TAGMED CLINIC

Treatment of sciatica

A non-surgical approach based on the assessment of likely cause, pain path and neurological signs.

Sciatica can cause pain that starts from the lower back or buttocks and descends into the thigh, calf, foot or certain toes. At the TagMed clinic, the treatment is not only chosen from the word “sciatica”. It is based on a clinical assessment to determine whether the symptoms are compatible with nerve root irritation, disc disease, foraminal stenosis or another mechanical cause.

  • Assessment of pain path, sensitivity and muscle strength.
  • Review of available imaging examinations when relevant.
  • Spinal decompression therapy when the clinical picture lends itself to it.
  • Personalized approach offered at TagMed clinics in Montreal / Mont-Royal and Terrebonne.
Make an appointment
1 (877) 672-9060
Clinical Evaluation of Sciatic Pain Radiating in the Leg
The pain path gives useful clues, but it should be interpreted with clinical examination.

Understand before processing

Treatment depends on the probable cause of sciatica

The term " sciatica Usually describes a set of symptoms consistent with irritation of a lumbar nerve root or sciatic nerve. It does not, on its own, constitute a complete diagnosis.

Two patients may experience pain that descends into the leg while having different mechanisms. In one, symptoms may be associated with a herniated disc or a disc protrusion. In the other, they can be linked to foraminal stenosis, to a disc pinching, joint irritation or referred pain from the pelvis, hip or deep muscle tissue.

This distinction is important, because a suitable approach to disc irritation will not necessarily be relevant for pain from another structure. The objective of the evaluation is therefore to link the symptoms, the clinical examination and, when necessary, the available imaging in order to guide the care plan.

Key takeaways

A cautious approach seeks first to clarify the probable cause, to identify the signs requiring a medical orientation and to choose a conservative strategy consistent with the patient's condition.

Nerve pathway

Where does sciatic pain go?

The pain can begin in the lower back, buttock or hip, then descend behind or on the side of the thigh, towards the calf, heel, foot or certain toes.

Anatomy of the Sciatic Nerve Path in the Pelvis and Leg
The painful territory varies in particular according to the nerve root involved, often L4, L5 or S1.

 

Irritation of the L5 root can cause symptoms to the side of the leg, the top of the foot or the big toe in particular. S1 irritation can further reach the back of the calf, the heel or the outer edge of the foot. These correspondences guide the assessment, but they are not always perfectly clear in each patient.

Pain

Burn, slender, deep pressure or feeling of electric shock in the buttocks and leg.

Sensory disorders

Twinges, numbness, or reduced sensation in the leg, foot, or toes.

Motor impairment

Difficulty lifting the foot, walking on your heels, rising onto the toes, or maintaining strength.

Clinical evaluation

The factors that guide the choice of treatment

The location of the pain is only one of the elements analyzed. Changes over time, aggravating factors, neurological signs, and functional impact also help define the clinical profile.

Aggravating positions

Sitting, trunk flexion, prolonged walking, or certain twisting movements can change the symptoms.

Centralization or progression

Pain that moves up toward the back or, on the contrary, pain that goes farther down the leg provides useful information.

Function

The ability to sleep, walk, work, drive, climb stairs, and carry out daily activities is taken into account.

Muscle strength

The assessment may look for weakness in the foot, ankle, calf, or other muscle groups.

Sensation

The presence of numbness and its area can help identify the specific nerve root involved.

Imaging available

An MRI or another exam that has already been done can be compared with the symptoms, without interpreting it in isolation.

When to consult urgently?

Loss of urinary or intestinal control, anesthesia of the stool area, significant or rapidly progressive weakness, fever, major trauma or unusually worsening pain that is rapidly growing require an urgent medical assessment.

Possible causes

What conditions can cause sciatica pain?

Pain can result from reduced space around a nerve root, local inflammation, disc-related mechanical pressure, or another musculoskeletal mechanism.

Sciatic Pain Associated with the Lumbar Region, Pelvis and Leg
Similar pain can come from different mechanisms; the assessment aims to distinguish between them.

 

Herniated disc

A displaced disc fragment can irritate a nerve root and produce radiating (radicular) pain in the leg.

Disc Protrusion

A disc bulge can reduce space around the root, especially when it aligns with the symptoms.

Disc space narrowing

A reduction in disc height can contribute to narrowing the foraminal opening.

Foraminal stenosis

The foramen through which the nerve root exits can become narrower and irritate the nerve in certain positions.

Spinal stenosis

A narrowing of the lumbar spinal canal can cause pain, heaviness, numbness, or weakness when walking.

Referred pain

The lumbar joints, the pelvis, the hip, or muscle tissues can sometimes reproduce similar pain.

TAGMED Approach

A non-surgical, personalized approach

The care plan is chosen based on the assessment results. Technologies are not applied automatically, and no single approach fits all forms of sciatica.

Patient positioned on a neurovertebral decompression table for sciatic pain
The Spinal decompression therapy can be considered when symptoms are consistent with a mechanical disc or radicular involvement.

Motorized neurovertebral decompression

Neurovertebral decompression uses controlled, progressive traction matched to the treated area. It aims to reduce certain mechanical stresses on the discs and nerve structures.

It may be considered when the clinical picture is consistent with a herniated disc, a disc protrusion, a disc pinching condition, or foraminal stenosis, as long as the assessment and contraindications are taken into account.

Specific osteopathy and targeted interventions

Depending on the condition, a low-amplitude manual approach or an instrument-assisted intervention may be used to address certain mechanical restrictions, compensations, or associated tensions.

The choice of interventions depends on the patient’s tolerance, the stage of the condition, and the response observed during treatment.

Activity guidance

Prolonged complete rest is generally not the goal. Activities are instead adapted according to pain, neurological signs, walking tolerance, and work demands.

Reassessment

Tracking how the pain pattern changes over time, as well as strength, sensation, and function, helps adjust the care plan or recommend a medical referral.

First consultation

How is sciatica assessed?

The first consultation aims to build a coherent picture of the condition and to determine whether a conservative approach can be considered safely.

1

Historical

Onset of symptoms, pain pattern, duration, intensity, aggravating activities, treatments already tried, and relevant medical history.

2

Clinical exam

Observing mobility, function, muscle strength, sensation, and certain neurological signs.

3

Clinical correlation

Results are compared with available imaging tests and the behavior of the symptoms.

4

Personalized plan

An approach is proposed when the condition is suitable for it; a medical referral is recommended when necessary.

Depending on your situation

Treatment may vary based on the pain profile.

A new sciatica episode without significant weakness is not necessarily managed the same way as persistent, recurrent pain, or pain accompanied by a neurological deficit.

New pain

The goal is to control irritability, maintain an activity level you can tolerate, and monitor the appearance of neurological signs.

Persistent pain

A reassessment of the likely cause, mechanical factors, and the care plan becomes important.

Numbness or weakness

The progression, the territory, and functional impact determine how quickly the assessment and direction are carried out.

Our clinics

Treatment for sciatica in Montreal and Terrebonne

The TAGMED Clinic sees patients at two real locations. The local pages provide the contact information and the specific details of each clinic.

Montréal / Mont-Royal

1140 avenue Beaumont
Mont-Royal, QC H3P 3E5
Phone : 1 (877) 672-9060

View sciatica treatment in Montreal

Terrebonne

1150 LĂ©vis Street, Suite 200
Terrebonne, QC J6W 5S6
Phone : (450) 704-4447

View sciatica treatment in Terrebonne

Does your pain travel down your leg?

An assessment can help clarify the path of the symptoms, the most likely cause, and the relevance of an appropriate non-surgical approach.

Make an appointment
1 (877) 672-9060
Consultation and Explanation of Sciatica Treatment Using a Spine Model
The plan of care is explained according to the results of the evaluation and the patient's objectives.

Frequently Asked Questions

FAQ about sciatica treatment

This section answers common questions about the length of care, neurospinal decompression, exercises, imaging, and signs that require prompt consultation.

Frequently Asked Questions

Sciatica

  • What is sciatica?

    Sciatica refers to pain related to irritation or compression of the sciatic nerve or a lumbar nerve root. It can cause pain that starts in the lower back, buttock, or hip and travels down the leg.

  • Is sciatica a disease or a symptom?

    Sciatica is generally a symptom rather than a disease on its own. It indicates that a structure, such as a disc, a joint, a muscle, or narrowing of the nerve canal, may irritate a nerve root or the sciatic nerve.

  • What are the most common symptoms of sciatica?

    Common symptoms include pain in the buttock or leg, a burning sensation, sharp pains, tingling, numbness, or sometimes muscle weakness in the leg or foot.

  • Can sciatica extend down to the foot?

    Yes. Depending on the irritated nerve root, the pain may travel down the thigh, calf, ankle, or foot. The exact path of the pain can help identify the involved low-back area.

  • Is leg pain always sciatica?

    No. Leg pain can also come from the hip, pelvis, knee, a muscle, a vascular problem, or another nerve irritation. A clinical assessment helps distinguish these causes more clearly.

  • What is the difference between sciatica and low back pain?

    Low back pain is pain located mainly in the lower back. Sciatica usually involves pain that radiates into the buttock or leg, sometimes with neurological signs such as tingling, numbness, or weakness.

  • What is the difference between sciatica and cruralgia?

    Sciatica mainly affects the back or side of the leg, while femoral nerve pain (cruralgia) mainly affects the front of the thigh, sometimes as far as the knee. Both can result from irritation of different lumbar nerve roots.

  • What are the common causes of sciatica?

    Common causes include a herniated disc, a disc protrusion, foraminal stenosis, spinal stenosis, lumbar osteoarthritis, spondylolisthesis, or certain muscle tightnesses that can irritate the sciatic nerve.

  • Can a herniated disc cause sciatica?

    Yes. A herniated disc can irritate or compress a lumbar nerve root, which can cause sciatica pain radiating into the buttock, thigh, calf, or foot.

  • Can a disc protrusion cause sciatica?

    Yes. A disc protrusion can reduce the space available around a nerve root and contribute to sciatica pain, especially if it is associated with inflammation or foraminal narrowing.

References

The following references are provided for informational purposes to support the educational content of this page.

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Jimenez, Alex. “Utilizing Decompression Therapy For Myelopathy.” https://personalinjurydoctorgroup.com/2022/05/24/utilizing-decompression-therapy-myelopathy/ (December 16, 2024).
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Low, How Spinal Decompression Can Relieve. “The Reoccurrence Of Low Back Pain Relieved By Spinal Decompression.” https://dralexjimenez.com/reoccurrence-low-back-pain-spinal-decompression/ (December 16, 2024).
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VanderWal, Candi. “You Are Browsing the Archive for Practice Management.”
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Nanni, Tanha Nosin. 2016. “Effectiveness of Manual Lumbar Traction for the Management of Low Back Pain Patient along with Physiotherapy Treatment.” PhD Thesis. Bangladesh Health Professions Institute, Faculty of Medicine, the University …. http://202.4.109.28:8080/xmlui/handle/123456789/403 (December 16, 2024).
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VanderWal, Candi. “You Are Browsing the Archive for Jeff VanderWal.”
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Chronic, Nonsurgical Spinal Decompression To Treat, and Low Back Pain. “On September 27, 2010, in Studies, by Admin.”
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VanderWal, Candi. “You Are Browsing the Archive for Spinal Decompression Certification.”
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Close, Lint. “Current Therapeutic Options for Chronic Low Back Pain: A Focus on Nonsurgical Approaches.” http://amtradetechnology.com/publications/Online%20CME%20Albert%20Einstein%20Univ%20(6)%20(2).pdf (December 16, 2024).

Medical references

Sources used for this page

The content is based on guidelines and publications on the assessment of low back pain with sciatica, lumbar radiculopathy, disc herniation, and certain conservative approaches.

NICE — low back pain and sciatica

The NG59 guideline covers the assessment and management of low back pain and sciatica in adults, including directing care based on the clinical profile and searching for signs of severity.

Consult NICE NG59

Disc herniation with radiculopathy

The North American Spine Society provides recommendations on the diagnosis and treatment of lumbar disc herniation with radiculopathy.

Consult the NASS guideline

Non-surgical approaches

A 2024 review examines various conservative approaches used in the presence of a lumbar disc herniation associated with radiculopathy.

Consult the 2024 review

Non-surgical decompression

A 2022 clinical trial studied adding non-surgical decompression to conventional care in patients with lumbar radiculopathy. The results should be interpreted based on the study’s limitations and the patient’s profile.

Consult the 2022 study

Important information

The information provided on this page is for educational purposes only. It does not replace a professional assessment or medical advice. Results may vary depending on the cause of symptoms, the patient’s condition, and the patient’s individual response to care.

Sylvain Desforges, docteur en ostéopathie

TagMed Clinic — Neurovertebral decompression and assessment of lower back, disc and sciatica pain.

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