Nerve
Sciatica
Leg pain may begin in the back,
but its effects follow you everywhere.
Radiating pain, tingling, or weakness can make sitting, driving, walking, and sleeping difficult. The first priority is identifying where the nerve is being irritated.
Serving Whitefish and the Flathead Valley.
The clinical picture
Persistent symptoms have a cause — and it can be identified.
Difficulty finding a comfortable position, disrupted sleep, and symptoms that worsen with sitting are characteristic of nerve-root involvement. Before considering injections or surgery, a proper evaluation should identify what is compressing the nerve and whether non-surgical decompression is likely to resolve it.
The position you can't find
What sciatica typically feels like day to day.
- Sharp or burning pain down one leg
- Numbness or tingling in the calf, foot, or toes
- Weakness lifting the foot or pushing off the toes
- Pain that worsens with sitting, sneezing, or bending forward
- Trouble finding any position that works at night
What this means over time
Nerve pain that dominates your days and disrupts your sleep is physically and mentally draining, and concern about progressive numbness or weakness is medically justified — prolonged compression can cause lasting deficits. The encouraging news is that most sciatica responds to structured non-surgical care when the source of compression is correctly identified and treated early.
When a nerve root stays compressed and inflamed, the muscles it powers get weaker and the sensation it carries gets duller. Foot drop, lasting weakness, and progressive numbness are the cost of waiting it out — and they don't always come back even after surgery.
A precise evaluation is the starting point.
Dr. Smith's examination identifies the specific structures involved, measures how they're functioning, and determines — honestly — whether our care is the right fit for what you're dealing with.
Causes & clinical context
Understanding what may contribute to sciatica.
Common underlying causes
- A bulging or herniated disc pressing on the sciatic nerve root
- Spinal stenosis — narrowing of the canal where the nerve travels
- Facet joint inflammation irritating the nerve as it exits
- Piriformis or deep hip muscles compressing the nerve below the spine
- Years of compression from sitting, lifting, or postural overload
What's usually offered — and where it falls short
Epidural steroid injections
Limit: Can calm inflammation for weeks to months but don't take pressure off the disc or nerve — and there's a real ceiling on how many you can safely receive.
Microdiscectomy and other back surgeries
Limit: Sometimes the right answer for a true structural emergency, but frequently offered before a real non-surgical trial — and revision rates aren't what most patients are told.
'Rest until it goes away'
Limit: Pure rest weakens the very muscles that protect the spine, and an irritated nerve that doesn't get decompressed often becomes a chronically sensitive one.
Evaluation and care
A plan based on the findings.
- A focused history and examination
- Orthopedic and neurologic screening when indicated
- Care matched to the structures and functional findings involved
- Objective reassessment with referral when appropriate
What to expect
First visit
Examination, findings, and a clear recommendation for the appropriate next step.
During care
Symptoms and function are tracked so the plan can be adjusted as needed.
Reassessment
Progress is measured rather than assumed, with referral when goals are not being met.
How Dr. Smith treats this differently
Our Sciatica Relief approach for Sciatica.
Computer-guided spinal decompression, nerve-glide rehab, and core stabilization targeted at the disc and nerve root driving your sciatica.
Explore the Sciatica Relief ProgramCommon Questions
Frequently Asked Questions
Stop living around sciatica.
Start with a $47 new patient evaluation and we'll tell you honestly whether we can help.