Q: How long is this going to take to go away?

A: It depends on …it depends on YOU. In general, it takes to four to eight weeks to go through the first 2 phases of healing (no pain, all movement, and strength back to normal). It may take another one to four months to get back to all activities you want to do…depending on how active you are. This is the third phase of healing. Here are ten variables that determine how fast someone can heal:

  • Overall health. Healthy people heal faster. Younger people heal faster.
  • Other health issues such as diabetes, heart disease, high blood pressure, tobacco use, alcohol abuse and body weight all influence healing rates…and make the time to heal longer.
  • People who consume more nutrients in their calories (Dr. Joel Fuhrman calls this “Nutritarian”) heal faster than those who primarily eat processed foods.
  • Rest levels. Our bodies need sleep and rest to rebuild. A lack of sleep slows healing time.
  • Stress levels. People who have high levels of stress heal more slowly.
  • Sedentary lifestyle. People who sit all day for work or to watch TV heal more slowly.
  • People who follow advice and instruction from top level healthcare professionals heal more quickly than those who do not follow-through with care.
  • People who are highly aware of their daily postures and habits heal more quickly…because they can adjust habits such as sleep or sitting positions more quickly.
  • Readers heal more quickly. People with higher attention spans are more likely to be self-educated on a topic and more likely to follow-through with successful treatment.
  • People who think there’s hope tend to be more persistent and won’t let anything stop them. (Recently we had a man with sciatica fly from Colorado to Pennsylvania to be successfully treated for sciatica).

Q: How long before I see improvements?

A: Most people we see in the clinic feel better in two to three visits…or within one to two weeks.

If you go longer than two weeks without feeling better or moving better…you may be wrong about the cause of your sciatica regardless of what your X-ray or MRI shows.

Q: Can I be completely healed or will this come back again?

A: Most people we see who complete the three Phases of Healing (meaning they no longer have pain, their motion and strength are back to normal, and they’re back to doing all the activities they want to do without pain) …they have a minimal chance the pain will return.

The stronger the person is…the less likely the sciatica symptoms will come back.

Your body is a bit like a car. If you take care of it, regularly change the oil and keep it running and fine-tuned…little chance of break down. If you ignore it…very likely to break down and be in need of repair.

Q: Do I need any special equipment?

A: At my practice, Robbins Rehabilitation, we use a minimalist approach… We don’t use big, fancy, expensive equipment…

The one exception may be for people needing traction. There is a machine (Saunders Lumbar Home Traction unit) which we find very effective for home use…for people who show signs their sciatica may be relieved with traction.

Otherwise, most exercises can be done with a simple ball, exercise bands and a safe place to exercise.

Our model focuses on world-class hands-on Physical Therapist, a table and some basic exercise equipment you can do at home or on the road if traveling. This works best for most people.

Q: Should I use heat or ice on my leg to help with the pain?

A: The cause of most pain (pain, numbness or tingling in the leg) is in the lower back. Ice or heat on the leg will not help. Consider that sciatica is “inflammation.” So if you’re inflamed…do you want to put heat on it and make it more inflamed? Or ice to calm the inflammation down. We have seen some people use ice on the lower back to calm down the inflammation temporarily.

Q: Which exercises should I do?

A: The best exercises for you depend on your type of back pain. We cover the three most common causes…

  • Herniated discs
  • Stenosis, Arthritis
  • Pelvic or SI joint problem.

Each has a series of gradually more advanced exercises. So the key to picking the right exercise is to find the cause of your back pain.

Q: How often should I do the exercises? And do I need to do them forever?

A: Most people we work with in the clinic for back pain do the exercises at least once per day…every day. Some will do them up to three times per day. Doing the same exact exercises for years without changing could be a mistake. In general, to get stronger, your exercise should progress and get more difficult. With training, your body adapts. Keeping that in mind, there are two rules to training:

  • Everything works.
  • Nothing works forever.

This means that any exercise (although painful) may make you stronger. But once your body adapts, it’s time to move on to something different or more challenging. One of the best programs you can move on to once you complete the three Phases of Healing for your back pain is a consistent walking program. People who walk every day have less risk of reinjuring their back and sciatica.

Q: What do I need to do for complete care? Am I going to relapse?

A: The best thing to do for back pain, if you are worried about it coming back again in the future, is to complete all three phases of healing.

  • Phase One is where you focus on getting rid of the pain, numbness, and tingling.
  • Phase Two is where you focus on getting normal movement back and full strength.
  • Phase Three is where you go back to previous activities you want to do.

In our clinic, after we see a person who had back pain…and they are now pain-free and have full motion and full strength, we ask:

“What activities have you avoided in the past month that you want to get back to doing?”

Some will say walking, or golfing or gardening…something along those lines. And we’ll tell that person to take the next month or two and do everything you want to do that you could do before.

They keep doing their exercises at home to get stronger and stronger. Most come back for a recheck appointment in two months and have no trouble with their pain.

We then take a look at the activity and at the program and help them get on the right track. As mentioned before, people who are stronger recover more quickly… So it’s usually only one or two visits before that person is on the right track again.

Q: How do I know the cause of my pain?

A: There are three common causes of pain…and here are some general guidelines for each.

  • People with back pain from a herniated disc usually have pain bending forward, twisting, coughing or sneezing.
  • The back pain they experience is usually sharp and runs specifically down the back of the leg, possibly into the foot.
  • People suffering from back pain from SI Joint or Pelvic problems usually have pain when sitting for long periods. The back pain they experience is usually on the outside of the thigh and symptoms may include heaviness of one leg or feeling twisted.

Q: Which position are best when I sleep?

A: On your back is best.

Next would be on your side.

Last would be on your stomach.

Regardless, an important key is to keep your spine in “neutral”. This means that it is not twisted to the right or left… but keeps the natural curve it normally has.

Pillows of folded towels can be placed under your knees, under your side, or under your feet to help you sleep in the least painful position for you.

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