Can You Have Sciatica Without Back Pain? | La Jolla, CA
Yes. You can have sciatica with very little lower-back pain, and sometimes no back pain at all.
Dr. Cassidy James Boelk, DC sees patients like this regularly. They come in because something is going on with the leg. Maybe there's a deep ache in the buttock that keeps returning. Maybe there's burning down the outside of the leg, numbness across part of the foot, or tingling into the toes. The patient may have already tried stretching, massage, physical therapy or other treatments directed at the leg because that's where the problem seems to be.
Then Dr. Boelk starts asking questions about the lower back and the patient says, “But my back doesn't hurt.”
That's a reasonable reaction, but it doesn't necessarily rule out a problem involving one of the nerves in the lower spine.
The nerves involved in sciatica originate in the lower back and travel into the leg. If a nerve is irritated or compressed near the spine, the symptoms can show up farther down the nerve. Where you feel something and where it's coming from aren't always the same place.
After more than 22 years working with disc injuries, sciatica and Non-Surgical Spinal Decompression, Dr. Boelk has learned to pay close attention to the details. Where does the pain begin? Where does it end? Is it actually pain, or is it burning, tingling or numbness? What happens when you sit? What happens when you walk? Is the leg getting weaker?
Those answers often tell you much more than simply asking whether someone's back hurts.
⭐⭐⭐⭐⭐ “My Sciatica Was Gone and I Was Nearly Back to Normal”
“Honestly, I wasn't sure I would ever heal.”
“I have had an outstanding experience with Dr. Boelk and his staff at The Spinal Decompression & Chiropractic Center of San Diego.
They follow a very structured treatment protocol and utilize the best spinal decompression equipment available. I've been treated elsewhere using lower-quality decompression systems and never experienced meaningful improvement.
Dr. Boelk is attentive, professional, and genuinely cares about every patient. You can see it in the way he interacts with everyone who walks through the door.
After about 12 treatments, my sciatica was gone and I was nearly back to normal. Honestly, I wasn't sure I would ever heal. What surprised me most was that after my very first treatment, I experienced significant relief and was able to sleep mostly pain-free for the first time in months.
The improvement has allowed me to get back to hiking, traveling, and enjoying life again.
This treatment was one of the best investments I've ever made.
Thank you, Dr. Boelk and your entire team.”
— Michael Langsdale, San Diego, CA
One of the things Dr. Boelk likes about Michael's story is that he talks about hiking and traveling again. That's usually what patients care about when you really get down to it. They don't come in because they want to change a number on a pain scale. They come in because something they used to do normally has become difficult.
If You're Not Sure What's Causing Your Leg Pain, Start Here
If you're in La Jolla or the surrounding San Diego area and you've had leg pain, burning, tingling or numbness that isn't going away, Dr. Boelk offers a No-Charge Consultation so you can sit down with him and go through what's actually been happening.
You aren't agreeing to start spinal decompression by scheduling the consultation. Dr. Boelk doesn't know yet whether you're a candidate.
That's what you're coming in to find out.
During the consultation, Dr. Boelk will:
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Go through how the problem started and how it has changed.
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Have you show him exactly where the symptoms travel.
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Discuss any numbness, tingling, burning or weakness.
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Talk about what makes the problem better and what sets it off.
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Review treatments you've already tried and whether they helped.
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Review your actual MRI images and report if you have them.
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Compare what's on the MRI with what you're actually feeling.
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Discuss whether additional examination or imaging may be appropriate.
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Determine whether Non-Surgical Spinal Decompression may be an option.
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Tell you if he doesn't think you're a candidate.
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Give you time to ask questions.
If you don't have an MRI, that's okay. You can still come in.
There is no charge for the consultation and no obligation to begin treatment.
Dr. Boelk does these consultations himself. He also treats the patients already under his care, so the office can only set aside a limited number of consultation appointments during the clinic schedule.
Call 619-298-0800 and ask for the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.
Sometimes the Leg Tells the Story Before the Back Does
There isn't one way sciatica feels.
A patient may have pain in the buttock that travels down the back of the thigh but never reaches the foot. Another patient may have very little pain above the knee but a constant burning sensation through the calf. Someone else says two toes have been numb for a month and that's the symptom bothering them the most.
Dr. Boelk may ask you to trace the symptoms with your hand because “my leg hurts” isn't specific enough.
He wants to know whether the symptoms stay above the knee or continue below it. He wants to know which part of the calf is involved and whether the symptoms reach the top or outside of the foot. If the toes are numb, which toes? If the leg feels weak, what are you having trouble doing?
Different nerves can produce different patterns, although patients don't always follow the diagrams in an anatomy book perfectly. That's why symptom location is useful, but Dr. Boelk doesn't use it by itself to decide what's wrong.
The whole picture needs to make sense.
“I've Been Stretching It Because I Thought My Hamstring Was Tight”
Dr. Boelk hears this a lot.
Someone feels a constant pulling through the back of the thigh, so they start stretching the hamstring. They stretch it in the morning, after work, after exercising. Maybe they roll it or use a massage gun. It loosens up for a little while and then the same feeling comes back.
Sometimes the hamstring really is the problem.
But sometimes what a patient describes as “tight” isn't behaving like a normal tight muscle.
If you stretch your hamstring and feel a normal muscular pull, that's one thing. If the stretch causes burning, tingling or pain to travel farther down the leg, that's something Dr. Boelk wants to know about.
The same mistake can happen with the buttock. Patients assume it's piriformis syndrome because that's where they hurt. Or they focus on the calf because that's where the burning is.
Those structures can certainly cause problems of their own, so Dr. Boelk doesn't label every leg complaint as sciatica.
But repeatedly treating the place where you feel the symptom won't solve much if the actual source is somewhere else.
Bring the MRI Images if You Have Them
Patients sometimes come in with an MRI report that sounds terrible.
It may mention a bulging disc at one level, degeneration at another, a herniation somewhere else and narrowing around one or more nerves. By the time the patient finishes reading it online, they may be convinced their entire lower back is falling apart.
Dr. Boelk looks at it differently.
He's trying to determine which findings actually matter.
If the symptoms are all going down the right leg, does something on the MRI reasonably explain what's happening on the right? If a certain part of the foot is numb or a particular movement is becoming weak, does that fit with the rest of the picture?
That's why he prefers to see the actual MRI images along with the radiologist's report.
A finding on an MRI can be important. It can also be something that's been there for years and isn't responsible for what brought you into the office.
The MRI has to be looked at in the context of the patient.
⭐⭐⭐⭐⭐ “I Will Not Go to Anyone Else for Back Treatment”
“I travel from the UK to see Dr Boelk and his wonderful team.”
“I travel from the UK to see Dr Boelk and his wonderful team . I have 3 bulging disc and one is touching the nerve. I have the spinal decompression treatment and it really helps keep me in my active life . I will not go to anyone else for back treatment, this place is number one and they genuinely care about their patients.”
— Lisa S., United Kingdom
The words “active life” are important.
That's often the conversation Dr. Boelk has with patients. What are you trying to get back to?
For one person it's walking without constantly looking for somewhere to sit. For someone else it's getting back in the gym. It may be golf, surfing, hiking, traveling, working a full day, playing with the kids or simply sleeping through the night.
The answer is different for everyone.
How Much Have You Already Changed Because of the Problem?
People can become very good at working around sciatica.
You take a shorter walk because you know what happens if you go too far. You stand during a meeting because sitting bothers the leg. You don't take the longer car ride. You stop doing one exercise at the gym, then another. You sleep in one particular position because you've figured out it's the least uncomfortable.
After a while, you stop thinking of these things as limitations. They're just how you do things now.
That's worth paying attention to.
A patient can still be functioning and have a problem that's taking quite a bit away from them.
If the symptoms started last week and they're clearly improving, that's one situation.
If you've been saying, “I'll give it another week” for the last three months while slowly doing less and less, that's different.
You don't automatically need spinal decompression because the symptoms have been there a long time.
But at some point it makes sense to understand why they haven't gone away.
Numbness and Weakness Can Matter More Than the Pain Number
Patients sometimes spend the entire consultation describing their pain and mention the numbness almost as an afterthought.
Dr. Boelk wants to know about both.
Tell him if part of your foot stays numb, the tingling is spreading, one leg feels weaker, you're having difficulty lifting the front of your foot, your foot is starting to slap when you walk, or you're catching your toes more often.
A decrease in pain doesn't necessarily mean everything is improving if weakness is getting worse.
Most cases of sciatica are not emergencies. Rapidly progressing weakness, new bowel or bladder dysfunction, difficulty urinating, or numbness involving the groin or saddle area requires prompt medical evaluation rather than waiting for a routine spinal decompression consultation.
Would Dr. Boelk Recommend Spinal Decompression?
Maybe. Maybe not.
That's a much more honest answer before he's met you.
Dr. Boelk evaluates patients with lumbar disc bulges and herniations, degenerative disc disease, disc-related sciatica, foraminal narrowing, selected cases of spinal stenosis, and other chronic disc-related lower-back and leg problems.
The Spinal Decompression & Chiropractic Center of San Diego uses the DRX9000 exclusively.
But an MRI showing a disc problem doesn't automatically qualify someone for treatment.
Dr. Boelk also needs to consider the patient's symptoms, neurological findings, spinal stability, bone health, medical history and previous spinal surgery.
There are situations where decompression may not be appropriate, including an unhealed fracture, significant osteoporosis, unstable spondylolisthesis, abdominal aortic aneurysm, pregnancy for lumbar decompression, certain malignancies and other medical or structural conditions.
Previous spinal surgery has to be looked at carefully as well, especially when there is fusion or metal hardware at the level that would need treatment.
★ Sometimes Dr. Boelk Tells a Patient Not to Do Decompression
That happened with Toni W.
She had significant hardware in her back, and after meeting with her, Dr. Boelk did not believe she was an appropriate candidate.
“But I'm glad I took the time to meet with him.”
“Very nice Dr. and Honest ! I would definitely recommend anyone who hasn't had metal put in there back in a surgery to go to him and give his program a shot. I believe it would definitely help. Just not in my personal case. As I have a lot of hardware in my back. But I'm glad I took the time to meet with him. It was very informative all around.”
— Toni W., Lake Elsinore, CA
That's also what the consultation is for.
Sometimes Dr. Boelk believes the patient is a good candidate. Sometimes he needs more information before making that decision. Sometimes he tells the patient that this isn't the right treatment for them.
There isn't much value in a consultation if the answer is always going to be yes.
Dr. Cassidy James Boelk, DC
Dr. Boelk has spent more than two decades working with spinal decompression and disc-related conditions.
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Doctor of Chiropractic
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More than 22 years of Non-Surgical Spinal Decompression experience
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More than 100,000 spinal decompression treatments
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Certified Spinal Decompression Doctor
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Certified Pain-Free Performance Specialist (PPSC)
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Founder, Non-Surgical Spinal Decompression Training Academy
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Trains other doctors in spinal decompression protocols and techniques
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Founding Member, American Spinal Decompression Society
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Member, International Disc Education Association
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California X-Ray Radiation Supervisor & Operator
His interest in spinal injuries is personal as well. Dr. Boelk suffered an L5 compression fracture when he was 16 and later dealt with disc injuries and sciatica himself.
He still surfs, plays hockey and exercises, so he understands the difference between simply being able to get through the day and actually getting back to the things you want to do.
If Your Back Doesn't Hurt but Your Leg Still Does, You Don't Have to Keep Guessing
You don't need to know whether you have an L4, L5 or S1 problem before coming in.
You don't need to know whether the problem is a bulging disc, a herniated disc or something else.
You don't even need to have an MRI yet.
And you certainly don't need to decide that you want spinal decompression treatment before scheduling a consultation.
Come in and let Dr. Boelk look at the problem first.
Your No-Charge Consultation includes:
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One-on-one time with Dr. Cassidy James Boelk, DC
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Review of how the problem started
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Discussion of exactly where the symptoms travel
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Review of pain, numbness, tingling, burning or weakness
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Discussion of what makes the symptoms better or worse
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Review of treatments you've already tried
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Review of your actual MRI images and report, if available
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Comparison of your imaging with your symptoms
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Discussion of whether additional examination or imaging may be appropriate
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An assessment of whether Non-Surgical Spinal Decompression may be an option
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An honest answer if Dr. Boelk doesn't believe you're a candidate
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Time to ask questions
There is no charge for the consultation and no obligation to begin treatment.
Dr. Boelk performs these consultations himself while continuing to treat his existing patients, which limits how many the office can put into the schedule.
If you've been dealing with the same leg problem for weeks or months, the decision right now isn't whether you're going to start treatment.
It's whether you'd like to find out what Dr. Boelk thinks is going on and whether he believes he can help.
Call 619-298-0800
Ask for the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.
If you have an MRI, bring the actual images and report. If you don't have one, that's okay.
The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
619-298-0800
SanDiegoBackCare.com
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