Sciatica Pain Treatment NYC by Marc Bystock L.Ac.

Some researchers estimate that over 50% of the general population will experience sciatica at some point in their lives. Sciatica is the pain that felt when the sciatic nerve becomes inflamed. The Sciatic nerve is the longest nerve in the human body. It emanates from between the 4th and 5th lumbar vertebrae. It runs down from the low back, across the buttocks, past the knee and ends in the lower leg just below the knee. The level of pain caused by sciatica may vary from a small tingling pain to a severe debilitating pain where it can be difficult to ambulate.

The sciatic nerve controls many of the muscles of the lower limbs and provides a sensory response to the skin, foot, and most of the lower leg. Sciatica pain may be felt locally at the low back, or the pain may radiate traveling downward. Typically, sciatica is one-sided, but the pain may switch to the other side anytime.

A medical history should be taken, and your physician should give a physical examination. The straight leg raise test is great to help diagnose a sciatica case. This test can determine the spinous process level, where the pathology may exist. Next, your practitioner may prescribe x-rays to search for any spinal fractures.

Magnetic resonance imaging (MRI) is used to look in detail at soft tissue structures for any pathology

Electromyography or nerve conductivity velocity testing (NCV) can be used to determine the rate at which the nerve impulse can travel through the sciatic nerve. A myelogram can be ordered to look for spinal pathology in a more detailed fashion. An injectable contrast dye goes into the spine while an x-ray is performed.

Most often, after examination by a physician, the sciatica patient may be referred to physical therapy

This first level of treatment for sciatica is non-invasive. It will usually consist of ice and heat therapy, stretching of the nerve and surrounding tissue with exercises to strengthen the surrounding regions. In the past, bed rest was given as a therapy for sciatica. In contrast, today, patients are advised to keep moving, walking, swimming, and exercising.

The next level of therapy may consist of medication, such as non-steroidal anti-inflammatory drugs (NSAIDS). Muscle relaxants such as Flexeril may be prescribed if the over the counter drugs are not effective.

A spinal injection may be performed. This is an injectable corticosteroid to drop the inflammation down, bring pain relief, and increase mobility.

Finally, there are the surgical options which may include a microdiscectomy or a laminectomy. Both procedures surgically remove either bone structure or bony fragments that may impinge into the sciatic nerve root, causing inflammation and pain.

Acupuncture offers a safe and effective treatment for sciatica pain relief. Its efficacy has been proven as a medical analgesic modality. Acupuncture treatments relax major muscle groups that surround the sciatica nerve area. This muscle tissue can become very tight constricting blood flow. 

Next, acupuncture allows the sciatic nerve itself to relax, which lowers the inflammation and pain level.

Finally, acupuncture increases perfusion of blood flow to the region, bringing in fresh oxygen and nutrients for repair, and it increases the outflow of waste materials.

Many of the acupuncture points are also trigger points and nerve motor points. When these points are stimulated with electrical-acupuncture, the nerves can become activated, often restoring them to their original function. Also, acupuncture activates the secretion of endorphins, enkephalins, neurotransmitters, endocannabinoids, and other endogenous opioid substances to block and substantially lower pain.