Sciatica Relief in Laguna Hills

Sciatica doesn't have a single cause.

Sciatica is irritation of the largest nerve in your body — typically from a disc or piriformis issue. The plan depends on which.

The sciatic nerve is formed from nerve roots in the lower lumbar spine and sacrum, runs through the buttock, down the back of the thigh, and branches below the knee into the lower leg and foot. It is roughly the width of a finger where it leaves the pelvis. Sciatica is not a diagnosis in itself — it is a description of what that nerve is doing when something upstream irritates it. The clinical question is always: irritated by what, and where.

Two causes account for most cases. A lumbar disc pressing on a nerve root before it joins the sciatic nerve produces symptoms that usually begin in the low back and travel down, are worse with sitting, and spike with coughing or sneezing. Piriformis involvement — where the nerve is compressed by a muscle deep in the buttock as it passes through the pelvis — tends to produce little or no back pain, a deep ache in the buttock itself, and symptoms that worsen with prolonged sitting on a hard surface or after a long drive. Less commonly, narrowing of the spinal canal produces leg symptoms that are worse with standing and walking and relieved by sitting or leaning forward.

Telling these apart is the entire point of the examination, because they do not respond to the same treatment. Straight-leg raise and related orthopedic tests provoke the nerve in specific positions. Neurologic testing of reflexes, sensation and strength maps which nerve root is involved. Palpation and positional testing assess the piriformis directly. The motion-study X-ray shows the lumbar segments and disc spaces that could be generating a root-level problem.

Treatment follows the cause. A disc-driven case is handled like a disc case — Gonstead and Diversified adjusting to restore motion to the involved segments, often with spinal decompression to reduce pressure on the root. A piriformis case is primarily soft-tissue work on the muscle itself, combined with adjusting the sacroiliac joint and pelvis, which is usually part of why the muscle is behaving that way. Both get specific at-home guidance, because sciatica is strongly affected by how much you sit and how you sit.

Acute sciatica often settles substantially once the source is addressed. A case that has been running for months with established numbness tends to improve more gradually, and nerve symptoms characteristically resolve from the foot upward — the pain retreating toward the back is a good sign, even before it is gone.

Sciatica FAQ.

How do I know if my sciatica is coming from a disc or from the piriformis muscle?

The pattern is usually the tell. Disc-driven sciatica generally starts in the low back, travels down the leg, is worse with sitting, and spikes when you cough or sneeze. Piriformis-driven sciatica often involves little back pain, a deep ache in the buttock, and symptoms that build after long sitting or a long drive. The orthopedic and positional tests at the first visit confirm which one you have — it is not something to diagnose from a description alone.

Should I be stretching, or will that make it worse?

It depends entirely on the cause, which is why general stretching advice for sciatica is unreliable. Piriformis cases often respond well to specific stretching. Disc-driven cases can be aggravated by the same stretches, particularly those involving forward bending. Dr. Rundle will give you movements matched to your findings after the exam.

How long does sciatica usually take to settle?

An acute episode addressed early often changes noticeably within the first few weeks of care. A case that has been running for months, especially one with established numbness, generally improves more gradually. Nerve symptoms tend to resolve from the extremity back toward the spine, so symptoms retreating from the foot to the calf to the thigh is progress even while the total pain is unchanged.

I have numbness in my foot. Is that going to be permanent?

Usually not, but it deserves attention rather than patience. Numbness means the nerve is being compressed or irritated enough to affect its function, and how long that has been going on matters. Dr. Rundle documents your sensation and strength findings at the first visit specifically so that change in either direction is measurable rather than remembered.

Can sitting really be causing this?

It is frequently a major contributor. Sitting raises pressure inside the lumbar discs compared to standing, and prolonged sitting on a firm surface compresses the sciatic nerve where it passes through the buttock. That is why sciatica so often shows up in people with long commutes and desk work, and why the at-home guidance around sitting is a real part of the plan rather than an afterthought.