That burning, shooting pain from your low back through your hip and down your leg — that is your sciatic nerve telling you something is compressing it. Sciatica is not a disease. It is a symptom of something specific. Dr. Lombardi finds what that something is and treats it directly.
Same-day appointments often available. Most insurance accepted.The sciatic nerve is the longest, thickest nerve in the human body. It originates from nerve roots at L4, L5, and S1 in the lumbar spine, passes through the pelvis, travels through or beneath the piriformis muscle in the buttock, and runs down the back of the leg all the way to the foot. When anything compresses or irritates it anywhere along that path, the result is sciatica.
That matters clinically because sciatica from a herniated disc is treated differently from sciatica caused by a tight piriformis muscle, which is different again from sciatica caused by a misaligned sacroiliac joint. Treating all three the same way is why so many people with sciatica get temporary relief at best.
Dr. Lombardi performs a thorough neurological and orthopedic evaluation at the first visit specifically to identify which structure is compressing the sciatic nerve and at what level. That diagnosis determines the treatment plan entirely.
The classic presentation — a shooting, burning, or aching pain that follows the path of the sciatic nerve on one side of the body.
When the sciatic nerve is compressed, it may produce altered sensation — tingling, pins and needles, or areas of numbness — in the leg, calf, or foot.
Significant nerve compression can reduce motor function — producing foot drop, weakness when climbing stairs, or difficulty pushing off when walking.
Sitting increases pressure on the lumbar discs and compresses the piriformis — both common sources of sciatic irritation. Worsening with sitting is a hallmark symptom.
Reducing load on the spine typically reduces disc pressure on the nerve. Relief when lying down suggests disc involvement.
The source of sciatic nerve compression determines the right treatment. These are the most common causes Dr. Lombardi identifies.
The most common cause of true sciatica. A herniated disc at L4-L5 or L5-S1 presses directly against the nerve root that becomes the sciatic nerve. This produces the classic radiating leg pain pattern.
The piriformis muscle in the buttock lies directly over or around the sciatic nerve. When it tightens — from prolonged sitting, overuse, or hip imbalance — it compresses the nerve and mimics disc sciatica almost exactly.
SI joint inflammation or misalignment can irritate the sciatic nerve roots at their origin. This is frequently missed and accounts for a significant portion of sciatica cases that do not respond to disc-focused treatment.
Inflamed facet joints in the lower lumbar spine can compress exiting nerve roots and refer pain in a sciatic pattern. The pattern is slightly different from disc sciatica — typically less distinct and more diffuse.
Narrowing of the spinal canal or the openings through which nerve roots exit can compress the sciatic nerve roots. Stenosis-related sciatica typically worsens with standing and walking and improves with sitting or flexion.
Leg length discrepancy, excessive pronation, or chronic pelvic tilt create asymmetric loading on the lumbar spine and piriformis — producing gradual sciatic irritation that worsens over months or years.
Treatment follows diagnosis. What works for disc-related sciatica is different from what works for piriformis syndrome. Dr. Lombardi uses these tools — in the combination your specific presentation requires.
For sciatica caused by disc herniation, decompression creates the negative intradiscal pressure that draws herniated disc material away from the nerve root. It addresses the source directly — not just the symptoms.
Learn about this treatment →Restoring lumbar and sacroiliac alignment reduces the mechanical pressure on sciatic nerve roots from misaligned joints. For SI joint and facet-related sciatica, adjustments are often the primary treatment.
Learn about this treatment →Piriformis syndrome responds exceptionally well to targeted piriformis and hip rotator stretching. Dr. Lombardi designs specific protocols for each patient's presentation.
Learn about this treatment →Cold laser therapy reduces the perineural inflammation — the swelling around the nerve itself — that perpetuates sciatic pain even after the initial compression is addressed.
Learn about this treatment →Finding the right treatment starts with finding the right diagnosis. Here is how that happens.
Dr. Lombardi tests reflexes, sensation, and muscle strength in a pattern that identifies which nerve root is involved and helps distinguish disc compression from piriformis syndrome from SI joint dysfunction.
Specific provocative tests — straight leg raise, FAIR test, Patrick's test, and others — help pinpoint the structure compressing the nerve.
Before treatment begins, you know what Dr. Lombardi found, what is causing your sciatica, and why he is recommending what he is recommending.
The first treatment session addresses the specific source. For disc sciatica, that may mean decompression. For piriformis syndrome, hands-on soft tissue work and stretching. For SI joint dysfunction, a specific adjustment.
Sciatica from lumbar disc herniation — the most common cause — has been extensively studied in the context of conservative care. The findings support chiropractic as an effective first-line approach.
A study in the Journal of Manipulative and Physiological Therapeutics found that 60% of sciatica patients who had not responded to medical management experienced significant relief with spinal manipulation — comparable to surgical outcomes for the same group.[1]
Research published in Spine found that patients with disc-related sciatica who received chiropractic care were 8.8 times more likely to avoid surgery compared to those who continued with medical management alone.[2]
Studies using serial MRI imaging have shown that 60 to 90% of lumbar disc herniations show measurable resorption over time with conservative care — the body's own healing mechanism doing the work when given the right support.[3]
Research findings are for informational purposes only. Individual outcomes vary. Dr. Lombardi provides personalized assessments at every first visit.
These are the misunderstandings that most reliably lead to ineffective treatment.
A herniated disc on MRI is not an automatic indication for surgery. The majority of lumbar disc herniations resolve with conservative care over time. Surgical guidelines recommend exhausting conservative treatment before operating, except in cases of significant neurological deficit.
Studies consistently show that 60 to 90% of disc herniations reabsorb spontaneously — and that conservative care including chiropractic and decompression therapy supports and accelerates that process.
Piriformis syndrome — sciatic nerve compression in the buttock — produces identical symptoms to disc sciatica and is frequently misdiagnosed as a spinal problem. The treatment is entirely different. This is exactly why an accurate diagnosis matters before treatment begins.
Dr. Lombardi evaluates the entire clinical picture — not just the spine — to identify where the nerve is actually being compressed. Treating the wrong location is the most common reason sciatica does not respond to treatment.
Straightforward answers. No sales pitch.
Acute sciatica from a disc herniation often improves meaningfully within 4 to 6 weeks of appropriate conservative treatment. Chronic sciatica that has been present for months or years takes longer. Dr. Lombardi gives you a realistic timeline based on your specific presentation at the first visit.
Some cases do — particularly mild acute presentations. But many people wait months for spontaneous resolution while the underlying mechanical problem worsens. Early treatment consistently produces better outcomes than watchful waiting beyond the first week or two.
Brief rest during an acute flare is appropriate. Prolonged bed rest worsens outcomes. Gentle movement within your tolerance, combined with specific treatment, produces faster recovery than rest alone.
Activities that increase sciatic pain — particularly prolonged sitting, forward bending with a rounded back, and heavy lifting in compromised positions — should be modified during acute flares. Dr. Lombardi gives you specific activity guidance at your first visit.
The key is identifying the source accurately before choosing the treatment. Dr. Lombardi has spent 17 years doing exactly that for Erie patients. If you are living around your sciatic pain, there is a better option. One call finds out whether he can help.
Same-day appointments often available. Most insurance accepted.The content on this page is for general informational purposes only and does not constitute medical advice. Individual results vary. Always consult Dr. Lombardi or another qualified provider about your specific condition before beginning treatment.