How is this different from dry needling at a physical therapy clinic?

Dry needling targets trigger points, which Dr. Zack also does with dedicated certification in myofascial trigger point therapy. The difference is scope: as a Doctor of Acupuncture, she combines trigger point needling with electroacupuncture, classical acupuncture, and whole-system care addressing the sleep, stress, and inflammatory factors that keep pain cycles going.

Does acupuncture for back and neck pain hurt?

Acupuncture needles are far thinner than injection needles, and most people find sessions relaxing. Trigger point needling can produce a brief muscle twitch or deep ache followed by relief. Treatment always stays within your comfort level.

How quickly will my back or neck pain improve?

Many patients feel some change after the first one to three sessions, especially with recent injuries. Pain that has persisted for years takes longer to unwind; a realistic timeline is set at the initial consultation and progress is tracked against it.

Can I combine acupuncture with chiropractic or physical therapy?

Yes. Acupuncture complements chiropractic and physical therapy well, and Dr. Zack frequently coordinates with other providers. Acupuncture can reduce muscle guarding and pain, often making other therapies more effective.

Do you treat work injuries?

Yes. Work-related neck, back, and shoulder injuries are a regular part of the practice, with experience communicating clearly with case managers and referring providers.

Acupuncture for Sciatica & Piriformis Syndrome — Santa Cruz

Medically reviewed by Dr. Ava Zack, DAcHM, LAc — Doctor of Acupuncture & Herbal Medicine, Certified Myofascial Trigger Point Therapist

Sciatica

Sciatica has a signature: pain that starts in the low back or buttock and shoots down the leg — burning, electric, or deep and aching — sometimes with numbness or tingling into the calf or foot. Sitting makes it worse. Driving makes it worse. Sleep gets complicated. And the advice to "rest and take ibuprofen" only goes so far.

Here's what many sciatica sufferers are never told: not all "sciatica" comes from the spine. A significant share of leg pain that looks like sciatica is actually piriformis syndrome — a deep buttock muscle clamping down on or irritating the sciatic nerve. The distinction matters, because the treatments differ, and piriformis-driven pain responds especially well to precise needling.

Finding the Real Source

Spine-driven vs. muscle-driven. Disc irritation, spinal stenosis, and piriformis syndrome can all send pain down the leg. Your first visit includes a careful assessment — pain pattern, what positions provoke it, relevant imaging history — to identify which you're dealing with. If your presentation suggests something that needs medical imaging or urgent attention (such as progressive weakness or bladder/bowel changes), I'll refer you immediately; those signs need a physician first.

Trigger point therapy for the piriformis and gluteals. This is where my Certified Myofascial Trigger Point Therapist training earns its keep. The piriformis and surrounding gluteal muscles are deep — hard to reach with massage or foam rolling — but directly treatable with precise needling that releases the contracted tissue pressing on the nerve.

Electroacupuncture for nerve pain. For the burning, electric quality of sciatic pain, gentle electrical stimulation through the needles provides sustained input aimed at calming nerve irritation and the amplified pain signaling that develops when sciatica becomes chronic.

Restoring the whole chain. Sciatica rarely exists alone — it comes with guarding, compensation patterns, and disrupted sleep. Treatment addresses the low back, hip, and leg as a system, with practical guidance on the positions and habits feeding the problem.

What Treatment Looks Like

Your first visit (about 75–90 minutes).

History and physical assessment to localize the source, an honest conversation about what's driving your pain, and your first treatment — typically acupuncture with trigger point work as indicated.

A typical course. Recent-onset sciatica often improves within a handful of sessions. Chronic or recurrent sciatica generally takes a series of weekly treatments, commonly 6–10, with progress measured in sitting tolerance, walking distance, and sleep.

Alongside your other care. Acupuncture pairs well with physical therapy and chiropractic. If you're considering injections or surgery, acupuncture is a reasonable conservative step to try first.

What Patients Say

"Ava has helped me so much with my piriformis syndrome as well as neck and shoulder pain from work. Her acupuncture sessions are the only thing that have provided me any relief from the discomfort. She has a calm, caring presence and is always attentive… I always leave feeling better." — Santa Cruz patient

Frequently Asked Questions

How do I know if it's true sciatica or piriformis syndrome? The patterns overlap, which is why assessment matters. Piriformis-driven pain often centers in the buttock, worsens with prolonged sitting, and may lack the low-back component of disc-related sciatica. Your first visit is designed to sort this out — and the treatment differs depending on the answer.

How many sessions until the leg pain eases? Recent flare-ups often respond within 1–3 sessions. Chronic sciatica typically needs a course of 6–10 weekly treatments. You should see a trend within the first few sessions — if you don't, we reassess rather than repeat.

Is needling the piriformis painful? Releasing a deep trigger point can produce a brief twitch or deep ache — patients usually describe it as "a good hurt" followed by noticeable release. It's always within your tolerance, and the relief in sitting comfort is typically worth it.

Can acupuncture help if I have a herniated disc? Acupuncture can help manage disc-related pain and the muscle guarding around it, alongside your physician's or physical therapist's care. Red-flag symptoms — progressive weakness, numbness in the groin, bladder or bowel changes — need immediate medical attention, not acupuncture.

Should I try acupuncture before injections or surgery? Conservative care first is a reasonable strategy for most sciatica, and acupuncture is a low-risk option in that category.

Is treatment covered by Medi-Cal? We are now accepting Medi-Cal. Contact us and we'll help you understand your coverage before your first visit.