Sciatica Treatment: Are Chiropractic Adjustments Safe for Sciatica and Disc Herniation?


Though manual adjustments to the spine are one of the most powerful and effective treatments for lower back pain, this type of treatment has to be used with careful consideration to a patient’s condition. When Dr. Horowitz considers treatment options for people who require sciatica treatment, she takes a multi-faceted approach while involving you in the process and empowering you to not only heal, but you also learn how to prevent future episodes.

When a patient does not exhibit neurological signs of muscle weakness due to atrophy, reflex and sensory changes, Chiropractic adjustments are safe to use in combination with a highly effective Sciatica program of care.

If Dr. Horowitz observes severe or progressive neurological deficits during her comprehensive spinal and neurological examination, she would make a timely referral to a medical specialist through a patient’s medical doctor.

Surgery for disc herniations is only considered either in emergency situations or when severe or progressive neurological deficits are present AND the amount of disability that a patient experiences is severe.

If you are referred to Dr. Horowitz while you await a specialist appointment related to progressive neurological deficits,  current guidelines do NOT recommend spinal manipulation.

However, there are targeted exercises and ergonomic advice that is of enormous help for the vast majority of patients with Sciatica. The Pulstar computerized scan can effectively and safely mobilize the spine, without the need for a twisting adjustment (where you hear a “pop”).

Chiropractic Care and Sciatica Treatment:

The types of Chiropractic care offered by Dr. Horowitz do not involve the use of drugs or surgery, which is beneficial in reducing the many side effects that come along with more invasive therapies. Chiropractic Care may include a combination of:

  • Spinal manipulation and or mobilization
  • Spinal manipulation/adjustments without the need for twisting the spine using the PulstarTM 
  • Low-level cold laser
  • Massage and other soft tissue techniques
  • Electrical Modalities such as Ultrasound and Muscle Stimulation
  • Spine stabilizing and strengthening exercises to heal deconditioned muscles and improve spinal ranges of motion.
  • Nerve “flossing” or mobilizing techniques
  • Education on self-care, reducing risk factors and remaining physically active
  • Education about spine-sparing strategies that teach how to avoid positions that strain injured discs
  • Cognitive-Behavioural Activation to change negative thinking patterns about carrying through with exercises and staying physically active
  • Mindfulness-Based Meditation to help reduce chronic pain

Goals of Sciatica Treatment include:

  • Providing pain relief naturally-by re-establishing normal spinal motion and accelerating healing of a disc bulge
  • Reducing inflammation and reducing compression of nerves
  • Reducing the need for medications
  • Speeding recovery
  • Allowing for a return to normal activities and work as soon as possible
  • Education about self-management strategies including reducing factors that exacerbate the condition
  • Identifying ways to continue participating in physical activities and hobbies, without aggravating the condition.
  • exercise rehabilitation to improve strength, flexibility, movement coordination and power is vital to reducing the risk of future injury
  • postural re-education

Patients who see the best results and are happiest with the outcome of their treatment, are those who are the most involved in their care and the most consistent with home follow-through.

Diagnosing the Source of Sciatic Nerve Pain is Key:

In order to prepare an individualized treatment plan, Dr. Horowitz takes the time to listen to each patient, gathering a full medical history. She then conducts a comprehensive diagnostic examination of your nervous system, back, pelvis, hips and lower extremities to determine the underlying cause of your sciatic symptoms.

Dr. Horowitz may order radiographs if a patient’s history warrants and she may refer a patient to his/her general medical practitioner in order to obtain advanced spinal imaging. It is important for patients to understand that diagnosis is made through the history and examination and not by MRI, CT or x-ray studies.

Research has revealed that there is no correlation between pain and areas of disc herniation found on MRI studies. For example, 15% or teenagers, and 60% of people over 60 can show areas of disc bulges on MRI with no pain. And there are people with severe pain, yet their MRI studies are completely normal.

Therefore, a number of considerations go into the decision to order advanced diagnostic imaging. These include the need to confirm or rule out a more ominous diagnosis, if treatment offered would be altered based on results of advanced imaging, if a patient was unresponsive to a trial of conservative management (6-8 weeks), if activities of daily life are severely affected, if pain is intolerable despite medications, or if there are rapidly progressing neurological deficits.

Both CT scans and x-rays expose people to radiation that are cumulative in the body and are damaging to the cells and should be used only when absolutely necessary.

Dr. Horowitz works closely with a patient’s general medical practitioner in co-managing the best treatment options available and to determine if and when diagnostic imaging is required.

Sciatic nerve pain may take weeks or as long as a year to resolve on its own. To speed recovery, conservative care including Chiropractic care are recommended as a first-line treatments.


Sciatica is a common condition seen by Dr. Horowitz. If you have a specific question about Causes of Sciatica and are looking for some advice, please don’t hesitate to contact us.

Call My Toronto Chiropractor Health Clinic (647) 349-4909 or to ask Dr. Leslie Horowitz a question, complete the form below: