- Low back pain is extremely common and usually not caused by anything dangerous — most cases respond very well to physical therapy.
- Sciatica is pain that travels down the leg from an irritated nerve in the low back; it often improves with the right movement-based care.
- Research consistently shows that hands-on care plus a targeted exercise program relieves pain and restores function for most people.
- Most low back pain does not require imaging, injections, or surgery.
- No referral is needed in most cases. We see new patients within a few days at Cedar Mill, Tigard, and Milwaukie.
What is low back pain and sciatica?
Low back pain can come from the muscles, joints, discs, and nerves of the lower spine, and most often it is a mix — a sensitive, overloaded system rather than a single broken part. The encouraging news is that most low back pain is not caused by anything dangerous, and the body is remarkably good at recovering when given the right movement and load.
Sciatica refers to pain, tingling, or numbness that travels from the low back down the leg, following the path of the sciatic nerve. It happens when a nerve root in the low back is irritated or compressed — often by a disc or by stiffness and inflammation around the nerve. Despite how alarming the leg pain can feel, sciatica frequently settles with the right movement-based program.
At Creekside Physical Therapy, we treat low back pain and sciatica by finding what is driving the symptoms — a stiff or sensitive segment, a weak link, a movement habit — and addressing it directly. Care pairs hands-on manual therapy with an individualized exercise program and clear education, so relief lasts instead of returning. You work one-on-one with the same therapist throughout.
The lower spine is a stack of vertebrae cushioned by discs, connected by small joints, supported by muscles, and threaded by nerves that travel out to the legs. It is built to move and to bear load. Pain can arise from any of these structures, but in most everyday low back pain the exact tissue matters less than how the whole system is moving and loading. When a nerve root is irritated where it exits the spine, the symptoms can radiate down the leg — that is sciatica. Restoring confident, well-distributed movement is central to calming the system down.
What it feels like
Low back pain and sciatica show up in several patterns. Common symptoms include:
- Aching, stiffness, or sharp pain in the lower back
- Pain that worsens with certain positions — prolonged sitting, standing, or bending
- Stiffness and difficulty straightening up, especially in the morning or after sitting
- Pain, tingling, or numbness that travels into the buttock and down the leg (sciatica)
- Muscle spasm or a feeling that the back has "locked up"
- Difficulty with lifting, twisting, or getting in and out of a chair or car
- Symptoms that ease with the right movement and worsen with prolonged stillness
Why it develops
Low back pain and sciatica develop for many reasons, often in combination:
- A sudden strain from lifting, twisting, or an awkward movement
- Prolonged sitting or poor positioning over time
- Weakness or poor control of the core, hip, and back muscles
- Stiffness in the hips or mid-back that overloads the low back
- Disc or joint irritation that sensitizes a nerve (sciatica)
- Deconditioning and a drop in regular movement
- Stress, poor sleep, and fear of movement, which amplify pain
How we evaluate low back pain
Your first visit is a one-on-one physical therapy evaluation that begins with listening. Your therapist takes a full history, screens how your spine and hips move, and tests strength, mobility, and which positions and movements ease or provoke your symptoms — including a nerve assessment if you have leg symptoms. We do not perform imaging; for most low back pain, imaging is not needed, and if your history reveals anything that warrants a medical work-up, we coordinate with your physician. You leave the same day understanding your diagnosis and with a personalized plan.
How physical therapy treats it
For most low back pain and sciatica, hands-on physical therapy plus the right exercise relieves pain and restores function. Your one-on-one plan typically includes:
- Manual therapy — hands-on joint mobilization and soft-tissue work to restore motion and reduce pain
- An individualized exercise program to rebuild strength, control, and mobility in the back, core, and hips
- Movement and posture retraining for the specific positions and tasks that aggravate you
- Nerve-mobilization and positioning strategies for sciatica
- Graded activity and load progression to rebuild confidence and tolerance
- Education on what is driving your pain and how to manage flare-ups
- Pain-relief modalities when helpful so you can move and progress
- A structured home exercise program to keep progress going and prevent recurrence
When to seek care
- Low back pain that has lasted more than a week or two, or that keeps coming back
- Pain, tingling, or numbness traveling down the leg (sciatica)
- Back pain that is limiting work, sleep, or daily activity
- New weakness in the leg or foot, or loss of bowel or bladder control — seek urgent medical care immediately
- Pain following significant trauma, or with fever or unexplained weight loss — see a physician first
Low back pain and sciatica are treated by Creekside’s physical therapists at all three clinics. Tim Dominick, DPT, brings advanced manual therapy training to spine care, and the whole team pairs hands-on treatment with movement-based rehab. In the small number of cases that need injections or surgery, we coordinate with your physician or surgeon and lead your recovery afterward.