Surgery was supposed to be her answer.

Two procedures later, they offered her a third.

She walked into my chiropractic office in Davie roughly two years ago, barely recognizing herself.

Chronic low back pain had taken over her life.

She had already had a laminectomy.
Then a discectomy.

Two surgeries. Months of recovery. Still in pain.

The next recommendation? Spinal fusion.

Manage it. Or fuse it. Those were her options.

She chose a different path.

Today she is pain-free.

She is outside.
She is moving.
She is living the life she thought she lost.

It took about 90 days of consistent chiropractic care to change her trajectory.

She still comes in. Not because she is broken.

Because she understands what it takes to keep a spine healthy.

Her story is not rare.

What is common is this: The root cause never got addressed.

  • Pain was chased.
  • Procedures were done.
  • Function was never restored.

If you are reading this because you are in pain, or because someone mentioned surgery, or because you have been searching “sciatica” trying to figure out what is actually going on…

This is where you start.

What is Sciatica?

Sciatica is not a diagnosis. It is a description.

It tells you that something is irritating the sciatic nerve. That's it.

The sciatic nerve is the longest nerve in your body.

  • It starts in your lower spine.
  • Travels through your pelvis.
  • Runs down your leg.
  • Into your foot.

When something irritates it, you feel it.

  • Sharp.
  • Dull.
  • Burning.
  • Numbness.
  • Weakness.

The question is not: “Do I have sciatica?”

The real question is: “What is causing it?”

Why the Pain Travels

Most people say: “My back feels fine. It is my leg.”

That makes sense. But it is misleading.

The nerve is irritated at the spine.

The pain shows up down the line.

The spine is the origin.

The leg is the speaker.

Treat the speaker, and the problem stays.

Address the source, and things change.

The Four Types of Sciatica

Not all sciatica is the same.

And treating them the same is where people get stuck.

1) Disc-Related Sciatica

This is the most common type. A disc bulge or herniation presses on a nerve. Sharp, electric pain. Often follows a clear path down the leg.

2) Joint-Driven Sciatica

Dysfunction in spinal or sacroiliac joints. Pain radiates into the glute and leg. Often mistaken for disc issues. Responds extremely well to restoring motion.

3) Piriformis Syndrome

The nerve gets compressed in the hip. Deep glute pain. Worse with sitting. Requires both spinal and soft tissue work.

4) Stenosis-Related Sciatica

Narrowing of the spinal canal. More common with age. Pain increases with standing or walking. Requires decompression and structural support.

Different causes. Different solutions. Same symptom.

The Disc Conversation Most People Never Have

If you have had an MRI, you have likely seen words like:

  • Disc bulge
  • Herniation
  • Degeneration

Here is what you were probably not told:

Disc damage does not equal permanent disability.

Discs can:

  • Rehydrate
  • Stabilize
  • Adapt

But they will not do that if the environment stays the same.

You cannot expect healing if:

  • Movement is restricted
  • Load is uneven
  • Stress is constant

Function matters more than the image.

What Most Treatment Paths Get Wrong

The standard path usually looks like this:

  • Medication
  • Physical therapy
  • MRI
  • Injection
  • Surgery

Each step has logic.

But most of it focuses on symptoms.

Not cause.

Anti-inflammatories reduce inflammation. They do not remove the mechanical stress causing it.

Injections quiet the nerve. They do not fix what is compressing it.

Surgery removes or fuses structure. But often leaves the surrounding dysfunction untouched. That is why recurrence happens. This is not about blaming providers. It is about understanding the system.

What a Different Approach Looks Like

When someone walks into my office, I am not just looking for pain.

I am looking for function.

Where is the restriction?

Where is the compensation?

What is the spine actually doing?

That includes:

  • Orthopedic testing
  • Neurological testing
  • Motion assessment
  • Imaging when needed

From there, we adjust. Specifically. Methodically.

Across the full lumbar and pelvic system.

Because the body works as a system. Not in isolated parts.

What an Adjustment Actually Does

A spinal joint is meant to move.

When it does not:

  • Muscles tighten
  • Inflammation builds
  • Signals distort

An adjustment restores motion.

When motion returns:

  • Muscles relax
  • Inflammation decreases
  • Signal improves

When motion returns:

Adjustments Don’t Lie

When Decompression Is Needed

For disc cases, we may use spinal decompression.

This creates targeted pressure changes inside the disc.

It helps:

  • Reduce nerve compression
  • Improve disc hydration
  • Support healing

Not general.

Specific.

What Recovery Actually Looks Like

There is no quick fix.

Sciatica does not resolve in two visits.

The body does not work like that.

Recovery is:

There will be progress.
There will be setbacks.
What matters is direction.

We are not chasing pain. We are changing the environment.

If You Were Told You Need Surgery

Sometimes surgery is necessary. But not always first.

If you have not:

  • Tried structured chiropractic care
  • Restored motion
  • Addressed mechanical dysfunction

Then you have not exhausted your options.

Ask better questions.

Understand your body. Then decide.

Frequently Asked Questions

Sciatica is a group of symptoms caused by irritation or compression of the sciatic nerve. It is not a specific diagnosis on its own, but rather a signal that something along the nerve pathway is not functioning properly. The key is identifying what is causing that irritation, because different causes require different approaches. Once the root issue is understood, treatment becomes much more effective.
Yes, many cases improve without surgery when the right conditions are created. The body has a strong ability to adapt and heal when mechanical stress is reduced and proper movement is restored. Conservative care often focuses on improving function rather than removing structure. Surgery can be necessary in certain situations, but it should not be the first step if other options have not been fully explored.
The sciatic nerve runs from the lower spine into the leg, so irritation at the spine can create symptoms anywhere along that path. Your brain interprets the signal where the nerve travels, not where it starts. That is why people feel pain in the leg even when the problem originates in the back. Treating only the area of pain often misses the actual cause.
Recovery time depends on the cause, severity, and how long the issue has been present. Some people improve within weeks, while others may take a few months of consistent care. The biggest factor is whether the root cause is being addressed or just the symptoms. The body heals over time when given the right environment and consistent input.
Chiropractic care can be very effective, especially when the cause is mechanical. By restoring motion and improving spinal function, it helps reduce pressure on the nerve and improve communication within the body. It is not about masking pain but correcting the underlying dysfunction. When done consistently, it can change both short-term symptoms and long-term outcomes.

Final Thought

Sciatica is not the problem.

It is the signal.

The real problem is what is causing that signal.

You can chase pain.

Or you can fix the system.

If you understand what is actually happening, you can change it.

About the Author:

Dr. Zev Mellman is a licensed chiropractor serving patients throughout South Florida and beyond. His practice focuses on spinal health, mechanical causes of pain, and conservative approaches to musculoskeletal care.

  • Licensed Doctor of Chiropractic in the State of Florida
  • Florida License Number: CH9524
  • License Original Issue Date: 01/15/2008