Physical Therapy Services
Sciatica
Tracing leg pain back to what is compressing the nerve.
Sciatica
Sciatica is characterized by pain in the lower back that radiates down one or both legs. The pain is described as dull, achy, sharp, like “pins and needles” or similar to electric shocks. Other symptoms associated with sciatica include burning, numbness and tingling sensations. Sciatic nerve pain varies in intensity from mild to severe, and frequency may range from occasional to constant. The onset is generally gradual and not necessarily associated with a previous event. Sciatica is also known as radiating or referred pain, neuropathy, or neuralgia.
Here at Midtown East Physical Therapy, we regularly treat patients with sciatica. Since there are many disorders that cause sciatica, we will determine what is the root cause of your sciatica by taking a thorough patient history during your physical and neurological exam. In some instances, diagnostic testing such as an x-ray, MRI, CT scan and/or electrodiagnostic test (electromyography) might be necessary. These examinations and tests help to detect possible contraindications to spinal manipulation and other manual therapies.
The best care for sciatic pain is to schedule regular physical therapy appointments. This allows us to better detect and correct any spinal dysfunction that may be a source of the sciatic pain. Call our office today at (212) 922-0044 to start living a pain-free life.
How It Works
How we work out what is causing it
"Sciatica" describes a symptom — pain travelling from the low back down the leg — rather than a single cause, so the first job is working out what is producing it. The therapist takes a thorough history, tests movement, and performs a physical and neurological examination including sensation, reflexes and strength in the leg.
Treatment then follows the finding: hands-on work for the restricted structures, positions and movements that reduce the symptoms travelling down the leg, and graded strengthening as the leg symptoms settle back toward the spine. What provokes it is identified and adjusted rather than simply avoided indefinitely.
What It Addresses
What sciatica treatment addresses
Treatment here is used to address presentations like these, once the examination has established what is producing them.
- Low back pain that radiates into the buttock, thigh, calf or foot
- Burning, numbness, pins and needles or shock-like sensations down one leg
- Symptoms provoked by sitting, bending, driving or standing for long periods
- Determining which structures are involved before more invasive options are considered
What to Expect
One-on-one care, built around you
Your care begins with a one-on-one evaluation. Rather than focusing on the symptoms alone, we establish a cause and effect relationship through accurate palpation and assessment of the body, then build a rehabilitation program customized to your individual needs.
- A physical and neurological examination, including testing of sensation, reflexes and strength in the affected leg.
- Questions about how far down the leg the symptoms travel and what changes that — this is one of the more useful things tracked between visits.
- Hands-on treatment plus specific positions and movements to use at home, chosen because they reduce the leg symptoms rather than because they are generic back exercises.
- A clear list of what to call about, and referral back to your physician if the examination finds anything that needs medical investigation first.
Common Questions
Questions we are asked about Sciatica
- Do I need a scan before physical therapy?
- Not always. The examination establishes what is involved, and in some cases diagnostic testing such as an X-ray, MRI, CT or an electrodiagnostic test is warranted — your therapist will tell you if that applies to you. Bring any imaging you already have.
- Is it safe to exercise with sciatica?
- Some movement is usually part of the plan, but which movements and how much depends entirely on what provokes your symptoms. That is set at the evaluation. Do not assume a general back routine from the internet applies to you.
- Why is the numbness moving?
- Where symptoms sit along the leg is tracked deliberately. Symptoms moving out of the foot and back toward the back is a change your therapist will want to know about, and so is the reverse. Report what you notice between visits.
- When is this an emergency?
- Loss of bladder or bowel control, numbness around the groin or inner thighs, or leg weakness that is getting worse are reasons to seek urgent medical care rather than wait for a physical therapy appointment.
- How do I get seen?
- Call (212) 922-0044 and the front desk will book a sciatica evaluation at whichever office suits you — 12 E. 46th Street in Midtown East, 274 Madison Avenue, or 1995 Broadway on the Upper West Side. You can also request an appointment through our Zocdoc listing. New patient forms are on the New Patients page as a PDF, and filling them in beforehand shortens your check-in.
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