Best Treatment for Sciatica in Fort Collins, Colorado

Sciatica can cause sharp, burning, or electric pain that travels from the lower back into the buttock and down one leg. Some people also experience numbness, tingling, leg weakness, or difficulty sitting, standing, walking, and sleeping. The best treatment for sciatica in Fort Collins depends on identifying why the nerve is irritated and developing a treatment plan that addresses the underlying cause rather than only masking the pain.

At Square One Health, our first goal is to determine what is causing your symptoms and whether you are an appropriate candidate for conservative treatment.

What Is Sciatica?

Sciatica is not a specific diagnosis. It is a collection of symptoms caused by irritation or compression of the sciatic nerve or one of the lumbar nerve roots that contributes to it.

The sciatic nerve is the largest nerve in the body. It begins in the lower spine, travels through the buttock, and continues down the back of the leg. When one of its nerve roots becomes inflamed or compressed, symptoms may travel anywhere along that pathway.

Common causes of sciatica include:

• Lumbar disc bulges or herniations
• Degenerative disc disease
• Spinal or foraminal stenosis
• Spondylolisthesis
• Spinal instability
• Arthritic changes in the lumbar spine
• Sacroiliac joint dysfunction
• Piriformis-related nerve irritation
• Loss of normal lumbar alignment and movement

Because several different conditions can create similar symptoms, treating every case of sciatica the same way is unlikely to produce the best results.

The Best Treatment Starts With the Correct Diagnosis

A proper sciatica evaluation should include more than simply asking where it hurts. A comprehensive examination may involve:

• A detailed history of how the symptoms began
• Orthopedic testing
• Neurological testing
• Muscle-strength and reflex testing
• Sensory testing
• Postural and movement assessments
• Evaluation of spinal alignment and joint function
• Weight-bearing X-rays when clinically appropriate

An MRI may be recommended when symptoms suggest a significant disc injury, spinal stenosis, progressive neurological involvement, or when a patient is not responding as expected to conservative treatment.

Imaging findings must also be compared with the patient’s symptoms and examination. A disc abnormality visible on an MRI is not automatically the source of pain. The location of the abnormality should correspond with the affected nerve, neurological findings, and symptom pattern before it is considered clinically significant.

Can a Herniated Disc Heal Without Surgery?

One of the most encouraging findings in the research is that many lumbar disc herniations can shrink over time without surgery. This process is known as spontaneous regression or disc resorption.

When part of the inner disc material moves through the outer layers of the disc, the body may recognize the displaced material as being outside its normal location. Immune cells called macrophages can migrate into the area and begin breaking down and absorbing the exposed disc material. New blood vessel formation and enzymatic degradation may also contribute to this natural healing response.

A systematic review and meta-analysis of patients receiving nonsurgical treatment reported that approximately 63% of symptomatic lumbar disc herniations demonstrated some degree of regression on follow-up imaging. However, this percentage represents an average across different disc types and patient populations, so it should not be interpreted as a guaranteed outcome for an individual patient.

Research also suggests that the type of disc herniation strongly influences the likelihood that it will shrink:

• Disc sequestration: approximately 96% showed regression
• Disc extrusion: approximately 70% showed regression
• Disc protrusion: approximately 41% showed regression
• Disc bulging: approximately 13% showed regression

Complete disappearance on follow-up imaging occurred less frequently—approximately 43% for sequestrated discs and 15% for extruded discs.

It may seem surprising that larger extrusions and sequestrations are more likely to shrink than smaller contained bulges. However, disc material that has escaped farther from the disc may be more exposed to blood vessels and the immune system, allowing the body to identify and absorb it more effectively.

Does That Mean You Should Just Wait?

Not necessarily.

Disc regression on an MRI and improvement in symptoms are related, but they are not the same thing. A person may continue experiencing pain because of nerve inflammation, reduced spinal movement, muscle weakness, altered movement patterns, stenosis, instability, or other contributing conditions.

Conservative treatment does not physically “push” a herniated disc back into place. Instead, the goals are to:

• Reduce mechanical stress on the irritated area
• Decrease nerve irritation
• Maintain safe movement and activity
• Improve spinal and pelvic mechanics
• Restore strength and stability
• Prevent physical deconditioning
• Create a favorable environment for natural recovery

Treatment should also include regular neurological monitoring. Increasing weakness or worsening numbness may indicate that the nerve is not recovering normally and that additional imaging or a specialist referral is necessary.

Conservative Treatment for Sciatica

Most patients without emergency neurological findings should begin with a structured course of conservative treatment. The appropriate combination will depend on the cause, severity, duration, and neurological presentation.

Chiropractic Care

Specific chiropractic adjustments or spinal mobilization may be used to improve joint motion, reduce mechanical restriction, and help the patient move more comfortably.

The technique should be selected according to the patient’s diagnosis. A patient with an acute disc injury may require a different approach than someone with chronic arthritis, spinal stenosis, or sacroiliac dysfunction. Treatment should never be based on a one-size-fits-all adjustment.

Non-Surgical Spinal Decompression

Non-surgical spinal decompression may be considered for appropriately selected patients with disc-related sciatica or certain forms of nerve-root compression.

The purpose is to gently unload the involved spinal area and reduce mechanical pressure on irritated structures. It is generally most effective when incorporated into a broader treatment program rather than used as a stand-alone treatment.

Not every patient is a decompression candidate. Patients should be screened for fractures, severe osteoporosis, instability, certain surgical changes, and other contraindications before beginning treatment.

Corrective Chiropractic and Postural Rehabilitation

Some patients have underlying biomechanical problems such as loss of the normal lumbar curve, abnormal pelvic positioning, spinal translation, scoliosis, or chronic postural stress.

Corrective rehabilitation may include specialized exercises, spinal traction, postural training, and movement correction designed to improve how forces are distributed through the spine. The goal is not merely to reduce pain temporarily, but to address mechanical factors that may contribute to repeated nerve irritation.

Therapeutic Exercise

Exercise is an important part of most sciatica treatment plans, but the exercises must match the diagnosis.

Depending on the patient, rehabilitation may include:

• Core stabilization
• Directional-preference exercises
• Hip and gluteal strengthening
• Nerve-mobility exercises
• Walking progression
• Postural training
• Movement retraining
• Gradual return to work, lifting, or recreation

An exercise that helps one form of sciatica may aggravate another. For example, repeated spinal extension may help certain disc-related symptoms but may worsen symptoms associated with some forms of spinal stenosis. This is why an examination should guide the exercise plan.

Activity Modification

Prolonged bed rest is generally not the best solution for uncomplicated sciatica. Remaining safely active can help preserve mobility, strength, and confidence.

However, this does not mean pushing through severe radiating pain. Temporarily modifying heavy lifting, prolonged sitting, repeated bending, or other aggravating activities may help reduce irritation while the nerve begins to recover.

Medication and Epidural Injections

Medication may be used to reduce pain or inflammation enough for a patient to sleep, move, and participate in rehabilitation. In more severe cases, an epidural steroid injection may provide temporary relief by reducing inflammation around an affected nerve root.

These approaches may be helpful for symptom control, but they do not necessarily correct the mechanical or structural condition contributing to the symptoms.

Surgery

Surgery may be appropriate when a patient develops progressive neurological loss, severe nerve compression, or persistent disabling symptoms that have not responded to an appropriate trial of conservative care.

Surgery should not automatically be viewed as a failure. For the right patient, it may be the most appropriate option. The purpose of a comprehensive evaluation is to determine whether conservative care is reasonable or whether a surgical consultation is needed.

When Sciatica Is an Emergency

Seek immediate emergency medical attention if sciatica is accompanied by:

• Loss of bowel or bladder control
• Inability to begin or stop urination
• Numbness around the groin, inner thighs, or saddle region
• Rapidly worsening leg weakness
• Loss of control of the foot or ankle
• Severe symptoms affecting both legs
• Significant symptoms following major trauma

These may indicate severe nerve compression or cauda equina syndrome and should not be managed as a routine chiropractic appointment.

Why Early Evaluation Matters

Pain may decrease before the underlying problem has fully recovered. Conversely, nerve symptoms may persist even while a disc is beginning to shrink.

Waiting too long can allow a person to develop weakness, guarded movement, poor balance, reduced activity tolerance, and compensatory movement patterns. Early evaluation helps determine the seriousness of the condition, identify neurological deficits, and establish appropriate treatment or referral.

The sooner the cause is identified, the sooner treatment can be matched to the condition.

What Is the Best Treatment for Sciatica?

There is no single treatment that is best for every patient. The most effective approach is usually a combination of:

1. An accurate diagnosis
2. Appropriate imaging when necessary
3. Treatment matched to the cause
4. Progressive rehabilitation
5. Ongoing neurological monitoring
6. Referral for injections or surgery when indicated

Many disc-related cases can improve without surgery, and research confirms that a substantial percentage of lumbar disc herniations shrink naturally over time. However, successful conservative care requires more than simply waiting. The patient must be evaluated, monitored, and guided through the recovery process.

Sciatica Treatment in Fort Collins, Colorado

If you are experiencing pain, numbness, tingling, or weakness traveling from your lower back into your leg, Square One Health in Fort Collins can evaluate the underlying cause and determine whether you are a candidate for conservative treatment.

Your individualized plan may include chiropractic care, non-surgical spinal decompression, corrective spinal rehabilitation, therapeutic exercise, and coordinated referral when additional medical treatment is necessary.

Do not settle for repeatedly masking the pain without understanding why it is occurring. Schedule a consultation and evaluation with Square One Health to determine what is irritating your sciatic nerve and what treatment options may be appropriate for you.

About Dr. Tim Cowan, DC

Dr. Tim Cowan, DC is a Doctor of Chiropractic at Square One Health and has written and reviewed this article. He earned his Doctorate of Chiropractic from the University of Western States after completing a Bachelor of Science in Exercise Science from Northern Arizona University. Dr. Cowan has advanced training in scoliosis rehabilitation, Chiropractic BioPhysics (CBP), and postural correction techniques. He focuses on helping patients improve posture, movement, and spinal function through individualized treatment approaches designed to address musculoskeletal conditions and movement-related dysfunction.

Research References

1. Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clinical Rehabilitation. 2015;29(2):184–195.
2. Zhong M, Liu JT, Jiang H, et al. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Pain Physician. 2017;20(1):E45–E52.
3. Wang Y, et al. The incidence of regression after the non-surgical treatment of symptomatic lumbar disc herniation: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2020;21:530.
4. Xie L, Dong C, Fang H, et al. Prevalence, clinical predictors, and mechanisms of resorption in lumbar disc herniation: a systematic review. Orthopedic Reviews. 2024;16.