Sciatica is pain that runs from the lower back or buttock down the back of one leg. It starts when the sciatic nerve, or one of the nerve roots that form it, is pinched or irritated. Thrive Spine and Sports Rehab treats sciatica in Belmar and Freehold, NJ with chiropractic care, physical therapy and acupuncture, all in the same clinic. You do not need a referral. Call (732) 359-7440 or use the button below, and the front desk will check your benefits before your first visit.
What sciatica feels like and what causes it
Sciatica is a symptom, not a diagnosis. Something is pressing on the nerve, and the right treatment depends on what that is. The pain is usually on one side and can feel sharp, burning or like an electric shock. Many people also have numbness, pins and needles or weakness in the leg or foot. Sitting, coughing and sneezing often make it worse.
The usual causes:
- A herniated or bulging disc in the lower back that presses on a nerve root. This is the most common one.
- Spinal stenosis, a narrowing of the spaces the nerves pass through that becomes more common with age.
- Arthritis and bone spurs in the lower spine.
- A tight piriformis muscle, which sits over the nerve deep in the buttock.
- A vertebra that has slipped forward over the one below it.
Not all leg pain is sciatica. A hip problem, a strained hamstring or a sore sacroiliac joint can each send pain down the leg, which is why the exam comes before the treatment. If your pain stays in your back and does not travel, see our page on lower back pain treatment.
When sciatica needs urgent care
Go straight to an emergency room if you have any of these:
- Loss of bladder or bowel control, or trouble urinating
- Numbness in the groin or inner thighs
- Weakness in a leg or foot that is getting worse, or symptoms in both legs
- Sudden severe pain after a car accident, a fall or another hard impact
- A fever along with the back pain
These are uncommon, but they can mean pressure on the nerves that needs treatment the same day.
Chiropractor, physical therapist or acupuncturist: who to see first
You do not have to decide before you book. All three work in the same building, and the first visit sorts it out. As a rough guide:
- Start with a chiropractor when the pain came on suddenly, your lower back feels locked, and bending or twisting sets off the leg.
- Start with a physical therapist when the pain has built up over weeks, keeps coming back, or comes with weakness in the leg.
- Add acupuncture when the pain is keeping you from sleeping, or from moving enough to do your exercises.
Many of our patients use two of the three: one to calm the flare-up and one to keep it from coming back.
How we treat sciatica
The plan depends on the cause found at your exam. It usually draws on one or more of these.
Chiropractic care
Chiropractic care restores motion to the joints of the lower back and pelvis that have stiffened around the irritated nerve, using hands-on adjustments and soft-tissue work. When the area is too sore for an adjustment, gentler techniques come first.
Physical therapy
Physical therapy starts by testing which movements push the pain further down the leg and which draw it back toward the spine. Your exercises are built around the ones that help. Later visits add nerve glides, hip and core strength, and practice with whatever sets the pain off: sitting, lifting, getting out of the car. The strength work is what lowers the odds of another flare-up.
Acupuncture and dry needling
Acupuncture uses very thin needles to ease pain and relax the muscles guarding the lower back and hip, sometimes with a light electrical current. Dry needling puts a needle straight into a trigger point, often in the glutes or the piriformis, to make the muscle release. At Thrive both are done by licensed acupuncturists.
Soft-tissue and myofascial release
Tight muscle and fascia in the hip and buttock can press on the sciatic nerve, or copy its symptoms when the nerve is fine. Hands-on release of that tissue often goes alongside the treatments above. Our guide to myofascial release therapy explains how it works.
What to expect at your first visit
The first visit is an exam, then treatment. We take your history, watch how you move, and test your back, hip and leg by hand to find the positions that bring on the pain. That shows whether the nerve is involved and where. If anything points to imaging or a specialist, you hear it then. Otherwise treatment starts in the same visit, and you leave with a plan and two or three exercises to do at home. Set aside about an hour.
Sciatica treatment in Belmar
The Belmar clinic is at 616 Fifth Avenue suite 105, Belmar, NJ 07719. Dr. Steve Bruno and Dr. Vinny Zappola provide chiropractic care in Belmar. Dr. Bruno moved into chiropractic after working in a hospital system, where he kept meeting patients with neck and back pain who were not finding lasting relief. Tom Corbisiero, DPT, and Shannon Moloughney, PT, DPT, provide physical therapy, and Clint Price, L.Ac., and AJ Adamczyk, L.Ac., provide acupuncture. The clinic holds a 5.0 rating across 410 Google reviews. Hours and directions are on the Belmar location page.
Sciatica treatment in Freehold
The Freehold clinic is at 20 Thoreau Drive in Poets Square, Freehold, NJ 07728. Dr. Vinny Zappola leads chiropractic care in Freehold. Rachelle Ross, DPT, the clinic's physical therapist, is trained in mechanical diagnosis of the spine through the McKenzie Institute, a method for working out which back problems respond to which movements. AJ Adamczyk, L.Ac., and Cheyenne Seonia, L.Ac., provide acupuncture. Freehold patients have left 135 Google reviews, with an average of 5.0. See the Freehold location page for hours and a map.
Frequently asked questions
How long does sciatica last?
Most flare-ups ease within a few weeks, and most people recover without surgery. Sciatica that has lasted longer, or keeps returning, usually has a cause that rest alone will not fix. That is the point to get it examined.
Can a chiropractor help with sciatica?
Often, yes. When stiff joints in the lower back or pelvis are part of what is irritating the nerve, adjustments and soft-tissue work can take the pressure off. A chiropractor also checks whether your pain is sciatica at all, and tells you if you need imaging or a different kind of care. Our article on chiropractic therapy for sciatica goes into more detail.
What is the most successful treatment for sciatica?
There is no single best treatment, because sciatica has more than one cause. For most people, hands-on care combined with targeted exercise is the first step, and it is enough. Injections and surgery are for the smaller number of cases that do not improve or that involve weakness that is getting worse.
What is the worst thing you can do for sciatica?
Staying in bed for days. Rest that long stiffens the back and weakens the muscles that support it. The other common mistakes are sitting for hours without a break, forcing stretches that send pain down the leg, and heavy lifting or twisting during a flare-up. Short walks and gentle movement usually help more.
Does acupuncture help sciatica?
It can. Research supports acupuncture for easing sciatic pain, and the risks are low. It does not move a disc or strengthen a muscle, so we usually pair it with chiropractic care or physical therapy.
Do I need a referral or an MRI before my first visit?
No to both. In New Jersey you can book a chiropractor or an acupuncturist directly, and see a physical therapist for up to 30 days without a doctor's referral. Some insurance plans want a referral on file before they pay, so the front desk checks that along with your benefits. Most sciatica does not need an MRI before treatment starts. If your exam points to one, we tell you at the first visit.
Does insurance cover sciatica treatment?
Usually. Thrive accepts most major plans, including Medicare, United Healthcare, Anthem and Cigna, and works with many others as an out-of-network provider. Coverage for acupuncture varies more than coverage for chiropractic and physical therapy. Call (732) 359-7440 and the front desk will verify your benefits first. The full list is on our insurance page.
