Epidural Didn’t Help My Sciatica — What Should I Do Next? | Chula Vista, CA

A lot of patients come to Dr. Cassidy James Boelk, DC after following a pretty familiar path.

Their sciatica starts. They try medication. They go to physical therapy. When the leg pain or numbness doesn't settle down, they have an epidural injection.

Then the injection doesn't give them the relief they were hoping for.

At that point, some have already been told that surgery may be the next step.

Sometimes it is. But an epidural not working doesn't automatically mean you've run out of non-surgical options.

Dr. Boelk has been treating disc injuries and sciatica for more than 22 years and has performed more than 100,000 spinal decompression treatments. Before recommending anything, he wants to see what's actually causing the symptoms, what your MRI shows and how you've responded to the treatment you've already had.

His clinic has seven DRX9000 systems and is the largest known Non-Surgical Spinal Decompression clinic in Southern California.

⭐⭐⭐⭐⭐ “I Never Ended Up Needing Either of Those Appointments”

“My doctor scheduled two follow-up appointments: one for pain management (spinal injections), and another to evaluate me for surgery.”

“Last year, I spent three months constantly going back and forth between doctor’s appointments and urgent care. The pain was unbearable—I was taking medication regularly just to get through the day. Getting out of bed was excruciating, and walking or standing felt like torture. Every step filled me with dread.

In December, my doctor finally ordered an MRI. That’s when I learned I had an extruded disc pressing on my L5 nerve, which affects the leg and foot. My doctor scheduled two follow-up appointments: one for pain management (spinal injections), and another to evaluate me for surgery.

Then I discovered spinal decompression therapy. I was thrilled to find a non-invasive alternative. I never ended up needing either of those appointments.

Now, I’m walking regularly, standing up straight—something I couldn’t do before. When I first sought help, I was so hunched over that I had to use a cane just to move forward. Because of the pain, I hadn’t exercised in months. But now, I’m doing a program called 75 hard which requires not one but 2 45-minute workouts per day, and I've even gotten back to lifting weights!

I’m so thankful I found this place. It’s conveniently located near my work, which makes it easy to fit sessions into my lunch break. Dr. Boelk and the staff are incredibly friendly and polite—it’s always a pleasure to come in.

The environment is so relaxing that I look forward to each visit. I truly thank God for leading me to this alternative. It’s made such a difference in my life.”

— Amanda, San Diego, CA

Amanda's MRI showed an extruded disc affecting the L5 nerve. She had reached the point where walking and standing were extremely difficult and was scheduled for both pain management and a surgical evaluation.

Her situation doesn't mean everyone scheduled for an injection or surgical consultation should choose spinal decompression instead. It does show why it can be worth finding out whether another option exists before making that decision.

---

If the Injection Didn't Help, Dr. Boelk Will Look at What's Happened So Far

You don't need to come in already convinced that you want spinal decompression.

In fact, Dr. Boelk would rather you didn't make that decision before he sees you.

The No-Charge Consultation is an opportunity to sit down with him and go through the case.

Bring your MRI images and report if you have them.

Dr. Boelk will want to know:

• Where the sciatica travels.

• Whether you have numbness, tingling or weakness.

• How long you can sit, stand or walk before symptoms start.

• What you did in physical therapy and whether anything changed.

• What happened after the epidural injection.

• Whether the injection did nothing, helped partially or gave significant temporary relief.

• How long any relief lasted.

• Whether you've had more than one injection.

• What your MRI shows and whether it matches your symptoms.

• Whether Non-Surgical Spinal Decompression makes sense for your particular condition.

If he thinks you're a candidate, he'll explain why.

If he doesn't, he'll tell you that too.

There is no charge and no obligation to begin treatment.

Dr. Boelk personally performs these consultations while also treating his existing patients throughout the week. That means the office can only set aside a limited number of consultation appointments in the schedule.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

---

An Epidural Can Help the Inflammation Without Changing Everything Else

This is something Dr. Boelk explains to patients fairly often.

An epidural steroid injection is used to reduce inflammation around an irritated spinal nerve. For some people, that can work very well.

But inflammation may not be the only thing involved.

If you have a disc herniation affecting a nerve, for example, reducing the inflammation around that nerve may decrease the symptoms without necessarily changing the disc problem itself.

That's one reason a patient can feel dramatically better for a period of time and then have the sciatica return.

It doesn't mean the injection was pointless.

It means Dr. Boelk needs to look at the whole problem instead of focusing only on whether the shot “worked.”

Tell Dr. Boelk Exactly What Happened After the Injection

Don't just say it didn't work.

Maybe it didn't.

But if you had three good weeks, tell him that.

If the pain down the leg improved but the foot stayed numb, tell him that.

If you were able to walk twice as far for a month before the symptoms came back, that's useful.

If absolutely nothing changed, that's useful too.

The response gives Dr. Boelk another piece of information to compare with your symptoms and imaging.

The same is true if you've had several injections.

If the first helped for three months, the second helped for three weeks and the third didn't do much at all, that's worth discussing.

Bring Your Actual MRI

By the time someone has gone through PT and an epidural injection, they usually have an MRI.

Dr. Boelk prefers to see the actual images, not just the report.

The report may say L4-L5 disc protrusion, L5-S1 disc extrusion, foraminal narrowing, degenerative disc disease or spinal stenosis.

Those words matter, but they aren't enough by themselves.

Dr. Boelk wants to see where the disc problem is and what the space around the nerve looks like. Then he compares that with what you're experiencing.

Does the side match?

Does the nerve involved make sense with where your pain or numbness travels?

Is there weakness?

Does sitting make you worse?

Or is standing and walking the bigger problem?

That's how the MRI becomes useful clinically rather than simply being a list of findings.

⭐⭐⭐⭐⭐ “For the First Time in 10 Years, I Am Completely Pain-Free”

“I was one step away from back surgery.”

“For the first time in 10 years, I am completely pain-free. My sciatca is gone, and I no longer have back pain.

Before finding Dr. Boelk, I tried chiropractic care, acupuncture, pain medications, and several other therapies that simply didn't work. I was one step away from back surgery when I discovered spinal decompression treatment at The Spinal Decompression & Chiropractic Center of San Diego.

The results have been incredible. Every visit was comfortable, relaxing, and completely pain-free. Dr. Boelk and Patty always took the time to explain everything and made me feel genuinely cared for throughout the process.

They are warm, welcoming, and truly dedicated to helping their patients.

Thank you, Dr. Boelk and Patty!”

— Toni H., San Diego, CA

Toni had been dealing with sciatica and back pain for 10 years and had already tried several different treatments before coming to the office.

Her situation was appropriate for spinal decompression. Someone else's may not be.

That's why Dr. Boelk wants to evaluate the patient before recommending treatment.

Where Non-Surgical Spinal Decompression May Fit

Dr. Boelk commonly evaluates patients with:

• Lumbar disc herniations.

• Lumbar disc bulges.

• L4-L5 and L5-S1 disc injuries.

• Degenerative disc disease.

• Disc-related sciatica.

• Foraminal narrowing.

• Selected cases of spinal stenosis.

The Spinal Decompression & Chiropractic Center of San Diego uses the DRX9000 exclusively.

Dr. Boelk doesn't recommend it simply because an epidural didn't work.

He looks at the MRI when available, neurological symptoms, previous surgery, spinal stability, bone health and the way the patient's symptoms behave.

There are patients he accepts for treatment and patients he doesn't.

Don't Judge Progress Only by Today's Pain Level

Someone can tell Dr. Boelk their pain is a 4 out of 10 and still be doing much worse than they were six months ago.

They've just changed their life around the sciatica.

They don't walk as far.

They stopped going to the gym.

They avoid long drives.

They haven't golfed in months.

They don't want to get on an airplane because sitting that long sounds miserable.

That matters.

A better question is whether you're getting those activities back.

If six months ago you could walk for 30 minutes and now you can only make it 10 before the leg starts burning, that's worth paying attention to.

Surgery Is Sometimes the Right Next Step

Dr. Boelk's practice is focused on helping appropriate patients avoid unnecessary surgery, but he doesn't believe surgery should be avoided when it's actually needed.

Progressive neurological weakness is concerning. Significant loss of function needs to be evaluated. New bowel or bladder dysfunction, difficulty controlling or initiating urination, or numbness involving the groin, inner thighs or saddle region requires prompt medical attention.

There are also non-emergency situations where the MRI, examination and patient's history make a surgical consultation appropriate.

★ Not Every Patient Who Wants Spinal Decompression Gets It

“He could not treat me as I have to wait until the fracture in my neck heals.”

“I decided to see Dr. Boelk after a pretty gnarly motocoss neck injury. At the Hospital I was at, I felt I was getting pressured into a surgery which I refused. A friend of a friend referred him after Dr. Boelk successfully treated his broken back.

Dr. Boelk is a compassionate individual who truly cares about his patients. He looked at my MRI images, explained what he saw and potential routes for recovery. He could not treat me as I have to wait until the fracture in my neck heals, but the level of professionalism, compassion, caring and knowledge displayed by him was exceptional.

He also recommended to seek an additional opinion form another neurosurgeon. My experience was that he really cares and he's not someone who would take advantage of the situation someone's in (unlike some other doctors). I will definitely be back and already recommended him to others as well! Thank you Dr. Boelk!”

— Jan H., San Marcos, CA

Jan wanted another option after a serious neck injury, but Dr. Boelk would not treat him while the fracture was still healing. He also recommended another neurosurgical opinion.

That's part of determining candidacy.

Sometimes the answer is yes. Sometimes it's no. Sometimes the patient needs to heal first or needs another specialist involved.

About Dr. Cassidy James Boelk, DC

Dr. Boelk has more than 22 years of experience with Non-Surgical Spinal Decompression and has performed more than 100,000 spinal decompression treatments.

His professional background includes:

• Doctor of Chiropractic

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist (PPSC)

• Founder, Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member, American Spinal Decompression Society

• Member, International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

Dr. Boelk also has his own history of spinal injury. He suffered an L5 compression fracture at age 16 and later dealt with disc injuries and sciatica.

If the Epidural Didn't Work, You Don't Have to Guess What Comes Next

Bring your MRI.

Bring the report.

Tell Dr. Boelk what happened with physical therapy, medication and the injection. Tell him what you could do six months ago that you can't do now.

Then let him look at the whole picture.

You may be a candidate for Non-Surgical Spinal Decompression.

You may not be.

That's what the consultation is for.

There is no charge and no obligation to begin treatment. The consultation is personally performed by Dr. Boelk.

Because he performs these consultations himself while continuing to treat his existing patients, only a limited number can be accommodated in the clinic schedule.

Call 619-298-0800 and ask about the next available No-Charge Consultation with Dr. Cassidy James Boelk, DC.

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

619-298-0800
SanDiegoBackCare.com

Live 24/7 Answering Service • Hablamos Español

Related Articles

Why Is My Sciatica Not Going Away? | Chula Vista, CA

Can Spinal Decompression Help Sciatica Nerve Pain? | Chula Vista, CA