Sciatica Brooklyn, NY
- Spinal Decompression Care
- Relief Down the Leg
- No Drugs or Surgery
As a doctor in my Nuro Chiropractic clinic in Brooklyn, I hear one of the most overused terms: sciatica. I’m Dr. Brian Donovan, and I frequently hear my patients say that they have this condition. When I ask them how they know, the answer is always the same: they feel pain that’s traveling down their legs. However, this alone doesn’t tell me much.
It can be true that there’s irritation with the sciatic nerve, or it could be the case of lumbar radiculopathy, which is a nerve issue in the lower back. It can also be referred pain that originates from the hips and may feel like sciatica. Before any treatment plan starts, I will do a thorough check-up, so I know what I’m actually looking at for a more accurate result.
What Sciatica Actually Feels Like
Some patients may describe a burning sensation that’s similar to being electrocuted. It may start in the buttocks and travel into the thigh, and sometimes down the foot. Some of the symptoms that may occur can include numbness or weakness that often travel along that same path. The pain can get worse when they change positions after sitting or standing for a long time.
The pattern matters, and if there’s lower back pain that’s traveling down the leg, the specialist might suspect a lumbar radiculopathy first. They may ask about changes in reflexes, and if the examination findings don’t point there, they are going to start looking farther down the leg or the surrounding muscles instead.
What’s Really Causing the Pain?
Referred pain can feel like lumbar radiculopathy and sciatic nerve irritation at the same time. However, they’re different, and some of the common factors that cause them are the following:
- A herniated disc pressing on a nerve root, causing irritation
- Spinal stenosis is the narrowing of the spine that puts pressure on the nerves
- A tight piriformis muscle irritating the sciatic nerve
- Degenerative disc disease in the spine
- • Sacroiliac joint dysfunction, which causes pain in the lower back
- A hip problem mimicking sciatica
Each of these conditions will need a different approach, and this is why finding the root cause of the problem is important. A herniated disc may require physical therapy, while a piriformis syndrome may need injections to reduce pain around the muscles.
How I Evaluate Sciatica?
The exam involves more than simply asking whether your leg hurts. Here’s what I check and why:
- 1 I check your back’s reflexes and see if it still has a range of motion. I correlate the findings with your medical history.
- 2 Our staff will run several neurological tests that put tension on the sciatic nerve to check for irritation and to see if this is what’s causing the pain in your legs.
- 3 I check the pelvis too, since referred pain can mimic sciatica closely.
- 4 We will watch whether your symptoms centralize or peripheralize with movement, which tells me if the plan is working or if there need to be changes.
MRI isn’t a requirement, and I’ll check first whether the findings of your exam point to a spinal condition like disc herniation before I order the test. An X-ray can show the changes in the bone, but it can’t confirm whether a patient has sciatica on its own.
Why I Don’t Have a “Sciatica Treatment”?
Many patients are surprised that they’re not getting a sciatica treatment when they share the symptoms with a specialist. However, sciatica only describes where the pain is located, and it doesn’t determine what’s actually wrong. Since different problems can cause the same symptoms, treatment must address the actual cause rather than just the pain itself.
“I don’t use one standard treatment for everyone with sciatica. Instead, I tailor the treatment to the specific problem causing the patient’s sciatic nerve pain.”
Dr. Brian Donovan, D.C.When the pain comes from a compressed nerve in the lower back, I treat this problem in the spine. However, if it’s the sciatic nerve that’s causing the irritation farther down the leg, know that I will use a different approach for that. This is also the same if the pain actually comes from the hips, since treating the sciatic nerve won’t fix the root cause of the condition.
Treatment Options I Consider
- I can help patients get relief through mobility work combined with targeted chiropractic adjustments. I can also do soft-tissue treatments for milder cases if necessary.
- Spinal decompression can be recommended to reduce pressure on the spinal discs in the lower back.
- SoftWave therapy may be tried to manage chronic pain such as plantar fasciitis and other soft-tissue injuries.
The more serious the condition is, the sooner I will consider further testing. I will refer you to a specialist if needed, and I’ll monitor your progress every visit. Adjustments can be made if you’re not improving as expected, especially if we’ve finished a reasonable number of sessions already.
When Do You Know if it’s an Emergency?
If there’s a loss of bowel control or you can’t control your bladder, then this condition needs a trip to the ER and not a chiropractic clinic. This is also the case if leg weakness keeps getting worse, because these are all signs of a medical emergency and you need to see a doctor immediately.
For symptoms like numbness that’s not improving, this may call for other tests like an MRI, or we can refer you to a neurologist. We’ll guide you on the next steps and refer you to the appropriate specialist if needed, rather than continuing treatment that isn’t helping.
Sciatica FAQs
Is sciatica the same thing as a pinched nerve?
No. The two are different, and a pinched nerve in the lower back is called radiculopathy, which is when a nerve root gets compressed as it leaves the spine. Sciatica technically means the sciatic nerve itself is irritated. Sciatica refers to irritation of the sciatic nerve, which can occur anywhere along its course through the buttocks and leg. Patients use the words interchangeably, but the distinction tells me where to actually treat.
How long does sciatica usually last?
The duration can depend on one’s case, as a mild irritation can improve within a couple of weeks given the right treatment. Meanwhile, a disc herniation that causes a sharp pain in the lower back can take longer. If your symptoms are worsening rather than improving, you need to be reassessed sooner, and it’s not advisable to wait longer.
Can a chiropractor treat sciatica, or do I need surgery?
Sciatica can improve with conservative chiropractic care after we identify what’s actually causing it. Surgery can be the last resort for significant nerve damage, especially if there are no meaningful improvements after a few sessions, but we will let you know which option is the best for you.
Should I rest or stay active with sciatica?
It depends on how movement affects your specific symptoms. Complete bed rest rarely helps, but pushing through activities that send pain farther down your leg isn’t the answer either. I base this on the findings of your exam and how your body responds to the treatment plan.
Do I need an MRI for sciatica?
Not usually. If your medical history points toward a disc herniation where there’s significant nerve damage, an MRI may make sense. However, plenty of cases can be diagnosed and treated well from the clinical exam alone.
Schedule Your Chiropractic Consultation
At Nuro Chiropractic, Dr. Brian Donovan offers customized treatment plans for back pain, neck pain, and injuries. Your care begins with a thorough assessment, followed by a clear treatment plan tailored to your needs. Call our Brooklyn office today to set up your consultation.