Is a Chiropractor or Physical Therapist Better for Sciatica?

Is It Better to See a Chiropractor or Physical Therapist for Sciatica?

Both chiropractors and physicals therapists can provide relief from sciatica but the answer often depends on your preferences for treatment.

• Chiropractors may offer quicker relief through the use of adjustments, also called manipulations, and other hands-on techniques.  While hands-on techniques can provide rapid relief they generally do not provide long-term relief as hands-on techniques alone generally do not address the entire system in which the nerve interacts. Now, there are some chiropractors that use physical therapy exercises and introduce movement throughout recovery. They often tell me, they practice a lot like a PT. I think that is great but they often don't have the in depth training that a physical therapist does.

• Physical therapists focus on solutions by addressing muscle weaknesses, movements dysfunctions and movements habits that may have contributed to the symptoms in the first place. This can especially great for nerve pain or tingling that is often related to sciatica. Physical therapists are also well versed in utilizing hands-on techniques such as mobilizations, manipulations and massage techniques in conjunction with exercise to provide the most robust approach to treating sciatic pain.

When dealing with sciatica, we will get many different opinions on how to treat this condition. Perhaps you have a friend who went to a chiropractor but you also know a family member that saw a physical therapist for their sciatic pain.

Chiropractors have done an excellent job of branding themselves as the go to provider for any spine or back related issue and physical therapists are often seen as the provider you go to if you had a surgery or need help with walking or balance. This just isn't true. Both are capable of treating sciatica but the treatment styles are different.

However, physical therapists have an expanded framework when it comes to the treatment of sciatic and related nerve pain conditions that are worth considering.

Do I Need a Physio or Chiropractor for Sciatica?

If you are considering physio or PT, and Chiro for sciatica the is good! They are both conservative options which has been shown in the research to be best. Whichever discipline you decide to seek care from should be based on what approach better fits your personal preferences.

• Physios or Physical Therapists emphasize strengthening, mobility and functional movement to address sciatic pain. Evaluations typically last 45-60 minutes. Which allows the PT to screen the nerves to make sure nothing serious is gong on. Physical therapists create individualized exercise programs that target the underlying causes of sciatica, such as disc bulges or herniations. When I work with patients with sciatica, I focus on restoring movement and building strength, reducing nerve tension, and getting you back to your normal life as soon as possible. Physical therapists also have knowledge in the use of manipulations which provide the same immediate relief that chiropractic adjustments can provide.

• ‍Chiropractic Care focuses on “spinal alignment” and uses adjustments to provide relief from sciatic pain symptoms. Evaluations typically last around 5-15 minutes. Chiropractors operate under the framework that by aligning the spine through the use of chiropractic adjustments you can reduce irritation of the sciatic nerve therefore providing relief. In my experience, a considerable amount of patients that I see with complaints of sciatic pain had pursued chiropractic care first.

Who is the Best Person to See for Sciatica: Physio vs Osteopath?

Osteopaths, which are a branch of Doctors of Osteopathic Medicine (DO), tend to have a more holistic approach to physical rehabilitation. I often look at them as doctors that do manipulation or Osteopathic Manipulative Treatment (OMT) as it is called in their profession.

However, I find a shortcoming in that osteopaths generally do not have the same robust command of exercise for the treatment of sciatic pain as physical therapists.

Similar to chiropractors, an osteopath may be able to provide some relief but the visits are very short and lack the proper education needed to recover.

What’s the Most Successful Treatment for Sciatica?

The most successful treatment depends on the underlying cause of the sciatica and individual needs. Sciatica from disc herniation is very different than sciatica from stenosis! 

That said, the most roboust an evidence supported treatment for sciatica includes

1. Moving of the sciatic nerve, often called nerve glides.
2. Regaining mobility of the spine through progressive stretching and mobility.
3. Regaining strength through exercises targeted at the hips and spine.

• Massage or Chiropractic for Sciatica? Massage can ease muscle tension and improve blood flow, offering temporary relief. Chiropractic care, on the other hand, focuses more on spinal alignment and nerve decompression. The two can complement each other but serve different purposes.

• Does Sciatica Get Better with Physical Therapy? Yes! In my experience, physical therapy is incredibly effective for sciatica. A well-designed rehab program improves movement strategies, strengthens the core, and enhances flexibility, reducing sciatic nerve irritation. Many patients notice a significant improvement after a few weeks of consistent exercises. These things take work! 

Should I see a physical therapist or chiropractor for sciatica?

Both providers absolutely can provide relief from sciatic pain but there are key considerations when choosing between the two providers:

• See a Chiropractor if:
  • You seek immediate relief from acute pain.
  • Looking for a quick fix.
  • Your values and beliefs do not align with the use of movement and exercise to improve nerve and back pain.
• See a Physical Therapist if:
  • You want a solution to mitigate this and potentially future episodes of sciatica.
  • You prefer to focus on strengthening and functional movement.
  • Looking for ways to improve overall spinal health and strength at the same time! 

Final Thoughts

When treating sciatica, the best approach depends on your specific needs. Chiropractic care offers short-term relief, while physical therapy provides a sustainable solution. In some cases, combining both treatments can lead to the best outcome. Always consult your healthcare provider to determine which approach is best for you.

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