What If Physical Therapy Hasn’t Helped My Sciatica? | La Jolla, CA

Physical therapy helped you get stronger. Your flexibility may be better. You're doing the exercises at home.

But the sciatica is still there.

Maybe you still get burning down the leg after standing for 15 minutes. Your foot may still go numb when you walk. Sitting through a long dinner or driving for an hour may still bring the symptoms back.

Dr. Cassidy James Boelk, DC sees patients in this situation regularly. Many have put real time and effort into physical therapy and improved in certain ways, but the nerve symptoms never completely changed.

That doesn't mean physical therapy was a bad choice. It means the next question needs to be more specific:

Why is the nerve still being irritated?

Dr. Boelk has spent more than 22 years working with disc injuries, sciatica and Non-Surgical Spinal Decompression and has performed more than 100,000 spinal decompression treatments. His San Diego clinic has seven DRX9000 systems and is the largest known Non-Surgical Spinal Decompression clinic in Southern California.

⭐⭐⭐⭐⭐ “I Was So Hunched Over That I Had to Use a Cane”

“Now, I’m walking regularly, standing up straight—something I couldn’t do before.”

“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 had an extruded disc affecting the L5 nerve and had reached the point where walking and standing were extremely difficult. What stands out in her story isn't just a change in pain—it's going from needing a cane to walking regularly, exercising and lifting weights again.

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Still Having Sciatica After Physical Therapy? Get Another Look at the Problem.

If you've already invested weeks or months in PT, the next step doesn't have to be blindly signing up for another treatment.

It can simply be finding out why the sciatica is still there.

Dr. Boelk offers a No-Charge Consultation so he can personally sit down with you, go through what has happened and determine whether he believes he may be able to help.

During the consultation, Dr. Boelk will:

• Listen to how your sciatica started and how it has changed.

• Go over where the pain, numbness, tingling or burning travels.

• Discuss what improved during physical therapy and what didn't.

• Review exercises or movements that consistently increased the leg symptoms.

• Ask how long you can sit, stand or walk before symptoms begin.

• Discuss weakness or other neurological changes.

• Review medications, injections, chiropractic care and other treatment you've tried.

• Review your actual MRI images and report if available.

• Compare your imaging with the symptoms you're experiencing.

• Discuss whether further examination or imaging may be appropriate.

• Determine whether Non-Surgical Spinal Decompression may be an option.

• Tell you if he doesn't believe you're an appropriate candidate.

• Answer your questions and explain what he believes makes sense next.

No MRI yet? That's okay. You can still schedule the consultation.

There is no charge and no obligation to start treatment.

You aren't deciding whether to become a spinal decompression patient. You're deciding whether it's worth getting an experienced opinion about why you're still having sciatica.

Dr. Boelk personally performs these consultations while also caring for his existing patients throughout the week. Because he sets aside the time himself, only a limited number of No-Charge Consultation appointments can be accommodated in the clinic schedule.

Once those appointments are taken, new patients are offered the next available openings.

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

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Why Didn't Strengthening Get Rid of the Leg Pain?

This is where the cause of the sciatica becomes important.

Physical therapy may improve strength, mobility, balance and movement. Those can all be valuable.

But a patient can become stronger and still have an irritated spinal nerve.

A lumbar disc herniation or bulge may affect a nerve traveling into the leg. Foraminal narrowing can reduce the space around a nerve as it exits the spine. Spinal stenosis can produce leg symptoms that appear or increase with standing and walking.

That doesn't mean strengthening is harmful or unnecessary. It means strength is only one part of the picture.

If you're stronger but still developing numbness in your foot every time you walk, Dr. Boelk wants to understand why.

What Changed During PT—and What Didn't?

This is one of the most useful things you can think about before coming in.

Maybe your back pain was originally an 8 out of 10 and now it's a 3. That's improvement.

But what happened to the leg?

If the burning still travels into your calf every afternoon, that's important.

If the numbness used to reach the foot but now stops above the knee, that's a meaningful change.

If you can stand twice as long before symptoms start, that's progress even if you're not symptom-free.

On the other hand, if you're stronger but can actually walk less than you could three months ago, Dr. Boelk wants to know that too.

The details matter more than simply saying physical therapy “worked” or “didn't work.”

Don't Treat an MRI Report Without Treating the Patient

Dr. Boelk sees patients whose MRI reports contain several findings.

Degenerative disc disease. Disc bulges. A herniation. Foraminal narrowing. Stenosis.

Sometimes more than one level is involved.

Seeing those words on an MRI report doesn't automatically tell you which finding is responsible for your symptoms.

That's why Dr. Boelk prefers to review the actual images when available and correlate them with the patient's history.

If the MRI shows a problem at L4-L5 or L5-S1, does that make sense with where the symptoms travel?

Does sitting increase them?

Does walking bring them on?

Is there numbness? Weakness?

What relieves the symptoms?

Imaging is valuable, but it needs to make sense when compared with the person sitting in front of you.

⭐⭐⭐⭐⭐ “I Travel From the UK to See Dr Boelk”

“I have 3 bulging disc and one is touching the nerve.”

“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

Lisa travels from the United Kingdom for care and describes three bulging discs, including one affecting a nerve. For her, an important part of treatment is being able to maintain an active life.

Patients don't necessarily need to be pain-free every minute to recognize meaningful progress. Being able to return to activities that had been taken away by the problem matters.

Could Non-Surgical Spinal Decompression Make Sense After PT?

Possibly.

Dr. Boelk commonly evaluates patients with:

• Lumbar disc bulges.

• Lumbar disc herniations.

• 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 for Non-Surgical Spinal Decompression.

But completing physical therapy without getting the result you wanted does not automatically make you a spinal decompression candidate.

Dr. Boelk considers your symptoms, neurological findings, imaging when available, spinal stability, bone health, previous surgery and response to prior treatment before recommending care.

Sometimes he recommends treatment.

Sometimes he doesn't.

Has Your Life Been Slowly Shrinking Around the Sciatica?

This can happen without patients realizing it.

You stopped running because it bothered the leg.

Then you stopped taking longer walks.

You avoid sitting too long because you know getting up will hurt.

You don't travel as much because you're worried about the flight.

You still say you're “doing okay,” but you're doing okay partly because you've stopped doing the things that aggravate the sciatica.

Look back three or six months.

Are you doing more now?

Or have you simply become better at avoiding the things you can no longer comfortably do?

That distinction matters.

When Another Conservative Treatment May Not Be the Right Choice

There are times when persistent sciatica needs a different level of evaluation.

Rapidly progressing weakness, significant neurological loss, new bowel or bladder dysfunction, difficulty initiating or controlling urination, or numbness involving the groin, inner thighs or saddle region requires prompt medical evaluation.

There are also patients whose examination, imaging or structural condition makes a surgical opinion appropriate even without those emergency symptoms.

Dr. Boelk does not believe the goal should be avoiding surgery at all costs.

The goal is choosing the right treatment for the right patient.

★ Sometimes the Consultation Ends With a Referral, Not Treatment

“We both determined that surgery was my only option to correct my back issues.”

“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”

— Jeff J., Tucson, AZ

Jeff traveled from Tucson looking for another option. After reviewing his situation with Dr. Boelk, they determined that surgery was the appropriate direction.

That's an important part of the consultation process.

Not everyone who hasn't improved with physical therapy needs another conservative treatment.

Sometimes the useful answer is knowing when it's time to move in another direction.

More Than 22 Years Focused on Non-Surgical Spinal Decompression

Dr. Cassidy James Boelk, DC 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 understands spinal injury personally. He suffered an L5 compression fracture at age 16 and later dealt with disc injuries and sciatica himself.

If You've Done the PT but the Sciatica Is Still There

Don't assume your only choices are to keep repeating the same exercises or move directly toward surgery.

The next step may simply be taking another careful look at the problem.

Bring your MRI images and report if you have them. Tell Dr. Boelk what improved during PT, what didn't, which exercises aggravated the symptoms and what you're still unable to do.

Then find out whether he believes another non-surgical option makes sense.

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

Because Dr. Boelk performs these consultations himself while continuing to care for 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

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