Expert Sciatica Treatment in Bee Cave, TX

Sciatica typically causes sharp, shooting, or burning pain that travels from the lower back or buttock down the leg, often below the knee. Numbness, tingling, or weakness can occur as well. Seek immediate medical attention if you develop bowel or bladder dysfunction, numbness around the genitals or anus (saddle anesthesia), or weakness in both legs. These can be signs of cauda equina syndrome, which requires urgent medical assessment. 

Research suggests that conservative treatment can be effective for many people with sciatica, although outcomes vary depending on the cause and severity of the condition. McMorland et al. (2010) reported a 60% success rate with spinal manipulation compared with 40% following surgery at the 2-year follow-up. Coulter et al. (2018) found a mean pain reduction of 12.07 points on a Visual Analog Scale across the manual therapy studies they reviewed.

In the study by Peul et al. (2007), 90% of patients receiving conservative care avoided surgery.

Chiropractic adjustments are generally considered safe when appropriate for the individual, but they are not suitable for every patient or every cause of leg pain. Treatment starts with a neurological and orthopedic examination to look for signs that require a different type of care. Temporary soreness or an increase in symptoms can occur after treatment. Dr. Hiben also reviews relevant medical history before deciding which techniques are appropriate.

Recovery time varies considerably with sciatica. Some cases improve within a few weeks, while symptoms that involve significant nerve irritation can take longer. Delitto et al. (2012) reported that 50% of patients experienced significant improvement within 6 weeks, while Pengel et al. (2003) reported that most patients with acute or subacute low back pain improved substantially within 12 weeks.

At EWC, treatment frequency is adjusted according to symptoms, function, and response to care rather than assuming every patient will need the same number of visits.

Not necessarily. Imaging isn't routinely needed for uncomplicated sciatica. MRI may be considered when symptoms persist, when the findings suggest a more serious problem, or when surgery or another intervention is being considered. X-rays can provide information about the bones and overall spinal structure, but they do not show nerves or disc herniations as clearly as an MRI.

The initial evaluation usually relies on your symptoms, neurological findings, and physical examination, including tests such as the Straight Leg Raise.

Your first visit includes a detailed medical history, neurological examination, and orthopedic testing such as Straight Leg Raise and slump testing. These findings help Dr. Hiben assess the pattern of your symptoms and look for signs of nerve involvement. X-rays may be recommended when clinically appropriate.

If treatment is appropriate, care may begin during the first visit. The appointment typically lasts 45-60 minutes.

Chiropractic care may be part of conservative treatment for people with sciatica who do not have an indication for surgery. In the study by Peul et al. (2007), 90% of patients receiving conservative care avoided surgery, and the long-term outcomes between the surgical and conservative groups were similar at follow-up.

But surgery can still be necessary in some cases, particularly when there is progressive neurological weakness, cauda equina syndrome, or another condition requiring surgical treatment.