A jolt runs from your buttock down to your calf every time you get up from a chair. A neighbor says go to a chiropractor; your cousin swears physical therapy fixed hers. For sciatica, chiropractor or physical therapy is the question we field most often by phone — and while you decide, you keep putting up with it. Here is what each one does and how to choose.
For sciatica, should I see a chiropractor or a physical therapist?
The question is framed wrong, which is why it confuses so many people. These are not two competing roads: they do different jobs.
- A chiropractor looks for why the nerve is being irritated — the mechanics of your spine and pelvis — and corrects that.
- Physical therapy strengthens and retrains the muscles that support the area, so the correction holds.
Think of a door that scrapes the frame. Physical therapy strengthens the arm pushing it. The chiropractic adjustment works on straightening the frame. Both help; only one changes why it scraped.
What is sciatica, really?
Sciatica is not a diagnosis: it is the name of a symptom. It means the sciatic nerve — the longest in the body, running from the low back down to the foot — is being irritated or compressed somewhere along the way.
That matters, because the cause changes the treatment. It can come from a disc herniation, from degeneration narrowing the space the nerve exits through, or from a misalignment loading the area unevenly. Treating “sciatica” without knowing which one it is means guessing.
That is why the first appointment does not start with an adjustment. It starts with an evaluation.
When does starting with the chiropractor make sense?
Generally, when one of these applies:
- The pain started recently and travels down one leg with shooting pain, tingling or numbness.
- It gets worse in specific positions: standing up from a chair, bending over, sleeping on one side.
- You do not know the cause, and nobody has shown it to you on an image.
- You already did exercises or therapy and the relief did not last — a sign the mechanical cause is still there.
Spinal manipulation for low back pain is among the most studied non-drug approaches. In this office, Dr. Julie Martínez Borgos, a chiropractor licensed in Puerto Rico since 2007, evaluates the whole case and, when it is warranted, takes digital X-rays in the same office, with no outside referrals. Seeing the mechanics before touching them is part of the method, not an add-on.
Does lumbar traction help with sciatica?
When the irritation comes from a disc pressing on the nerve root, taking that pressure off is part of the job. That is what lumbar traction is for: a gentle decompression of the lower spine that slightly separates the vertebrae and can help relieve pressure on discs and nerves.
It does not replace the adjustment — it goes with it. The adjustment corrects the mechanics that leave the area unevenly loaded, and lumbar traction works on the disc and on the space the nerve exits through. In sciatica and herniated disc cases, Dr. Martínez combines the two within the same care plan, in the same Cupey Plaza office.
Not everyone is a candidate. That is decided after the evaluation — and after digital X-rays when the case calls for it — never over the phone.
When is physical therapy the right call — or both?
Physical therapy comes into its own when what is missing is stability: weak core musculature, a movement pattern that keeps re-injuring the area, or recovery after surgery.
And plenty of patients do both. The order that tends to work is: correct the mechanics first, then strengthen what was corrected. Strengthening on top of a misaligned structure is building on an uneven floor.
If you are already in physical therapy, do not drop it. Mention it at your evaluation so the care gets coordinated instead of duplicated.
What actually happens at the evaluation?
So you know what you are walking into:
- History. When it started, what makes it worse, what helps, whether there was an accident, what medications you take.
- Exam. How your spine and pelvis move, reflexes and leg strength, and where exactly the shooting pain reproduces.
- Imaging, if the case warrants it. Digital X-rays on site, without sending you to another facility.
- Explanation. What was found, what is causing it, and what is proposed. If your case is not one for chiropractic, you are told so and pointed elsewhere.
That last point matters: not every leg pain is mechanical, and an honest evaluation includes recognizing when the problem belongs to another professional.
What if I spend the day driving or at a desk?
It is the most common pattern we see in Cupey, Guaynabo and Trujillo Alto. Hours in traffic, a wallet in the back pocket, a seat reclined too far — all of it loads the pelvis unevenly, day after day.
In those cases, stretching alone rarely does it. The mechanics get corrected, and then the habits that bend them back get adjusted: seat height, wallet out of the back pocket, breaks to stand up. That gets explained in the office, with your own case in hand.
When should you seek immediate medical attention?
Stop weighing options and seek immediate medical attention at an emergency room if you have:
- Loss of bladder or bowel control
- Numbness in the groin or inner buttocks
- Worsening weakness in a leg, or a foot that drops as you walk
- Severe pain after a fall, a hard blow or a car accident
- Fever together with severe back pain
These signs point to something needing urgent evaluation, not a routine appointment.
What to do now
Call (787) 223-9160, Monday through Thursday, 8:00 AM to 12:00 PM and 1:30 PM to 5:00 PM, and Fridays from 8:00 AM to 12:00 PM. On that call we verify your plan and schedule your evaluation at Cupey Plaza, Suite 6. You can also reach us on WhatsApp or book online.
To read more about this condition, here is how we treat sciatica, and here is what happens at your first visit. If you would rather write to us, use the contact page. And if your question is about coverage, here is what Medicare covers and the plan-by-plan guide for Triple-S, MCS and MMM Advantage.
This information is educational and does not replace a professional evaluation. Every case of sciatica has a different cause and needs to be examined in person.