Sciatica & Herniated Discs: What Actually Helps

Sciatica — pain that radiates from your lower back through your hip and down your leg — is one of the most common reasons patients come to Asa Wellness Center. It's usually caused by a herniated or bulging disc pressing on the sciatic nerve, and it can range from a dull ache to pain sharp enough to stop you mid-step.

What the Research Says

Chiropractic care for sciatica has more direct research behind it than most people expect. Here's what it shows.

A randomized clinical trial in the Journal of Manipulative and Physiological Therapeutics compared spinal manipulation directly against microdiscectomy surgery in patients with sciatica from a confirmed disc herniation who had already failed three months of other treatment. After one year, 60% of patients who received spinal manipulation improved to the same degree as the surgical group, without surgery. The other 40% went on to surgery and did well there too, so manipulation gave patients a real shot at avoiding surgery first, with surgery still there as a backup. Read the study (PMID 21036279)

A 2022 retrospective cohort study in BMJ Open, drawing on U.S. health records for over 11,000 matched patients, found that adults who received chiropractic spinal manipulation for a newly diagnosed herniated disc with radiculopathy had significantly lower odds of ending up in discectomy surgery over the following one and two years — a large, real-world dataset pointing the same direction as the trial above. Read the study (PMID 36526306)

A 2023 randomized trial adds a useful detail: comparing spinal manipulation against gentler mobilization (both paired with neurodynamic exercise) for disc herniation with radiculopathy, the gentler mobilization group did even better on pain and function at every follow-up. Both approaches helped — it's part of why treatment here is matched to your specific presentation rather than a one-size-fits-all technique, with options like spinal decompression available when a gentler approach is the better fit. Read the study (PMID 36950742)

How We Approach Sciatica & Disc Pain at Asa Wellness Center

Every case of sciatica is different depending on which disc is involved, how long you've had symptoms, and whether there's any nerve weakness or numbness. Your evaluation determines the plan, which may include:

• Chiropractic adjustments matched to your specific presentation

• Nonsurgical spinal decompression — often the better-tolerated option for acute disc-related pain or when direct manipulation isn't appropriate yet

• Functional medicine evaluation if inflammation is a contributing factor

• A referral back to your physician if your symptoms suggest you need surgical evaluation

  This is part of our broader approach to back pain — read more on the Back Pain Treatment page.

When to Seek Immediate Medical Care Instead

Sciatica usually responds well to conservative care, but some symptoms need a doctor or the ER first: numbness in the groin or inner thighs, loss of bladder or bowel control, or leg weakness that's getting worse quickly. These can signal a more serious condition (cauda equina syndrome) that needs emergency evaluation.

Frequently Asked Questions

Can chiropractic care fix a herniated disc?

Chiropractic care doesn't reverse a disc herniation, but it can reduce the nerve irritation and pain caused by it. The research above shows meaningful improvement is common.

Is spinal decompression better than adjustments for sciatica?

It depends on your specific case. Decompression tends to be gentler and is often better tolerated for acute, actively inflamed disc pain, while adjustments may be more appropriate once the acute phase has settled. Dr. Martinsen will recommend based on your evaluation, not a default protocol.

How long does sciatica take to improve?

Highly variable — some patients notice relief within a few visits, others need a longer course of care. You'll get a realistic timeline after your evaluation, not a generic estimate.

Do I need an MRI first?

Not always. Dr. Martinsen will let you know if imaging is recommended based on your symptoms and history.

Ready to find out what's driving your sciatica? Schedule an appointment online or email asawellnesscenter@gmail.com. We're located at 2405 E. Southern Ave., Suite 3, Tempe, AZ, serving Tempe, Chandler, Mesa, and the greater Phoenix area.