Conditions

Sciatica

One-on-one care for sciatica and radiating leg pain in a private South Natick studio: a full session with a Doctor of Physical Therapy every visit, built for people who are tired of a leg that dictates their day.

Pain that travels needs a plan that follows it

Sciatica is not a diagnosis so much as a description: pain, numbness, or tingling that starts in the low back or buttock and runs down the leg along the sciatic nerve. Sitting makes it worse. Driving makes it worse. Sometimes standing up straight is the hardest part of the day.

Many of the people who come to us for leg pain have already been told to rest, stretch, and wait. Some have done a round of physical therapy elsewhere and stalled. Sciatica care here is led by clinicians with advanced residency training at the Institute of Orthopedic Manual Therapy, with an emphasis on hands-on spine care, and board certification as Orthopedic Clinical Specialists. Every session is one-on-one for the full visit. No aides, no handoffs, no exercise sheet doing the treating.

In Massachusetts you have direct access: no physician referral is needed to start. If your evaluation shows something outside the scope of physical therapy, we will tell you and point you to the right practitioner.

A Doctor of Physical Therapy guiding a lower back and hamstring stretch on the treatment table

Find the source. Mobilize what's tight. Strengthen what's weak.

Leg symptoms can come from a disc, a stiff spinal segment, a tight hip muscle pressing on the nerve, or nerve tissue that has simply lost its ability to glide. Your evaluation works out which of those is driving your pain, and treatment works both sides of the equation every session.

Hands-on treatment for what's tight

Taking pressure off the nerve and restoring motion where it is lost:

  • Joint mobilization & manipulation
  • Nerve mobility (neural glide) techniques
  • Instrument-assisted soft tissue mobilization (Graston)
  • Deep tissue massage for the hip and glutes
  • Dry needling
  • Assisted stretching & mobility work

Progressive strengthening for what's weak

Rebuilding the support system so the nerve stops getting irritated:

  • Core stabilization
  • Lumbopelvic-hip strength and control
  • Glute and hip strength that unloads the low back
  • Graded return to sitting, walking, lifting, and sport
  • An individualized home program that evolves with you

Leg and nerve problems we treat

  • Sciatica / radiating leg pain
  • Herniated or bulging discs
  • Numbness or tingling in the leg or foot
  • Piriformis syndrome
  • Spinal stenosis
  • Nerve pain with sitting or driving
  • Leg weakness after a back episode
  • Post-surgical recovery
  • Recurring flare-ups
  • Sciatica that comes and goes with training

Not sure what yours is? That is what the evaluation is for.

Back pain without leg symptoms? See our low back pain page.

A Doctor of Physical Therapy coaching a core stabilization exercise on the stability ball

Results from real legs

"A couple of years ago, I was experiencing back and leg pain which interrupted my running routine and often made my 50-minute commute to work agonizing. I connected with Dr. Shawn Sprague and, after a few sessions with him, began to feel better, and my ride to work eventually became pain-free. Shawn asked me a lot of questions and shared alternative ideas for exercise and movement. Then he offered me a weekly routine with him that involves manual manipulation of my legs and back and strenuous stretches and exercises to strengthen my core."
Dan Gutekanst Back and leg pain, back to running · Google review
"Shawn has been amazing! Went to see the doctor for back pain and he suggested a pain medication and physical therapy. Shawn removed the need for medication and the pain was gone after about 2 sessions."
Mauricio Villalba Back pain, no medication needed · Google review
Case study: how one golfer went from managing back pain to playing his member tournament pain-free. Read the story →

Read all 81 reviews on Google →

Where it leads

The goal is not just a quiet leg. It is a back and hip you trust again. When symptoms resolve, your plan progresses from rehab into performance training with the same clinician in the same facility, so the strength that keeps the nerve calm keeps building instead of stopping at discharge. That transition is the Progression Method.

Sciatica FAQs

Do I need a referral to see a physical therapist for sciatica in Massachusetts?
No. Massachusetts has direct access, so you can start physical therapy without a physician referral. Book a free 15-minute fit call and we'll tell you whether we're the right place to start.
How soon should I see a physical therapist for sciatica?
Sooner is better. Nerve pain that runs down the leg tends to make people move less, sit differently, and guard, and those habits are harder to undo the longer they set in. If pain, numbness, or tingling is changing how you sit, walk, sleep, drive, or train, that's reason enough to be evaluated.
Is sciatica the same as a herniated disc?
Not always. Sciatica describes the symptom: pain, numbness, or tingling that travels from the low back or buttock down the leg along the sciatic nerve. A herniated disc is one common cause, but stiff joints, tight hip muscles, and irritated nerve tissue can produce the same picture. The evaluation sorts out which is driving yours, because the treatment differs.
Do I need an MRI before starting physical therapy?
Usually not. Disc bulges and degenerative changes show up on scans of plenty of people with no symptoms at all. A thorough orthopedic and neurological evaluation tells us more about what's driving your leg pain. If we see signs that imaging or a physician consult is warranted, we'll tell you.
Do you take insurance?
We're an out-of-network, fee-for-service practice. That's what lets every visit be a full session, one-on-one with a Doctor of Physical Therapy, with no aides, no double-booking, and no visit limits set by a payer. Many PPO plans reimburse a portion of out-of-network care through the Super Bill we provide, and HSA/FSA funds typically apply. We'll walk you through what care costs on your free fit call.
What happens in a session?
You work start to finish with one senior Doctor of Physical Therapy. Sessions combine hands-on treatment, such as joint mobilization or manipulation, nerve mobility work, Graston, deep tissue work, or dry needling, with corrective and strengthening exercise, plus a home program you actually understand.
Can I keep lifting, running, or golfing with sciatica?
Often yes, with modifications. Complete rest is rarely the answer, and for nerve pain it can make things worse. Part of the evaluation is working out what you can keep doing safely and what needs to change temporarily, so you're not starting from zero once the leg settles.
I already had back surgery. Can you still help?
Yes. We treat clients after lumbar surgery, including people whose leg symptoms improved but who never got their strength or confidence back. The work is the same: restore what's stiff, build what's weak, and progress load until you're back to what you did before.

Start with a free 15-minute fit call

Tell us where the pain goes and what it is keeping you from. We'll tell you honestly whether we're the right fit, what care would look like, and what it costs.

Book a Free 15-Minute Fit Call