Chronic Sciatica Treatment

Lower back pain is one of the most commonly reported physical conditions, with over a hundred billion dollars spent on it yearly. Sciatica is a condition involving damage to nerves in the lower back. Though it can be intensely painful, the New York Dynamic Rehabilitation clinic (NYDNRehab) offers advanced methods for chronic sciatica treatment and pinched nerve treatment.

Sciatica physical therapy is a form of rehabilitation focused on the sciatic nerve, the longest and widest nerve in the body. This nerve is responsible for innervating the legs and relaying signals between the skin and muscles. Sciatica is characterized by intense pain that radiates through the buttocks down the lower limbs to the foot.

Sciatica must be distinguished from another nerve condition, piriformis syndrome, which it closely resembles. Whereas sciatica typically results from compression caused by a bulged disc in the spinal column impinging on the sciatica nerve, piriformis syndrome results from compression by the piriformis muscle, a pear-shaped muscle in the buttocks. Piriformis syndrome therapy differs from sciatica physical therapy in that it focuses on trigger points in the muscles, hyper-sensitive muscle knots that can cause intense pain. Piriformis syndrome therapy seeks to relieve those tight knots and increase range of motion in the affected area.

Sciatic nerve pain therapy can take several forms depending on the severity of the condition and its origin. In cases where sciatica originates from the pelvis, extracorporeal shockwave therapy (ESWT) is a pinched nerve treatment that softens the tissue around nerves and increases blood flow with the assistance of acoustic pressure waves. In some cases, a physician may prescribe sciatic nerve physical therapy to reduce direct pressure on the nerve. The physician may also reduce pressure on the nerve indirectly through specific rehabilitation exercises designed to increase spinal and pelvic stability. In whatever form it takes, sciatic nerve physical therapy restores motion in the joints and improves motion control in the areas causing nerve impingement.

At NYDNRehab we provide a range of options for both mild and chronic sciatica treatment, expanding on conventional approaches to sciatica nerve pain therapy by offering treatments that are not normally offered to the public. Prominent among these is Computer-Assisted Rehabilitation Environment (C.A.R.E.N), a virtual-reality environment that until recently was only used by research facilities and military hospitals. Employing a computer-operated platform with a surrounding projection screen, C.A.R.E.N treats sciatica by creating unique situations and environments that allow the patient to undergo exercises that can’t be done in a typical clinical setting. Additionally, because shockwave therapy uses both a low-intensity and high-intensity setting, we use ESWT for both mild and chronic sciatica treatment. Regardless of whether the patient needs sciatica therapy or piriformis syndrome therapy, NYDNRehab offers treatment. With over fifteen years’ experience treating orthopedic and sports injuries, our clinic on Manhattan’s Upper East Side is the most advanced physical therapy and chiropractic in New York.

130 West 42 Street Suite 1055, New York NY 10036
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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

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Separation of muscle ends due to tear elicited
on dynamic sonography examination

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