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Sciatica Treatment
Stop guessing at your sciatica. See a specialist who finds the exact cause and eliminates it.
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The shooting pain down the back of your leg. The numbness in your foot. The positions you now avoid — sitting too long, bending wrong, a specific side of the bed. You've tried rest, stretches, maybe PT. Maybe an injection that helped for a few weeks and then didn't. You may have been offered surgery, or told nothing else can be done.
Sciatica is one of the most complex pain conditions to treat because it has so many possible causes. A herniated disc, facet arthritis, spinal stenosis, an SI joint problem, piriformis syndrome, or the sciatic nerve being compressed along its course can all produce similar symptoms. Treat the wrong cause and nothing changes.
Sciatica is one of the most complex pain conditions to treat because it has so many possible causes. A herniated disc, facet arthritis, spinal stenosis, an SI joint problem, piriformis syndrome, or the sciatic nerve being compressed along its course can all produce similar symptoms. Treat the wrong cause and nothing changes.
OUR APPROACH
Why sciatica demands precision
Pinpoint the exact cause
The most important step in eliminating sciatica is identifying the specific source. More than half the battle is figuring out exactly what's compressing or irritating the sciatic nerve—which is the longest in the human body—along its path. Once we know that, the right treatment becomes clear. Too many clinics skip this step and default to generic pills and injections.
Treat the actual cause
Once we've confirmed the source, we build a plan that treats that specific structure, not a generic "back pain" protocol. That could mean a precisely-placed injection, a specific rehab protocol, or a nerve hydrodissection to free a trapped nerve in the muscle. The treatment has to match the cause.
A full range of non-surgical options
Most sciatica, even sciatica that other clinics think needs surgery, is treatable without an operation. The key is matching the right procedure to the right cause.
HOW IT WORKS
Your first visit
- Full history — when it started, what makes it worse, what you’ve tried
- Detailed neurological and orthopedic exam
- Review of MRI, X-ray, or CT imaging
- In-office diagnostic ultrasound when relevant
- Clear explanation of which structure we believe is driving your sciatica
- A staged plan that starts with the least invasive option likely to work
WHAT WE TREAT
Why your sciatica is happening
Lumbar disc herniation
For a disc compressing a specific nerve root, iImage-guided epidural PRP injections calm the inflammation, and focused rehab addresses the mechanical factors.
Lumbar facet arthritis
Often missed. Facet joint disease can produce radiating pain that mimics classic sciatica. Diagnostic facet blocks confirm the source and regenerative therapies, or radiofrequency ablation provides long-lasting relief.
Spinal stenosis
Narrowing of the spinal canal that compresses nerves. Interventional treatments, decompression, targeted rehabilitation, and in some cases spinal cord stimulation can provide substantial relief without surgery.
SI joint dysfunction
A commonly missed cause of pseudo-sciatica. Diagnostic SI injections confirm the source, and treatment ranges from therapeutic injections to radiofrequency to minimally invasive SI fusion.
Piriformis syndrome and nerve entrapment
The sciatic nerve can be compressed along its path in the buttock or thigh. Ultrasound-guided injections can free this nerve entrapment, and targeted rehab are highly effective here.
Post-surgical sciatica
Sciatica that persists or returns after back surgery has specific causes — scar tissue, adjacent segment disease, incomplete decompression. Each has a targeted treatment path.
Treatments
What we actually do
Conservative care
- Targeted physical therapy — specific to the cause, not generic core work
- Chiropractic care when appropriate
- Medication support as part of a plan, not as the whole plan
- Acupuncture and soft tissue therapy
Advanced treatments
- Image-guided epidural PRP or steroid injections — precise to the level causing your symptoms
Nerve hydrodissection to free nerve entrapment in muscle and surrounding structures
Platelet rich plasma and other regenerative procedures to strengthen the architecture of the spine to improve mechanics and limit nerve irritation
- Diagnostic and therapeutic facet joint procedures
- Radiofrequency ablation for facet-mediated radiating pain
- Selective nerve root blocks
- SI joint injections and minimally invasive fusion when the SI joint is the cause
- Spinal cord stimulation for severe, refractory cases
PRECISE FIT
Is Compass the right place for your sciatica?
You're a good fit if
- You have pain radiating into your buttock, leg, or foot
- You have numbness, tingling, or weakness in the leg
- Other treatment hasn’t resolved your symptoms
- You’ve been told you need back surgery but want to exhaust non-surgical options first
- You’ve had back surgery and still have sciatic pain
- You want a real diagnosis, not another round of generic care
You should see a surgeon urgently if
- You have rapidly worsening leg weakness
- You lose bowel or bladder control
- You develop numbness in the saddle area
These are medical emergencies. Go to an ER.
WHY COMPASS
Why patients come to us for sciatica
Diagnostic precision
Our diagnostic process for sciatica is more thorough than what you’ll find at most clinics. That’s why our outcomes are different — we take the time to pinpoint the exact source before treating anything.
Every procedure image-guided
Every injection in the spine or around the sciatic nerve is performed under fluoroscopic or ultrasound guidance. There is no other responsible way to do this work.
A clear, staged plan
We start with the least invasive option that’s likely to work for your specific case, with a clear progression if needed. No jumping to surgery. No stacking procedures without a reason.
An honest read on whether you need surgery
Most sciatica, even sciatica other clinics have declared surgical, can be eliminated non-surgically when the root cause is properly identified and treated. When surgery truly is the right answer, we tell you and refer you to the right surgeon.
from pain to wellness
Real Patient success stories
Here’s how our clients have experienced profound healing and personal growth through our services.
Jordan Schwartz
After a recent car accident, they’ve taken incredible care of me. The team is compassionate, professional, and truly focused on helping me manage and recover from my pain. I always feel heard and supported during each visit. Highly recommend to anyone dealing with injury-related pain or looking for a wellness-focused clinic that truly cares.
John Porter
WONDERFUL! KNOWLEDGEABLE! COMPASSIONATE! LIFE SAVERS! I will always be grateful for what this staff did for me. I was in so much intense pain when I came here. For the first time in over a year, I’m able to stand up straight and walk without cringing and moaning with every step. After my treatment, I was in tears of happiness. My neverending thanks and appreciation to all of you!
Christi
Inviting, calm environment. Helpful staff. Incredibly patient, informative & empathetic doctor. I’m so excited to have been referred here & look forward to continuing my care with Compass Pain & Wellness!
Leslie SLC
First visit left me with a game plan & 1st/2nd steps that totally made sense. (I felt all relevant info was gathered, and based on my layperson’s research, this plan was appropriately paced & outlined.) Very impressed by Dr Peterson, his PA and Office Mgr. All were generous with their time & answered my questions without rushing me.
amanda bausk
I have back discomfort and wanted to try trigger point injections again. I had my first appointment with Dr. Balog and he was fantastic. He was very kind and detail oriented in gathering my medical history. The trigger point injections gave me relief and the process was easy. Everyone in the office was very friendly and the scheduling process was painless. I will be going back in the future for more injections. Definitely reccomend!
Maria Mercedes Martinez
They are amazing—friendly, professional, and trustworthy! Dr. Petterson and Dr. Welch are truly the best. The whole team—Andrea, Miranda, Megan, and Jesse—are all wonderful and make every visit a great experience!
Maribel Najar-Dobbins
I just walked out of my first appointment with Dr. Balog. Super impressed with his attention to detail he took the time to listen to my concerns and established a plan to move forward that made me feel heard. I completely recommend him! Staff is also amazing. This place is on it!
Frankbackzek B
My initial consultation visit was a very good experience with the doctor and PA. I feel they were very thorough in their approach to beginning a diagnosis and very efficient in getting the program rolling. I’m looking forward to my next visit.
Abby Timmons
I was pleasantly surprised with how quickly I was seen and how much the physical therapy and massage treatments actually helped with my shoulder pain. Everyone is knowledgeable and super nice!
Google rating score: 4.8 of 5, based on 53 reviews
about us
what makes us different?
At Compass, treating pain is personal.
We’ve all had family members, friends, or loved ones struggle to get the answers they need. Doctors are short on time, and often short on knowledge. We take care to listen to your concerns and use the most advanced diagnostics to find the right treatment for you.
Dr. Carl Balog, MD.
Portland, Oregon
