Sciatica, Knee Pain, and Neuropathy: 9 Questions Our Bee Cave Patients Ask Most

By Dr. Jarrod Bagley, D.C., B.C.N., C.B.P. | Corrective Health ATX, Bee Cave, TX | Published October 2026

Every week, people message us after watching one of our videos with a follow-up question. Some of those questions come up so often that they deserve a full written answer. These are the nine we hear most, answered the way I answer them in the exam room.

1. How do I know which stage of sciatica I am in?

Short answer: Most sciatica falls into three stages based on how long it has lasted and how the nervous system has responded. Stage one is acute irritation, stage two is chronic compression, and stage three is a nervous system that has become sensitized to the pain signal.

• • Stage 1 (weeks to a few months): Pain is often sharp and can be severe. Muscle spasm is common and movement feels harder than usual.

• • Stage 2 (about 3 to 12 months): The acute intensity has settled but has not gone away. You have good days and bad days.

• • Stage 3 (over a year): You have tried several things, some helped for a while, and nothing has held. The pain can feel more diffuse and harder to pinpoint.

The reason this matters is that the approach changes. In stage one, the priority is calming inflammation and relieving pressure on the nerve root. In stage two, correcting the structural load on the spine tends to matter most. Stage three usually needs structural work and specific attention to the sensitized nervous system. The most common mistake I see is stage one care applied to stage three pain, followed by confusion about why nothing is working.

Stage three is still treatable. It just takes longer. These stages are a clinical framework, and every person is a little different, which is why an exam comes first.

When sciatica needs emergency care, not a chiropractor

Four patterns need urgent medical evaluation: leg weakness that keeps getting worse over days, any change in bladder or bowel control, sciatica in both legs at once, and numbness in the saddle area. These can signal cauda equina syndrome. Go to an emergency room.

2. Is the 90/90 stretch good for sciatica?

Short answer: It depends on the type of sciatica. The 90/90 position stretches the piriformis and the deep hip rotators, so it can help when a tight piriformis is pressing on the sciatic nerve. If a disc at L4 to S1 is the source, the same position can add tension to an already irritated nerve and increase pressure at the back of the disc.

A practical test: if leg symptoms such as shooting pain, tingling, or numbness are worse for 24 to 48 hours after you do the stretch, stop and get the source identified. Another stretch is not the answer to a diagnosis problem. The same logic applies to the straight-leg hamstring stretch, and to daily habits like sitting on a thick wallet or sleeping flat on your back with your legs straight.

3. Why does my knee hurt going down stairs but not up?

Short answer: Knee pain that shows up mainly on the way down usually points to patellofemoral tracking, meaning the kneecap is not gliding properly in its groove as the knee bends under load.

Going downstairs, the quadriceps control your descent while the knee flexes, and the force between the kneecap and the thigh bone climbs to several times your body weight. If the kneecap drifts inward or outward, that force lands unevenly on the cartilage underneath. The usual causes sit above and below the knee: weak hip external rotators, a weak VMO (the inner quad muscle), and foot mechanics that change how the knee lines up.

This is why quad stretching and rest often bring only brief relief. The tracking pattern is what needs to be assessed and retrained.

4. What should I do before I agree to knee surgery?

Short answer: Get a full mechanical and inflammatory evaluation first. Some people do need surgery, and I would never tell them otherwise. But many people are asked to decide after an X-ray or MRI alone, with nobody having looked at how the joint actually loads.

The sequence I walk patients through starts with a functional assessment of the joint: patellar tracking, hip strength, and foot mechanics. Next comes the inflammatory environment of the joint, because chronic inflammation speeds up cartilage breakdown. From there, shockwave therapy can be used to stimulate tissue repair, and corrective work retrains the loading pattern so the same stress does not return. Surgery repairs a structure. It does not change the mechanics that wore the structure down.

Two notes on evidence. “Bone on bone” describes a narrow joint space on X-ray. It does not tell you how much remaining cartilage still functions, how inflamed the joint is, or what is driving the load, so it does not automatically mean nothing else can be done. And for degenerative meniscus tears, as opposed to sudden traumatic tears, several large randomized trials found surgery produced outcomes no better than physical therapy at two years. If you are told you need meniscus surgery, ask your surgeon which type of tear you have.

5. What is the difference between diabetic and non-diabetic neuropathy?

Short answer: The symptoms can look the same, including burning, numbness, tingling, and weakness, but the main driver is different, so the plan should be different too.

In diabetic neuropathy, sustained high blood sugar damages the small blood vessels that supply the peripheral nerves, and nerve damage follows. Care has to include active blood sugar regulation, vascular support, and nerve repair. Near-infrared light therapy is one tool we use because it targets circulation in that tissue.

Non-diabetic neuropathy is more common than most people realize. The drivers include nutrient deficiencies such as B12, gut-related inflammation, toxin exposure, autoimmune processes, and sometimes no cause that can be found. A protocol built for diabetes will miss those. The evaluation should decide the protocol, not the other way around.

6. Why does neuropathy usually need more than medication?

Short answer: Medications like gabapentin and Lyrica (pregabalin) work on the pain signal. They can give real relief, and many people need them. They are not designed to improve blood flow to the nerve, correct nutritional deficiencies, relieve compression at the spine, or lower inflammation.

In my experience, neuropathy has up to five contributing drivers, present in different combinations from person to person:

• • Structural: compression at the lumbar nerve roots (L4 to S1) before the signal reaches the feet.

• • Circulatory: reduced microvascular blood flow to the nerve tissue.

• • Nutritional: B12 and other co-factors, based on each person’s bloodwork.

• • Inflammatory: blood sugar swings and, where history points to it, gut permeability.

• • Nerve function: actual sensation and reflex testing, not guesses.

When treatment addresses one driver and the others keep going, results tend to plateau. That is not a miracle claim. It is just arithmetic.

An important safety point: never stop or reduce gabapentin or Lyrica on your own. Changes to these medications should happen with your prescribing physician. Our role is to identify and treat the underlying drivers so that you and your physician have real clinical information to work with.

Four food changes that support nerve health

• • Cut back on processed seed oils such as canola, soybean, and corn oil, and cook with olive oil, avocado oil, or butter.

• • Steady your blood sugar by improving carbohydrate quality. The goal is fewer spikes, not zero carbs.

• • Eat more long-chain omega-3s from salmon, sardines, and mackerel, or discuss EPA and DHA supplements with your care team.

• • Add fermented foods such as kefir, kimchi, sauerkraut, or yogurt with live cultures to support gut health.

These changes will not reverse neuropathy on their own. They improve the environment the nerves are working in.

7. What is facet syndrome, and how is it different from stenosis or a herniated disc?

Short answer: All three can cause back or leg pain, but they involve different structures and respond to different care.

• • Facet syndrome: The small paired joints at the back of each vertebra become overloaded or inflamed. Typical signs are morning stiffness that eases with movement, pain that worsens when you lean back or sit for long periods, and tenderness to the side of the spine. Reduced lumbar curve often shifts more load onto these joints.

• • Disc herniation: Disc material presses on a nerve from one direction. In many people there is potential for the material to shrink over time, and traction-based decompression is one way to support that.

• • Spinal stenosis: The canal or nerve openings narrow because of bone changes or thickened ligaments. Bone does not resorb the way disc material can, and traction aimed at a herniation can aggravate stenosis in some people.

Which one you have changes the plan, so getting the diagnosis right matters more than the label on an MRI report.

8. Is it safe to get care for sciatica during pregnancy?

Short answer: Many pregnant patients can be cared for safely with pregnancy-appropriate chiropractic methods, positioning guidance, and trimester-specific exercises. Please check with your OB or midwife as well.

Sciatica is common in pregnancy. The hormone relaxin loosens pelvic ligaments in preparation for delivery, which makes the sacroiliac joint and lower spine less stable. As the abdomen grows, the center of gravity shifts forward and the load on the L4 to S1 nerve roots changes. The goal is to ease that load without any risk to the pregnancy. Waiting it out is one option, but it is not the only one.

9. Does shockwave therapy help Achilles tendinitis?

Short answer: It is one of the better-studied uses of shockwave, and the evidence is encouraging, especially for chronic cases when it is combined with a progressive loading program.

The Achilles has a region roughly 2 to 6 centimeters above the heel bone with limited blood supply, which is why injuries there heal slowly. Shockwave is thought to stimulate new small vessel growth and organized collagen production in that tissue. If your Achilles has hurt for more than three months, it is worth asking about. Results vary, and a proper exam determines whether it fits your case.

What happens when you come in to Corrective Health ATX

Here is exactly how it works, with no surprises:

• • Free consultation. A real conversation about what you are dealing with, how long you have had it, and what you have already tried. No obligation.

• • $27 initial exam and imaging (X-ray) for qualified candidates. If we both agree you are a candidate and you want to move forward, the exam is $27 (regularly $275). It includes a structural evaluation, neurological testing where indicated, and imaging when it is clinically appropriate.

• • Honest answers. You leave knowing what we found, what we think is driving it, and whether we believe we can help. 

We are at 11412 Bee Caves Rd., Ste. 250, Bee Cave, TX 78738, serving Bee Cave, Lakeway, Spicewood, West Lake Hills, Dripping Springs, and the greater Austin area. We recently moved into this space, and we have more treatment room and a layout built for the protocols we use.

Frequently Asked Questions

How much does a first visit cost at Corrective Health ATX in Bee Cave?

The initial consultation is free. If you are a qualified candidate and want to move forward, For a limited time, the initial exam and imaging are $27 (regularly $275).

Do I need a referral to see you?

No referral is needed. If you have an existing diagnosis, bring your MRI or X-ray reports and a list of treatments you have tried.

What conditions does Corrective Health ATX treat?

Neuropathy, sciatica, back pain, neck pain, knee pain, and tendon problems such as plantar fasciitis, rotator cuff tendinopathy, and Achilles tendinitis. Care may include Chiropractic BioPhysics (CBP), shockwave therapy, near-infrared light therapy, and nutritional guidance.

How is Chiropractic BioPhysics different from standard chiropractic care?

Standard chiropractic care focuses on joint motion and pain relief. CBP adds a focus on spinal geometry, the curves of the spine, and tracks changes on X-ray over time. If relief from past chiropractic care never lasted, a structural evaluation is often the missing piece.

About the author

Dr. Jarrod Bagley is a board-certified in Neuropathy Treatment (B.C.N.) and certified Chiropractic BioPhysics practitioner (C.B.P.) with more than 20 years of clinical experience. He founded Corrective Health ATX to bring corrective, root-cause care for neuropathy, back and neck pain, sciatica, and knee pain to the Bee Cave and Hill Country community, and has helped more than 1,500 neuropathy patients and thousands more with spinal, neurological, and physiological conditions.

This article is for general education and is not a substitute for medical advice, diagnosis, or treatment. Results vary, and individual outcomes depend on the person and condition. If you think you are having a medical emergency, call 911