Sciatica Treatment in Elkhorn & Omaha Nebraska

Shooting pain or tingling?

Shooting pain down your leg. Numbness or tingling that won’t quit. Maybe it’s worse when you sit, or when you stand, or when you try to sleep.

If you’ve been dealing with sciatica, you’ve probably heard all the usual advice: stretch more, rest, take anti inflammatories. Maybe you’ve been told surgery is your only option. Or worse, that you just have to live with it.

Here’s what we’ve found: sciatica usually has more than one cause. And when we address what’s actually going wrong—not just where it hurts—most people get better without surgery.

Below, we’ll walk you through what commonly causes sciatica, how we treat it, and what you can expect when working with us.

What Causes Sciatica?

Your sciatic nerve runs from your low back, through your glutes, and down the back of your leg. When something puts pressure on that nerve, on your spine or in the surrounding muscles, you get pain, numbness, tingling, or weakness.

Here’s what we typically find:

Low Back Problems

When the joints in your low back aren’t moving properly, or when discs bulge or herniate, they can compress the sciatic nerve right at the source. Some people don’t even realize they have low back issues until the sciatic pain shows up.

Tight Piriformis Muscle

In most people, the sciatic nerve runs directly through the piriformis—a deep glute muscle underneath your larger gluteus muscles. When this muscle gets tight (which happens a lot in people who sit most of the day), it can squeeze the nerve and cause pain down your leg.

Tight Psoas Muscle

Your psoas is a deep hip flexor that connects your spine to your legs. When it’s tight, it pulls on your low back and can contribute to nerve compression. This muscle tightens up from prolonged sitting, but also from stress and poor posture.

Disc Bulges or Herniations

When a disc in your low back bulges or herniates, it can press directly on the nerve roots. Sometimes people hear a “pop” when this happens while lifting something heavy, but not always.

Arthritis

Degenerative changes in the spine can narrow the spaces where nerves exit, putting pressure on the sciatic nerve. This is more common as we age, but it doesn’t mean you’re stuck with the pain.

Important Note: Not All Leg Pain Is Sciatica

A lot of people assume any leg pain is sciatica, but that’s not always true. If you have numbness or tingling on the outer side of your leg (not the back), that’s usually a different nerve called the lateral femoral cutaneous nerve. The condition is called meralgia paresthetica, and it’s still coming from the low back, but it’s not technically sciatica. We treat both.

How We Treat Sciatica

The key to treating sciatica is figuring out where the pressure is coming from. Usually, it’s more than one thing. That’s why I work on both your low back and the muscles that could be involved.

Chiropractic Adjustments

When the joints in your spine aren’t moving properly, it creates inflammation and nerve irritation. Adjustments restore motion and take pressure off the nerve. We use different techniques depending on what you’re comfortable with—drop table (Thompson technique) or side-posture adjustments.

Flexion Distraction

This is a specialized chiropractic technique using a table that moves gently to stretch your low back in ways you can’t do yourself. It’s great for disc problems because it helps the vertebrae open and close, which brings nutrients into the disc space and can actually help pull a bulged disc back in. Most patients say this is their favorite part, it feels amazing.

Piriformis and Psoas Muscle Release

If the piriformis is contributing to your sciatica, we’ll work on that muscle directly to release the tension. Same with the psoas—though to be honest, releasing the psoas requires working from the front of your body through your pelvis, so it’s not the most comfortable treatment. But it often makes a huge difference for both sciatica and low back pain.

Shockwave Therapy

For stubborn inflammation and muscle tightness, we use shockwave therapy (also called pressure wave therapy). It helps reduce inflammation, improves blood flow, and speeds up healing. A lot of patients notice improvement after just a couple sessions.

Acupuncture

Acupuncture reduces inflammation, helps with pain relief, and supports overall healing. It works particularly well when combined with chiropractic care and muscle work.

We usually use a combination of these treatments. We’ll feel out what’s going on during your appointment and adjust the treatment plan as we go.

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What to Expect

Your First Appointment (Full Hour)

We’ll spend time talking through your history—when the pain started, what makes it better or worse, what you’ve already tried. Then we’ll do an exam to figure out whether your sciatica is coming from your spine, your muscles, or both.

From there, we’ll start treatment. That might include adjustments, muscle work, flexion distraction, or a combination. We don’t typically order X-rays unless you’re not getting better or we need more information.

Timeline

Some people feel better after one or two visits. Others take a few weeks—especially if the problem has been going on for a long time or if you have a disc issue.

Be honest with yourself about what’s realistic. If you’ve had sciatic pain for months (or years), it’s going to take consistent care to turn things around. But you should start noticing changes within the first few weeks.

Between Appointments

We’ll give you specific exercises or stretches based on what we find. Some people need to move more. Some people need to stop doing certain things that are making it worse. We’ll figure that out together.

How We Adjust as You Heal

As you improve, we’ll shift from frequent appointments to maintenance care. The goal is to get you feeling better and keep you there—not to have you coming in forever.