Your sciatic nerve is the longest nerve in your body, emerging from the vertebra in your low back and descending through the buttocks and backs of your upper legs. Just above the knee, the nerve separates into branches, traveling all the way to the feet and toes.
The sciatic nerve can become impinged or entrapped anywhere along its path, but entrapment most commonly occurs near the spine itself, or at the site of the periformis muscle, located deep within the buttocks. Pain symptoms that occur anywhere along the sciatic nerve are referred to as sciatica.
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Sciatica symptoms can range from a mild nuisance to an excruciating pain that cannot be ignored.
Pain is usually felt on one side of the body, but it can affect both sides in some instances.
A number of things can initiate a bout of sciatica, including trauma, muscle strain while lifting heavy objects, and overuse from sports or exercise. Degenerative conditions of the spine related to aging can increase the risk of sciatica, as can being out of shape or overweight.
Herniated disc in the lumbar spine
Entrapment beneath the piriformis, a short band of muscle deep within the buttocks
Spinal stenosis, where the spinal passage narrows from wear and tear, compressing part of the nerve
Slipped disc (spondylolisthesis)
Sciatica often resolves itself with rest and self-care. However, sometimes sciatica pain relief requires professional intervention.
Diagnosis of sciatica begins with a clinical exam. Your care provider may ask you to perform activities that may cause pain to worsen, like walking on your toes or heels, performing leg raises while lying down, or rising from a squat. An EMG may be ordered to measure impulses along the sciatic nerve.
At NYDNR, we use real-time diagnostic ultrasound to view the sciatic nerve along its entire pathway. Ultrasound imaging enables us to view the nerves and surrounding structures while the patient is in motion, making it a superior diagnostic tool to Xray or MRI. Quick and accurate imaging on-site at our clinic means we can begin treatment immediately, without having to outsource or wait for imaging results.
Traditional treatment approaches often focus on sciatica pain management, but fail to get to the source of pain and correct it. Muscle relaxants, pain medications, and steroid injections are common traditional treatments. Surgery is sometimes considered in severe cases.
At NYDNR, we take a holistic, non-invasive and drug-free approach to sciatic pain treatment. Our team of back pain experts understands the interconnectedness of the structures that affect the sciatic nerve.
Depending on the location and nature of sciatica, certain exercises can help relieve pain. Sciatic nerve flossing exercises may help to release the nerve so it can glide more smoothly. Pelvic stability exercises can help relieve disc pressure on the nerve.
Our chiropractic team uses a variety of treatments to help ease sciatica pain. Heat and cold, spinal manipulation and ultrasound may all be incorporated into a treatment plan.
At NYDNR, treatment for sciatica is individualized for each patient. We pride ourselves on accurate diagnosis and innovative treatment methods that go beyond pain relief to restoring full function, so you can get back to your active pain-free life.
Dr.Kalika has revolutionized low back pain and sciatica care by using high resolution diagnostic ultrasonography for structural diagnosis, combined with gait and motion analysis technology. The NYDNRehab motion and gait analysis lab is the only private lab in the US to feature research-grade technologies found only in the world’s top research labs, and made available to patients in our private clinic. Dr.Kalika’s modern approach to low back and sciatica pain has put him on the radar of some of the world’s top pro athletes and professional ballet dancers.
Sciatic nerve pain is characterized by sharp pain in the lower spinal region that may radiate into the gluteal muscle and continue down the leg, causing pain, numbness, tingling and weakness. It is caused by compression or entrapment of the sciatic nerve, which is one of the largest and longest nerves in your body. Roots of the sciatic nerve exit the spinal column from the vertebral junctions L-4/L-5 and L-5/S-1, where they conjoin and descend to innervate the muscles of your legs, feet and toes.
When unimpeded, the sciatic nerve glides freely as the body moves, providing a conduit for messages and sensory feedback, to and from the brain. Because of its location in the pelvic region, where the transfer of large force loads between the upper and lower body take place, the sciatic nerve may become compressed or entrapped from other structures, including muscles, tendons, bones and ligaments. It may also be injured from over-stretching, which may occur from sports or yoga.
Symptoms of sciatic nerve pain include:
Sciatica pain has several potential origins, including:
Irritation of the sacroilliac joint can mimic symptoms of sciatica, but it does not involve the sciatic nerve.
Diagnosis takes into account the patient’s medical history, clinical profile and location of the symptoms. MRI may be prescribed to identify and confirm sciatica, but is not always reliable, and over reliance on MRI may result in treating the wrong cause of pain.
At NYDNR, we use diagnostic ultrasound to visualize the sciatic nerve, spinal discs, hips and pelvis, to identify the exact location and origin of sciatic nerve pain. We may also perform nerve conduction and electromyography tests, which are conducted in our office. Clinical experience is our most effective tool for diagnosing and treating sciatic nerve pain.
Most sciatic nerve pain can be resolved with conservative treatment. Treatment approaches for sciatic nerve pain largely depend on where the sciatic nerve is affected. Treatment should not only be directed at relieving pain and correcting structural damage, but at treating whatever dysfunction led to the structural damage in the first place.
At NYDNR, we provide individualized treatment based on the specific needs of each patient. A combination of treatment methods may be used, including:
Our goal is to relieve sciatic nerve pain and eliminate its source, to restore optimal function and improve physical performance.