Your sciatica is not going away because nothing you are doing is treating the thing that is causing it. In most cases that thing is a disc herniation at L5-S1 pushing into the canal where the nerve lives. Until the pressure comes off that disc, the nerve stays pinched and the pain keeps coming back.
Picture a healthy lumbar spine. L3, L4, L5, all stacked, all with good disc height between them. Behind those discs is the canal, and that is where your nerves run. At the very bottom, at L5-S1, is where I see the majority of sciatica come from. When that bottom disc herniates, the material pushes backward into that canal and lands right on the nerve root that becomes your sciatic nerve.
That is why your pain runs down your leg and not just across your back. The disc is the problem. The leg is where you feel it.
Listen. If you have been chasing that leg pain for months and it keeps coming back, you are not doing anything wrong. You are just treating the wrong structure.
What is actually causing the pain running down my leg?
Sciatica is a symptom, not a diagnosis. The pain down the back of your leg is nerve pain, and the nerve is being irritated by disc material that has pushed out of place. Most of the time that is L5-S1 or L4-L5.
Think of a disc like a jelly-filled donut. The outer ring, the annulus, is the dough. The inside, the nucleus, is the jelly. When too much pressure builds up in that disc, the jelly spits out through the dough. It does not have to be huge. A lot of the herniations I treat are about the size of your pinky nail, and that is more than enough to ruin someone’s life.
My patients describe it the same way over and over. The leg feels like it is on fire. The toes feel achy, like little critters crawling around down there. Some of them want to kick their leg straight through the door just to make it stop. If this is you, you know exactly what I am talking about.
I know it because I lived it. April 2020, I was 35 years old, and I herniated my own disc at L5-S1. About 5 millimeters. I had already been a chiropractor for 10 years at that point.
Why don’t stretching, physical therapy, and adjustments make it go away?
Stretching, PT, and chiropractic adjustments are all good at what they do, and none of them are designed to pull a herniated disc back off a nerve. They work on the muscles and the joints around the problem. They do not change the pressure inside the disc itself.
You can stretch a hamstring all day. You can strengthen a core all day. If disc material is sitting on a nerve root, the nerve does not care how flexible you are. It is being physically compressed, and compression is a mechanical problem that needs a mechanical answer.
When I hurt my own back, I threw everything I knew at it. Everything I had used on patients for 10 years. Stretching, adjustments, therapy, rest, all of it. Nothing worked. I was in a dungeon. I am talking about hopeless, because that is exactly how I was.
What finally worked was the one thing nobody had offered me: taking the pressure off the disc. I bought a decompression table out of pure desperation. I was pain-free in 5 to 8 weeks.
Do cortisone shots fix sciatica?
A cortisone shot can quiet down the inflammation around an angry nerve for a few weeks. It does not move the disc. It is a chemical solution for a physical problem, and that is why the pain almost always comes back.
Here is the path most people get put on. Online physical therapy first. Then a cortisone shot when that does not hold. Then a second shot. Then a referral, and now you are on a surgery waitlist for a problem nobody ever actually measured the pressure on.
I hear the same sentence in my Walnut Creek office every single week. Why did nobody tell me about this? These are people who did everything they were told to do, in order, for a year or more, and never once had the disc itself treated.
Can spinal decompression actually pull a herniated disc off the nerve?
Yes, and it is not a theory. Decompression changes the pressure inside the disc so the herniated material can move back in, off the nerve. We have documented it on post-treatment MRIs in a peer-reviewed published paper.
Here is the short version on video, where I walk through it on a spine model and show you exactly which disc we are targeting and why.
Think about an airplane at 10,000 feet. Change the cabin pressure and everything in that cabin changes with it. Your disc works the same way. When we drop the pressure inside it, the disc can finally draw that material back toward the center instead of pushing it out toward your nerve.
The key is oscillation. The table pulls and relaxes, pulls and relaxes, like an accordion, over and over across the session. That cycling is what creates the pressure change. That is the entire difference between real decompression and generic traction, and it is the reason an inversion table does not do this. Inversion is just hanging. No oscillation, no control, no targeting. That is why people spasm on them.
In our published research we followed 4 patients through a course of care and measured the herniations on MRI before and after. The reductions came in at 9%, 27%, 30%, and 78% in under 4 months. All 4 were 100% pain-free. None of them had surgery.
Why does the angle matter so much at L5-S1?
The angle is what decides which disc you are actually treating. Move it a couple of degrees and you are pulling on a different level. When I say 12.5 degrees, I mean 12.5. It is not 11. It is not 14.
This is the part almost nobody gets right. If your herniation is at L5-S1, we set the angle to target L5-S1. Not L4-L5. Not L3-L4. One disc. If the angle is off, you can run a full course of care on the wrong level and feel nothing, and then you walk away thinking decompression does not work.
There are 3 dials on this. Angle, adjusted in 2.5 degree increments based on the disc type and how the patient tolerates it. Weight, where the textbook says 50% of body weight and the textbook is flawed, because that is way too aggressive. We start low and build. And oscillation, the pull-and-relax rhythm that does the real work.
Decompression tables are Ferraris. They are incredible machines, but you have to know how to drive stick or you crash it. That is why two people can be on the same equipment and get completely different outcomes.
Surgery removes the jelly but never fixes the pressure
A discectomy takes out the piece of disc that is touching your nerve. It does not address why that piece came out in the first place. The compression that pushed it out is still there the day after your surgery.
That is the missing factor in this whole conversation, and it is why about 25% of the patients in my program have already had spinal surgery. They did the operation, they got a few good months, and the pain found its way back.
I am not against surgeons and I am not against surgery. Some people need it. What I am against is rushed, unnecessary surgery for someone who was never given a real shot at fixing the pressure first. My whole job is to help you avoid the unnecessary one.
Where can I get spinal decompression for sciatica in Walnut Creek?
We treat sciatica and disc herniations at Dudum Chiropractic in Walnut Creek, California. We run 13 DOC decompression tables and have performed more than 51,000 decompression treatments. You can reach us at (925) 300-3302.
We see roughly 300 patients a week from Walnut Creek, Lafayette, Concord, Pleasant Hill, Danville, and across Contra Costa County, and we have patients who fly in from other states and other countries to be here. Every one of them starts the same way: we look at the actual imaging, we correlate it to the exam and the symptoms, and we find out which disc is doing this to you before we touch a single dial.
Because an MRI on its own is not the whole story. An MRI does not equal pain, and a report that says “not that bad” or “normal for your age” tells you nothing about your life. Something that is normal can also be ruining someone’s life. That is why we correlate imaging to what is actually happening in your body.
Quick questions, straight answers
How do I know if my sciatica is coming from a disc?
Nerve pain that runs below the knee, along with numbness, tingling, or burning in the calf, foot, or toes, points strongly toward a disc at L5-S1 or L4-L5. Pain that stays in the low back and glute is more likely joint or muscle. An MRI correlated to a hands-on exam is how you confirm it.
How long does spinal decompression take to work for sciatica?
Most patients start noticing changes in the first few weeks, and a full course of care generally runs a few months depending on the size and type of the herniation. In our published research, the 4 patients we tracked reached documented disc reductions in under 4 months. Your timeline depends on your disc, not on an average.
Is an inversion table the same thing as decompression?
No. An inversion table just hangs you upside down. There is no oscillation, no angle targeting, and no control over the load, which is why so many people end up in spasm after using one. Decompression is a controlled, angle-specific, pull-and-relax cycle aimed at one disc.
Can I still do decompression if I already had back surgery?
Often yes. About 25% of the patients in our program have already had spinal surgery and came to us because the pain returned. We evaluate the post-surgical spine carefully and build the protocol around it. It starts with a proper exam and a look at your imaging.
Where do I go for spinal decompression near Walnut Creek?
Dudum Chiropractic in Walnut Creek serves patients throughout the East Bay, including Lafayette, Concord, Pleasant Hill, and Danville. Call (925) 300-3302 to find out whether you are a candidate.
If you’re dealing with back pain and want to find out whether you’re a candidate for spinal decompression, contact us at Dudum Chiropractic in Walnut Creek or call (925) 300-3302. You deserve relief without spinal surgery.
I’m Dr. JD Dudum. This is Back At It with Dr. Decompression.