The caring doctors at Long Island Rehabilitation Medicine are highly skilled when it comes to sciatica diagnosis and treatment. If you are plagued by the ongoing, often severe, pain of this condition and looking for relief, you have come to the right place. Our physiatrists (physicians who specialize in pain management and restoration of function) have a record of successfully treating patients with sciatica throughout Long Island and the greater New York metropolitan area for many years. From our five conveniently located offices, we offer noninvasive, highly successful sciatica therapies.
What exactly is sciatica?
Sciatica is pain that radiates along the path of the sciatic nerve, a long nerve that branches from the spinal cord down into the legs. The pain results from a compression of this nerve in the lumbosacral (lowest) region of the spine. Typically, only one side of the body is impacted by sciatica, with pain radiating through the hip and buttock and down the affected leg.
Sometimes sciatic pain is mimicked in the upper body when a nerve in the cervical spine is pinched. When this occurs and pain is experienced in an upper limb or extremity as a result, the condition is referred to as “sciatica of the arm.”
Reasons for Sciatica
There are a number of reasons for sciatic pain, including pressure on the sciatic nerve due to:
- Bone spur
- Disc herniation
- Spinal stenosis
- Localized inflammatory conditions
- Congenital defect
- Muscle spasm in the back or buttocks
- Spondylolisthesis (a disorder in which one vertebra slips forward over another)
- Other more rare medical conditions
Whatever the cause of sciatic nerve compression, the pressure on the nerve may result in a range of symptoms with varying levels of discomfort.
Risk Factors for Sciatica
Some individuals appear to have a congenital propensity to sciatica as evidenced by the fact that several relatives, spanning generations, have had the same problem. Other risk factors for sciatica are:
- Smoking – which contributes to more advanced degeneration of the spine
- Aging, which makes herniated discs and bone spurs on the vertebrae more common
- Diabetes, which can also cause peripheral neuropathy and may make the spinal nerves also more vulnerable
- Occupations or lifestyles that involve lifting heavy loads or sitting for long periods at a desk or in a motor vehicle and when such activities are conduction with improper form or posture
- Obesity, which can contribute to reductions in overall fitness and strength of the musculature surrounding the spine
Our doctors are well aware, however, that having no risk factors for sciatica does little to soothe you when you are experiencing its sharp pain.
Symptoms of Sciatica
As with most symptoms that bring us into doctor’s offices, the symptoms of sciatica cause a great deal of discomfort and incapacity, eventually interfering with our normal routine. Patients who come to us for relief from sciatica usually complain of one or more of the following:
- Muscle spasm and inflammation
- Pain in the back
- Pain down the hip, buttock, thigh or in the knee, calf, foot or toes
- Numbness or tingling in the limb or extremities
- Difficulty sitting, standing, or bending
The extending pain patients suffer with sciatica, known as radiculopathy, may be intermittent or constant. It may be described as “stabbing,” “burning,” “aching,” “electric,” “shooting,” or “excruciating.” Certain actions may make it worse, such as sneezing, coughing, standing or sitting for a length of time, straining to lift or exert force, or rising from a low sitting position. In severe cases, sciatica may involve significant leg weakness and/or incontinence.
Diagnosis of Sciatica
Although the symptoms of sciatica are hard to miss, at Long Island Spine we will not attempt to treat you for the condition until we verify the diagnosis. After a thorough physical examination, we may also have you undergo imaging such as an X-ray or MRI of your lumbar spine, or cervical spine if the pain affects the neck and arm. We are might also in select cases administer an electrodiagnostic study (EMG and nerve conduction study) if the diagnosis is less clear or if the severity of injury needs to be better established. In some instances these studies will help us to differentiate sciatica or a pinched spinal nerve from a peripheral neuropathy, plexopathy, or pinched nerve at the elbow or wrist, for example – carpal tunnel syndrome with associated numbness of the hand.
Sciatica Treatments Offered by Long Island Spine
Fortunately, at Long Island Spine we offer several sciatica treatment options. Our doctors’ primary focus is on relieving your sciatica pain and restoring normal function to your back and legs. We will only refer you on to a surgeon as a last resort. Our noninvasive sciatica therapies have proven successful again and again, even in patients who had nearly given up hope of ever experiencing a pain-free life again.
Sciatica physical therapy
Our physical therapists are certified by the McKenzie Institute and have in-depth knowledge of therapeutic techniques as well as extensive hands-on experience. We maintain ongoing contact with them to ensure progress and patient satisfaction. Sciatica therapy may include applications of ice and heat, ultrasound, electrical muscle stimulation, traction, and postural therapies.
Our goal is to lessen your pain level with the lowest effective dose of medication. Though we may prescribe stronger analgesics or more potent anti-inflammatory agents initially for acute pain, we will work hard to use other treatments in conjunction so that your doses can be lessened quickly and you can move down to less dependence upon medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). We may also prescribe muscle relaxants to help relieve your pain and to assist with sleep and evening discomfort. We will always pay close attention to your medical history and ordinary medication and supplement regimen in order to avoid dangerous interactions.
Our sciatica treatments include several types of injections, sometimes given once and sometimes administered during a series of sequential visits. Our therapeutic injections include:
- Transforaminal selective epidural injections administered with the help of fluoroscopic guidance
- Spinal epidural injections guided by fluoroscopy
These injections of a corticosteroid and a local anesthetic greatly reduce or eliminate pain by decreasing inflammation and compression on the affected spinal nerve.
Other Noninvasive Treatments
We also treat sciatica with:
- Acupuncture (available in our East Meadow and Great Neck offices)
- Herbal therapies administered by our licensed herbalist and oriental medicine clinician
- Additional recommendations for pain coping and management
Whichever sciatica treatments we use to relieve your pain and get you up and functioning again, you can trust that they will be safe and noninvasive, requiring no period of recuperation.
Contact Us For Sciatica Physical Therapy Treatment Today
We are here to help and will make relieving your pain our top priority. Contact us for a consultation and initial examination as soon as you can. We look forward to relieving your pain and your worry simultaneously.