The spine surgeons of
Atlas Rehabilitation and Pain Medicine, located on Park Avenue South in Manhattan,
New York and on Millburn Avenue in Millburn, New Jersey is a renowned pain treatment centre at the forefront of
advanced therapies for sciatica. Sciatica is a syndrome describes as
pain radiating from the back into the buttock and into the lower
extremity along its posterior or lateral aspect and most commonly
caused by prolapse of the intervertebral disk, the term is also used
to refer to pain anywhere along the course of the sciatic nerve.
The sciatic nerve is the
largest nerve in the body, the sciatic nerve begins from nerve roots
in the lumbar part of the spinal cord (in the lower back) and
extends through the buttock area to send nerve endings down to the
legs. Pain resulting from irritation of the sciatic nerve is called
sciatica. The pain is typically felt at the back of the thigh. While
sciatica is most commonly a result of a disc herniation directly
pressing on the nerve, any cause of irritation or inflammation of
this nerve can reproduce the symptoms of sciatica - this is why a
proper diagnosis is necessary to treat the painful condition.
Pain relief can be
achieved by: 1) medications; 2) nerve blocks; and, 3)
neuroaugmentation.
Diagnosis and Treatment of Sciatica: A thorough history and
physical examination is necessary in the diagnosis of sciatica.
Nerve root tension tests can be used to confirm the presence of
sciatica by attempting to reproduce the discomfort with certain
motions and body positions. These tests are performed by a doctor
and involve moving the legs in certain ways that slightly stretch
the sciatic nerve. If the patient experiences pain during these
tests, an irritated sciatic nerve is likely to be a source of the
pain.
With the medications, the treatments for sciatica include: 1)
non-steroidal anti-inflammatory medications; 2) narcotics; 3)
anti-depressants; and, 4) muscle relaxants. Non-steroidal
anti-inflammatory medications are limited in that there is a ceiling
effect, meaning that we cannot prescribe beyond certain levels. The
benefit of the narcotics is that there is no ceiling effect.
However, the dangers of narcotics lie in their tendency to cause
physical dependence and can also lead to addiction. Anti-depressants
have two effects: 1) they normalize the sleeping pattern; and, 2)
they tend to reduce a patient’s pain.
Pain relief can be achieved by nerve blocks. A nerve block is an
injection of local anesthetic into a region of the body. This serves
to block a nerve impulse similar to what a dentist uses to provide
pain relief. The most common one is epidural steroid injections.
Neuroaugmentation. Modern technology has allowed us to use updated
techniques to provide pain relief. Dorsal column stimulation serves
to treat pain of a specific origin, for example, in post laminectomy
syndrome, reflex sympathetic dystrophy, and vascular conditions.
Intraspinal infusions are used to block nerve pathways. These are
infusions of local anesthetic either in the epidural space or in the
cerebral spinal fluid.
If you need your sciatica pain condition diagnosed, or want to
consider a minimally invasive alternative to traditional spine
surgery or are seeking a spine surgeon, the spine doctors of
Atlas Rehabilitation and Pain Medicine of Manhattan, New York and Millburn, New Jersey would be happy to see
you for a consultation and help you learn about the treatment
options available to you to help treat and manage your sciatica
pain.
