If you’ve ever felt that deep, shooting pain down your leg that makes sitting, standing, or even lying down uncomfortable—you already know the beast that is sciatica. It’s not just annoying. It’s debilitating. And for some, it lingers longer than it should.
Now here’s the truth: when it comes to sciatica, most people are told to rest, pop some pain meds, or just wait it out. Maybe get referred for injections or even surgery if things don’t improve. But there’s one powerful solution that doesn’t get nearly enough attention—manual therapy.
At TruStrength Performance and Rehab, we specialize in hands-on care that treats the root of your sciatic pain, not just the symptoms. So let’s break it down—what manual therapy really is, how it helps with sciatica, and whether it could be the game changer you’ve been looking for.
What Exactly Is Sciatica?
Sciatica isn’t a diagnosis—it’s a symptom. It describes pain that radiates along the path of the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg.
Depending on what’s causing the nerve irritation, sciatica can feel like:
- Sharp, stabbing pain
- Burning or tingling down the leg
- Weakness in the glutes or hamstring
- Numbness or difficulty standing for long periods
The pain is usually felt on one side, and it often worsens with sitting, bending, or coughing.
Common Causes of Sciatica
Sciatic nerve pain can come from a range of issues—not just herniated discs. At TruStrength, we take time to assess the full picture. Here are the most common culprits:
1. Herniated or Bulging Disc
A classic cause—when a spinal disc presses on the nerve root.
2. Piriformis Syndrome
The piriformis muscle, located deep in the glutes, can tighten and compress the sciatic nerve. This is technically a “pseudo-sciatica,” but it feels the same.
3. Spinal Stenosis
Narrowing of the spinal canal compresses nerves, often in older adults.
4. Sacroiliac (SI) Joint Dysfunction
Misalignment or inflammation in the SI joint can irritate the sciatic nerve.
5. Pelvic or Hip Imbalances
Tight hips, weak glutes, or poor posture can all change how forces travel through the pelvis—putting unwanted stress on the sciatic nerve.
6. Muscle Guarding or Spasms
Even without structural damage, intense muscle tension can create a “clamping effect” around the nerve.
Knowing the exact cause is key to treating it. That’s where manual therapy comes in—because unlike generic stretching or pain meds, it’s tailored to how your body is moving.
What Is Manual Therapy?
Manual therapy is a hands-on approach performed by trained physical therapists. It includes techniques like:
- Joint mobilizations
- Soft tissue release
- Myofascial release
- Trigger point therapy
- Nerve glides and tension reduction techniques
In other words, we use our hands to move, release, and realign the areas that are contributing to your pain.
At TruStrength Performance and Rehab, we don’t just go through the motions. We assess how your spine, hips, muscles, and nerves are interacting—then apply manual techniques that are specific to your version of sciatica.
How Manual Therapy Helps with Sciatica
Let’s get to the good stuff—how it actually works.
1. Releases Muscle Tension Around the Nerve
Tight muscles (especially in the glutes, piriformis, hamstrings, and QL) can compress the sciatic nerve. Manual therapy helps soften and release these tissues, giving the nerve room to breathe.
2. Improves Joint Mobility
When your lumbar spine or SI joint isn’t moving correctly, it creates compensation patterns. Mobilizing these joints helps restore healthy mechanics and reduce pressure on the nerve root.
3. Enhances Circulation and Healing
Hands-on techniques stimulate blood flow, reduce inflammation, and accelerate recovery in both soft tissue and nerve tissue.
4. Reduces Nerve Irritation
Certain techniques—like nerve gliding—help the sciatic nerve slide and move freely, decreasing that “electric shock” sensation many people describe.
5. Corrects Muscle Imbalances
Manual therapy paired with strategic exercise retrains underactive muscles (like the glutes and core) and shuts down overactive ones (like the hip flexors), balancing out tension across the pelvis and spine.
6. Relaxes the Nervous System
This one’s underrated: manual therapy downregulates the nervous system. That means less pain perception, less guarding, and more natural movement.
What a Sciatica Session Looks Like at TruStrength
We don’t do cookie-cutter care. Here’s how we approach manual therapy for sciatica:
Step 1: Thorough Evaluation
We look at posture, range of motion, strength, and nerve tension tests. We’ll also dive into your pain history and movement patterns.
Step 2: Hands-On Work
This may include:
- Deep tissue release on the piriformis or glutes
- Mobilization of the lumbar spine or sacrum
- Myofascial release along the sciatic nerve path
- Neural flossing or gliding
- Core or hip activation to stabilize movement
Step 3: Corrective Exercise + Home Plan
Once your body is moving better, we lock in the gains with exercises that reinforce the changes. Think: mobility work, glute activation, and posture resets.
We also give you easy at-home drills so you don’t lose progress between sessions.
When to See a Pro for Sciatica
Here are some signs it’s time to stop self-diagnosing and get in for a proper evaluation:
- Your leg pain has lasted more than a week
- Pain radiates below the knee or into the foot
- You have numbness, weakness, or foot drop
- Pain is worse at night or with coughing
- Stretching and rest aren’t helping
- You’re tired of chasing temporary relief
We can usually identify the root cause in your first session and start hands-on treatment the same day.
Other Treatments We Combine with Manual Therapy
Manual therapy works best as part of a comprehensive plan. At TruStrength Performance and Rehab, we often pair it with:
- Dry needling for deep trigger point release
- Cupping therapy to decompress tissues
- Therapeutic exercises to retrain movement
- Posture and gait training
- Diaphragmatic breathing to calm the nervous system
- Core strengthening to stabilize the lumbar spine
You don’t need 10 different providers—you just need the right team that can do it all.
What You Can Do Right Now to Ease Sciatica
Until you come in, here are a few go-to strategies we often recommend:
Try the Piriformis Stretch
Lie on your back, cross one ankle over the opposite knee, and gently pull that leg toward your chest. Hold for 30 seconds.
Gentle Nerve Glides
Lying flat, extend one leg and flex the foot back toward your face, then relax. Repeat slowly 10–15 times. This helps “floss” the nerve.
Avoid Prolonged Sitting
Use a lumbar roll or small pillow behind your back if you must sit. Move frequently, even if it’s just standing up for 30 seconds.
Stay Active—But Smart
Walking is usually better than bed rest. Just keep it low impact and avoid hills or stairs during flare-ups.
Take Back Control From Sciatica
If you’re dealing with sciatica, you know it’s more than just pain—it’s frustration, fear, and feeling like your body is working against you. But here’s the truth:
Sciatica is fixable. And manual therapy, done right, can be the catalyst that gets you there.
At TruStrength Performance and Rehab, we’ve helped hundreds of patients ditch the nerve pain, regain movement, and feel like themselves again—without pills, injections, or endless waiting.
You don’t have to live with it. Book your consultation today and find out what’s really behind your sciatica—and how we can help you beat it for good.