Conditions
Low back pain & sciatica
A sports chiropractor can help with most low back pain and sciatica, which is usually mechanical: a disc, joint, or muscle irritating a nerve. Treatment calms the irritation and retrains the pattern. At Next Move in Orlando, a full-hour exam finds which structure is involved before anything is adjusted, and Dr. Nguyen refers you out if it is not mechanical.
The deep ache after deadlifts. The electric line down the back of your leg. The back that 'goes out' every few months like clockwork. It usually has a mechanical cause, and mechanical causes can be found, treated, and trained.
The anatomy
What's actually going on back there
'Low back pain' is a location, not a diagnosis. Five different structures produce most of it, each behaves differently under load, and each needs a different plan. Part of your first hour is working out which one is yours.
Disc injury
The discs between your vertebrae are shock absorbers with a tough fibrous wall. Strain that wall, usually with repeated rounded-back loading, and the disc can bulge and irritate the nerve sitting right behind it.
The tell: Worse sitting and bending forward, often better walking. Can send pain, tingling, or numbness down the leg.
SI joint dysfunction
The sacroiliac joints connect your spine to your pelvis. When one stiffens or gets irritated, it produces a focused ache just to one side of the low spine, right around the dimple of the pelvis.
The tell: Hurts standing up from a chair, on one leg, or rolling over in bed. Usually one-sided and finger-point specific.
Facet syndrome
Facet joints are the small paired joints on the back of each vertebra that guide how you bend and twist. Irritated facets produce a localized, pinching kind of back pain rather than a radiating one.
The tell: Worse arching backward, twisting, and long standing. Usually eases when you sit or curl forward.
Stenosis
A narrowing of the passages the spinal nerves travel through, which gives the nerves less room under load. More common with age, and very pattern-specific in how it behaves.
The tell: Legs that ache, cramp, or go heavy the longer you walk or stand, then calm down when you sit or lean forward, like over a shopping cart.
Piriformis syndrome
The piriformis is a deep hip rotator the sciatic nerve passes directly beneath. When it gets overworked and irritable, it can compress or irritate the nerve and mimic disc-driven sciatica.
The tell: Deep, one-sided buttock pain, worse with long sitting (especially on a wallet or hard seat), sometimes running down the leg.
So where does sciatica fit?
Sciatica isn’t a condition. It’s a symptom: nerve irritation felt along the sciatic line down the leg. A disc, stenosis, or the piriformis can all produce it, and they need different treatment. That’s exactly why the exam matters more than the adjustment.
The pattern
Why your back keeps 'going out'
A quick adjustment can genuinely calm a flared back. But if that's the whole plan, you're booked for the same flare next quarter, because the thing that sent your back over the edge is still there.
Most recurring low back pain isn’t bad luck. It’s a pattern: hips that don’t hinge, so your lumbar spine does the bending on every pick-up, every rep, every hour in a chair. A trunk that braces fine when you’re fresh and folds when you’re tired. Loading that jumps faster than tissue adapts. Cracking the sore segment masks the symptom of that pattern. Fixing the pattern is what makes the symptom stop coming back.
Masking it
- Adjust the sore segment, feel looser, walk out
- Rest until the flare calms down
- Avoid bending, lifting, and the gym entirely
- Repeat the whole cycle at the next flare-up
Fixing it
- Identify which structure is involved and what keeps loading it
- Restore the hip hinge so your hips bend instead of your spine
- Build a brace that holds up under fatigue, not just when fresh
- Reload lifting and sport gradually so your back adapts, not flares
How we treat it
The four-step pathway, applied to your back
Same honest structure as every plan at Next Move: here's what each step actually looks like when the problem is your low back or sciatica.
Assess & Collaborate
A full hour on your back, not a two-minute poke. Movement screen, hip hinge assessment, and loading tests that help tell a disc from an SI joint from a facet, plus the training and life history that explains how the flare started. You leave visit one knowing what we suspect and why.
Reduce Pain
Hands-on care to calm the flare: adjustment where joints are restricted, soft tissue work for muscles locked in protective spasm, and direction-specific movement that takes pressure off the irritated tissue so you can move again this week, not next month.
Fix Your Patterns
For low backs this almost always means rebuilding the hip hinge so your spine stops doing your hips' bending, teaching a brace that survives rep eight of a hard set, and reintroducing the exact positions that scare you, at a dose your back can adapt to.
Become Resilient
Progressive loading back to deadlifts, sport, yard work, whatever set it off, with programming that keeps building. The goal is a back that gets stronger from a heavy week instead of getting taken out by one.
Honesty first
When to see someone today, not us
Most low back pain and sciatica is mechanical and responds well to conservative care. Some isn't, and pretending otherwise is how people get hurt.
Go to urgent care or the ER first if you have
- Numbness in the groin or saddle area
- New loss of bladder or bowel control
- Leg weakness that is getting worse, or a foot that slaps or drags
- Back pain with fever, unexplained weight loss, or a history of cancer
- Severe pain after a fall, crash, or other significant trauma
None of this is a diagnosis. It’s a triage rule we take seriously. Those signs can point to nerve compression or medical problems that need imaging and a physician the same day, not a chiropractic visit. Get them checked first; we’ll still be here for the rehab side once you’re cleared.
Everything else is exactly what the new patient exam is built to sort out: the ache, the stiffness, the leg symptoms that come and go with position. And if you’re not sure which side of the line you’re on, the free 15-minute consult exists for precisely that call.
Start here
One hour to a real answer
No mystery pricing, no prepaid care plans. Your first visit is a full hour, one-on-one with the doctor, and you'll leave knowing what's driving your back pain and what the plan is.
New Patient Exam
$150
60 min
A full hour, one-on-one: history, movement assessment, root-cause diagnosis, and your first treatment.
Start hereFree Consultation
$0
15 min · telehealth
Not sure if this is the right fit? Talk through your injury with Dr. Nguyen before booking anything.
Book a free consultGoing deeper
Signs your sciatica is improving, and what speeds it up
The most useful sign is not less pain. It is where the pain is. When leg symptoms retreat toward the spine (calf pain becomes thigh pain, thigh pain becomes buttock ache, buttock ache becomes low back stiffness), clinicians call it centralization, and most of the research treats it as a favorable sign that the nerve is calming down. Back pain that gets a little more noticeable while the leg clears is usually progress, not a setback. The reverse, pain marching further down the leg or new numbness or weakness, is the signal to get reassessed rather than wait it out.
What speeds recovery is mostly boring: keep moving. Cleveland Clinic and the American College of Physicians say the same thing: short rest in the first day or two is fine, and more than that tends to slow things down. In practice that usually means walking first, in short bouts as often as you can tolerate. Ice in the first few days and heat after that, if either helps. Bed rest, holding yourself rigid, and avoiding all bending tend to teach your back that movement is dangerous, and that is exactly the pattern the rehab work exists to undo.
What slows it down is the daily load you have stopped noticing: hours in a soft chair, the rounded-back pick-up, the drive that leaves you stiff. Many people with sciatica also have a directional preference, one direction of movement that eases the leg and one that provokes it. Part of the exam is finding yours, and part of the plan is a short list of positions to favor and positions to avoid for the next few weeks, so the hour in the clinic is not undone by the other 167.
Where to start
Chiropractor, physical therapist, or orthopedist?
The right first stop depends on what your back is doing, not on who has the better website. Here is how we would sort it if you were a friend asking.
Sports chiropractor at Next Move
Mechanical low back pain or sciatica without red flags: pain that changes with position, load, or activity, and leg symptoms that come and go. Also the recurring flare that has been adjusted before but never properly assessed. You get the exam, hands-on treatment, and rehab in one visit, and a referral out the same day if the exam turns up something that is not ours to treat.
Physical therapist
A good option for the same mechanical cases, and the natural choice if you already have a diagnosis and imaging and mainly need supervised, progressive rehab, or you are recovering after spine surgery. A well-known trial comparing physical therapy and chiropractic for low back pain (it excluded people with sciatica) found no significant difference in outcomes between the two, so the bigger variable is usually the individual clinician and how much time you get with them. Seeing both is fine, but let one lead the plan.
Orthopedist or your physician
First stop, not us, if you have any red flag: saddle numbness, new bladder or bowel changes, progressive leg weakness or a dragging foot, fever, unexplained weight loss, a history of cancer, or significant trauma. Also the right call when leg pain has not improved after weeks of well-done conservative care, when pain is severe enough that you cannot function, or when you want to discuss injections or surgery. Your physician can order imaging and rule out non-mechanical causes; if the exam points that way, that is exactly where we send you.
When imaging makes sense
For most low back pain and sciatica, imaging is not the first step (see the MRI question below). Next Move has no imaging on site: if the exam or your progress says you need it, Dr. Nguyen refers you out for it and works from the results.
Questions
Straight answers
How many chiropractic sessions do I need for sciatica?
There is no honest fixed number. It depends on what is driving the leg pain, how long it has been there, and how quickly your symptoms respond to the first few visits. After the exam you get a plan with a set number of visits and a reassessment date built in. If you are not moving at that checkpoint, the plan changes or you get referred, rather than rebooked. You should not need us forever, and the plan is written that way.
Can a chiropractor make sciatica worse?
It can feel sore for a day or two after treatment, and that is different from being made worse. The research on low back manipulation contains a small number of serious case reports, so the risk is not zero. That is why the exam comes first: an adjustment is not the right tool for every back, and a disc that is irritating a nerve is often treated with direction-specific movement and soft tissue work before manipulation. If leg symptoms spread further down or you lose strength, tell us immediately.
Should I see a chiropractor or a doctor first for lower back pain?
If you have any of the red flags on this page, a physician or the ER first. Same if the pain followed a fall or crash, or you have a history of cancer, osteoporosis, or long steroid use. For the ordinary case, the ache after deadlifts or the leg line that comes and goes with sitting, a sports chiropractor is a reasonable first stop, because the exam includes the screening that decides whether you belong here. If it finds something outside our lane, you get referred that day.
Do I need an MRI to find out if it's a herniated disc or piriformis?
Usually not at the start. American College of Physicians guidance advises against routine imaging for low back pain unless there are severe or progressive neurological deficits or a serious cause is suspected. Much of the disc-versus-piriformis question is answered in the exam: which positions provoke the leg pain, which calm it, and what nerve tension and hip tests show. Imaging earns its place when leg symptoms are not improving after weeks of care, or an injection or surgery is being considered. We refer for it when it is warranted.
How long does sciatica take to go away?
Cleveland Clinic's estimate: many cases improve within four to six weeks, and most people recover without long-term problems. The catch is the tail. Some cases drag on for months, often because whatever is irritating the nerve keeps getting loaded every day: the chair, the rounded-back lift, the long drive. Treatment aims to calm the irritation and take that daily load off it, so you land on the short end of the range. If you are already past six weeks, that is a reason to be assessed, not to wait.
Does chiropractic help a bulging disc, or only 'mechanical' back pain?
Yes, a bulging or herniated disc is mechanical too. It just needs a different plan than a stiff facet or SI joint. Disc-driven leg pain often responds to direction-specific movement, hands-on work on the muscles guarding the segment, and a gradual return to hinging and loading, with manipulation used selectively rather than by default. Research also shows herniated disc material can shrink on its own, which is part of why conservative care is the standard first step. Sixty minutes one-on-one is what makes a plan that specific possible.
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