Pattern · 01
Piriformis compression
Tight piriformis muscle compresses the sciatic nerve. Presents with buttock pain radiating down the posterior thigh, often worse sitting. ~40% of cases - responds fastest. Usually 5–6 sessions.
Nerve-root-origin leg pain that tracks down the buttock, thigh, and calf in a defined dermatomal pattern. The SpinalSync sciatica pathway runs zone-V and zone-VI protocols together - with a fast-track imaging-and-referral pathway if the scan or exam flags disc herniation that warrants orthopaedic review.
Sciatica is a symptom, not a diagnosis. The intake and scan sort which of three underlying patterns is actually driving the referred leg pain.
Tight piriformis muscle compresses the sciatic nerve. Presents with buttock pain radiating down the posterior thigh, often worse sitting. ~40% of cases - responds fastest. Usually 5–6 sessions.
L4/L5 or L5/S1 facet joint dysfunction producing nerve-root irritation without a disc. Pain follows a dermatome; no deficit on motor exam. Standard zone-V + VI protocol, 6–8 sessions.
True disc pathology. Always imaged on intake if suspected. If stable and non-progressive, we co-manage with orthopaedic input; if motor deficit or red flag present, we refer out first and re-assess later.
Phase one is acute relief (sessions 1–3). Phase two is stability (sessions 4–8). Deceleration from weekly to monthly happens when the pain pattern no longer reproduces on straight-leg raise.
Pressure-pain threshold at L4/L5 and piriformis point. Primary outcome measure.
Straight-leg raise + lumbar flexion composite. Direct sign the nerve-root is settling.
Pain-driven sympathetic load drops as sciatica settles. HRV rises almost linearly with relief.
Paraspinal guarding asymmetry. Reflects the protective spasm that accompanies acute sciatica.
Sciatica responds best when nerve-mobility drills are done twice daily between sessions. We issue specific drills based on your pattern.
Any of the patterns below trigger referral before or during the protocol. We share your scan history with the specialist.
Not always. If there's no motor deficit, no red flags, and the pattern is mechanical on exam, SpinalSync is appropriate conservative care - and often resolves the symptom without ever needing imaging. If anything on intake suggests disc pathology requiring review, we coordinate the MRI and the orthopaedic referral ourselves.
No, and nobody can - discs don't "slip". A bulge or herniation is a structural change in the disc wall. What SpinalSync can do is reduce the nerve-root irritation, open the facet pattern, and restore the mobility that the guarding has locked down. Many disc-origin sciatica cases improve without any change to the disc itself.
Usually yes - provided there's no progressive motor deficit. SpinaliQ's low-force impulse is distinctly different from traditional high-velocity manipulation and is often preferred for disc-origin pain. We image first if there's clinical suspicion.
Varies significantly by pattern. Piriformis cases often break in 2–3 sessions. Facet-origin cases usually need 5–6. True disc-origin pain can take 8–12 sessions combined with load management. Your clinician forecasts your arc after the first scan.
Depends on the pattern and the phase. Acute phase: usually reduce to walking for 10 days. Stability phase: gradual reintroduction guided by the straight-leg raise response and your CellSync trajectory. We work with your coach or trainer if you have one.
Baseline scan, nerve-root exam, first correction. If imaging is indicated, we coordinate it before the next session.