Sciatica Pain (Sciatic Nerve)

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.

Sciatica Symptoms

Symptoms of sciatic nerve pain include:

• Unrelenting sharp searing pain, usually on one side of the body, next to the lower spine and into the buttock
• Pain that along the path of the sciatic nerve, which travels from the low back, along the back of the leg, and all the way to the foot and toes
• Pain that gets worse with sitting and standing
• Prickling sensations along the leg
• Numbness or weakness in the leg, foot and/or toes

Causes of Sciatic Nerve Pain

Sciatica pain has several potential origins, including:

• A protruding or herniated disc the places pressure on the nerve root
• Spinal stenosis, usually due to aging, where the spinal canal narrows, reducing space for the nerve to glide
• Compression or entrapment by a too-tight periformis muscle
• Inflammation of strained back muscles that compresses the nerve
• Trauma from sports, a fall, or an accident
• Over-stretching of the nerve, causig painful irritation
• Pressure from a cyst or tumor
• Other less common causes

Irritation of the sacroilliac joint can mimic symptoms of sciatica, but it does not involve the sciatic nerve.

Diagnosis of Sciatic Nerve Pain

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.

Physical Therapy for Sciatica

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:

• Neurodynamic treatment to release nerve pressure and enable the nerve to glide freely
• ESWT (extracorporeal shockwave therapy) to reduce inflammation and stimulate regeneration of nerve tissue
• Gait retraining to eliminate over-activation of the periformis muscle
• DNS (dynamic neuromuscular stabilization) to restore dynamic lumbopelvic alignment
• Manual therapies to ease pressure and restore functional alignment

Our goal is to relieve sciatic nerve pain and eliminate its source, to restore optimal function and improve physical performance.