to a disc finding on their MRI.
What Treatment Looks Like
- Disc-driven presentations: We use chiropractic techniques specific to disc involvement. That is not the same as a standard lumbar adjustment. We avoid loaded flexion, use decompression-oriented positions, and add traction-based work when appropriate.
- Piriformis involvement: We combine dry needling of the piriformis muscle with SI joint mobilization to release the compression at the source.
- Combined cases: Most patients have both components active at the same time. A combined approach consistently outperforms treating only one driver in isolation.
A Real Patient Outcome
A patient from the Baymeadows area came to us after four months of right-sided sciatica that two prior providers had attributed entirely to his L5-S1 disc bulge. That disc finding was real. But hip rotation testing immediately reproduced his full sciatic pattern, pointing to the piriformis as the dominant driver. Three dry needling sessions targeting the piriformis, combined with lumbar chiropractic work, cleared his leg pain. The disc is still visible on his MRI. His leg pain is gone.