Sciatica Specialist

About Sciatic Nerve Pain

The sciatic nerve is the largest nerve in the human body, with its roots emerging from the lower spinal vertebrae L4 to S3, and merging to form a single nerve that runs down the leg, all the way to your feet. While sciatic nerve pain is most commonly felt on one side of your lower back, compression or entrapment of the sciatic nerve can cause pain, numbness and tingling anywhere along its path. Chronic sciatic nerve pain is not normal, and it can be completely eliminated with sciatica physical therapy.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Sciatica Specialist
Dr. Lev Kalika

NYDNRehab clinical director Dr. Lev Kalika has devoted his life’s work to finding new and innovative ways to relieve human pain and dysfunction. Dr. Kalika has developed his own approach to treating sciatica via targeted release and regeneration of the sciatic nerve, using ultrasound guidance.

Dr. Kalika’s approach combines:

  • Focused and radial shockwave therapy
  • Ultrasound guided percutaneous neuromodulation
  • Extracorporeal magnetic wave therapy to decrease inflammation
  • Nerve ultrasonography using the highest resolution ultrasound equipment, with matrix sensors that visualize the nerves of the hip

Dr. Kalika’s expertise in musculoskeletal ultrasonography and ultrasound guided dry needling make him a best-rated doctor for sciatica treatment in NYC.

The NYDNRehab clinic is one of the best-equipped private rehabilitation clinics in the world, featuring cutting edge regenerative technologies and therapies that revolutionize the way sciatica is treated and resolved.


Why Physical Therapy Alone May Not Resolve Your Condition

Physical therapy is a valuable and effective approach to resolving musculoskeletal pain and dysfunction, but in many cases, physical therapy does not provide a stand-alone solution. Prior to beginning physical therapy, patients often need to address underlying issues that contribute to their pain and disability.

Unfortunately, mainstream physical therapy clinics are often not adequately equipped or experienced to identify and treat complications that undermine the effectiveness of physical therapy. They often rely on one-size-fits-all treatment protocols that overlook the unique characteristics of the individual condition, opting to treat the symptoms and not the patient.

Issues that should be addressed prior to beginning physical therapy include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury
Block PT

Holistic Non-Invasive Diagnosis and Regenerative Therapy

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to do so can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

At NYDNRehab, we use a broad range of advanced technologies and innovative therapeutic approaches to resolve issues that can potentially undermine the success of physical therapy.

Our talented staff is certified in a diverse array of treatment methodologies, rarely found in run-of-the-mill physical therapy clinics. Our one-on-one sessions are personalized, based on the patient’s unique diagnostic profile.

Obstacles to physical therapy success include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

Sciatica Treatment at NYDNRehab is
Unparalleled in NYC

Due to the length of its pathway as it glides among the body’s structures, the sciatic nerve can be irritated by a broad range of mechanisms. Conventional medical practitioners are trained to treat the locus of pain, often managing sciatica with drugs and surgery, without diving deep into its underlying causes. Even chiropractors and physical therapists often take a cookie cutter approach to sciatica treatment, despite vast differences in patient profiles.

The sciatica specialists at NYDNRehab know that human anatomy varies immensely from one patient to the next, and that sciatica can have multiple causes that require specific treatment approaches. We never take a one-size-fits-all approach to patient care. Our one-on-one personalized treatment protocols are based on each patient’s specific diagnostic results, ensuring successful treatment that eradicates sciatic nerve pain.

Sciatica Symptoms, Causes and
Risk Factors


  • Low back pain on one side of your spine

  • Pain and tingling in the buttocks, legs or feet

  • Pain that gets worse during physical activity

  • Numbness in the lower extremities

  • Loss of bowel or bladder control

  • Reduced range of motion in the lumbopelvic region


  • Poor static and dynamic posture

  • Repetitive overuse from occupation, sports or exercise

  • Weak core and pelvic musculatur

  • Degeneration of the lower vertebrae

  • Poor lifting technique

  • Sciatic nerve compression or entrapment

Risk Factors

  • Sedentary lifestyle

  • Being overweight or obese

  • Excessive sitting for extending periods

  • Occupations that require driving or lifting

  • Pregnancy

  • Smoking cigarettes

Our Advanced Diagnostic Capabilities Ensure Successful Sciatica Treatment

During your preliminary exam, we will ask about your symptoms and health history, but it doesn’t stop there. We use the highest resolution diagnostic ultrasonography to visualize the sciatic nerve in motion along its entire length, in real time. This allows us to pinpoint the exact location and mechanism by which the sciatic nerve is impinged or entrapped.

Once we fully understand the precise mechanisms underlying your sciatic nerve pain, we design a personalized treatment plan, to restore uninhibited gliding of the sciatic nerve and initiate the healing process.

Our Sciatica Treatment Toolbox

Our Sciatica Treatment Toolbox

The sciatica specialists at NYDNRehab have diverse skills and expertise for treating sciatica. Our large inventory of advanced technologies and innovative treatment options give us all the tools we need to ensure that every patient gets the personalized care they deserve to eliminate sciatic nerve pain.

Depending on your unique needs, your treatment plan may include a combination of some or all of the following treatment options:

  • Chiropractic care that may include spinal manipulation
  • Postural correction therapy to realign your spine
  • Physical therapy exercises to strengthen your core and pelvic muscles
  • Extracorporeal magneto transduction therapy (EMTT) to relieve pain and inflammation
  • Extracorporeal shock wave therapy (ESWT) to stimulate healing at the cellular level
  • Dynamic neuromuscular stabilization (DNS) to restore optimal movement patterns
  • Ultrasound guided dry needling to release myofascial trigger points
  • Patient education to prevent future bouts of sciatica

We Use Regenerative Therapies
to Accelerate Healing

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms.

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields to trigger a regenerative response. EMTT waves can penetrate deep tissues, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues, to accelerate the healing process.

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes.

NESA Neuromodulation Therapy

NESA Neuromodulation Therapy

The NESA device generates an algorithm that delivers a biphasic low-frequency electrical current via semi-electrodes attached to the hands and feet. It emits a series of intermittent and cyclical stimuli that travel through autonomic neural pathways, restoring optimal neural signaling to the brain.

INDIBA CT9 Radiofrequency Device

Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.

INDIBA Radiofrequency Therapy

Ultrasound Guided Injection

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.

Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)
Prolozone Therapy

Prolozone Therapy

Prolozone therapy is a new regenerative needling procedure that takes Prolotherapy to the next level. With prolozone therapy, a combination of procaine, anti-inflammatory medications, vitamins, minerals, and a mixture of ozone/oxygen gas is injected into joints or tissues that have been injured or have degenerated. When performed under ultrasound guidance, Prolozone therapy quickly reduces pain and inflammation while jump-starting the healing process.

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to sciatic nerve pain. Dry needling is an outpatient procedure where non-medicated needles are inserted into trigger points to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Ultrasound Guided Dry Needling

Ultrasound Guided Shock Waves for
Neurological Disorders

When guided by high resolution ultrasound imaging, focused extracorporeal shockwave therapy (ESWT) is an evidence-based therapeutic approach to treating nerve entrapments, peripheral neuropathy and neuralgia.

Dr. Kalika is an expert in neural ultrasonography and extracorporeal shockwave therapy. The clinic at NYDNRehab features the highest-resolution research-grade ultrasound equipment currently available.

Ultrasound guided ESWT provokes the following effects in neural tissue:

  • Improved axonal transport

  • Provokes axonal regeneration

  • Promotes reinnervation

  • Limits and slows muscle atrophy associated with peripheral neuropathy

  • Accelerates remyelination

  • Modulates neurogenic inflammation

  • Improves intraneural vascularisation

The effects of ESWT are achieved via the following mechanisms:

  • Stem cell proliferation

  • Mediation of Schwann cell function

  • Endothelial cell recruitment/migration

  • Regulation of pro- and anti-inflammatory cytokines

  • Voltage-gated sodium channel blocking

Get Personalized Sciatica Physical Therapy in NYC that Really Works!

Get Personalized Sciatica Physical Therapy in NYC that Really Works!

If you are tired of taking dangerous drugs and getting the runaround from doctors who fail to resolve your sciatic nerve pain, it’s time to take charge of your own health. The sciatica specialists at NYDNRehab never stop until they get to the root cause of your sciatic nerve pain and resolve it, without drugs or surgery.

At NYDNRehab, our personalized one-on-one sciatica treatment approach uses cutting edge technologies and advanced physical therapy that really works. We help you eliminate sciatica pain for good, so you can enjoy the very best quality of life with pain-free mobility. Contact NYDNRehab today!

Our Awards

Clinical Case Studies

Resolving Chronic Sit Bone Pain in a Female Runner

Our patient is a 45 year-old female runner complaining of left sit bone pain when running and sitting. She has a history of proximal hamstring tendinopathy, and had been treated with plasma injections about 5 years prior, along with physical therapy. Her pain was initially resolved by the injections, and she continued to run.

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Peroneal Nerve Entrapment

Our female patient came to us after unsuccessful treatment at another clinic. She presented with painful hip snapping, leg paresthesia (tingling/numbness), low back pain, sacroiliac(SI) joint pain, and gluteal pain.

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Patient with Back Pain, Scoliosis and External Foot and Hip Rotation Successfully Treated

Our patient was a 22 year-old male presenting with low back pain, scoliosis, and external hip and foot rotation.

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Patient with Facial Pain and Complex Neurological Dysfunction Successfully Treated with Alternative Therapies

Our patient, a 28 year-old male, had been suffering for over two years with unexplained facial and upper body pain. He had seen two separate neurologists and undergone MRIs of his brain and cervical spine, with no concrete diagnosis.

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Ultrasound Reveals Sciatic Neuropathy and Life-Threatening Peripheral Vascular Disease

Our patient is a 62-year-old female complaining of leg pain, calf and foot muscle weakness, and sensations of numbness in her lower extremities.

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Case Study: Hamstring and SI Joint Dysfunction in Female Runner

Our patient is a 52 year-old female runner who came to us after unsuccessful treatment elsewhere, complaining of mild low back pain shooting down her right leg.

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    Range of Available Unique Physical Therapy
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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)


    Complete tear of rectus femoris
    with large hematoma (blood)


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

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