The debilitating leg pain and loss of feeling, called sciatica, shouldn’t be underestimated and can signal a serious underlying problem, like an inflamed or damaged nerve. Sciatica symptoms will worsen daily if left untreated, interfering with the quality of life or functionality. At Redefine Healthcare in New Jersey, we offer cutting-edge sciatica pain treatments and therapies. Call or schedule an evaluation today to determine how our best sciatica doctors in NJ can help improve your health and guarantee your return to normal life.
What is Sciatica?
Sciatica (lumbar radiculopathy) is common nerve irritation. The sciatic nerve can produce pain, numbness, and weakness down the leg along the areas innervated by the sciatic nerve. It is located under the piriformis muscle.
According to PubMed, inflammation and compression are essential for the symptomatic nerve root. Studies indicate that people with physically demanding jobs run a higher risk of lumbar radiculopathy compared to the general population. It’s advised to stay active and use prescribed non-steroidal anti-inflammatory drugs. Epidural corticosteroid injections and transforaminal peri-radicular injections of corticosteroid can treat your knee pain. Sciatica surgery may be an option if you don’t have severe progressive neurological symptoms.
Anatomy & Background
The vertebra of the lumbar spine is the largest in the body because they carry the most weight, are subject to the greatest amount of stress, and are also most associated with back and leg pain.
The two lowest levels (L4-L5) and (L5-S1) have the most flexion and extension motion stress and the highest injury rate. The intervertebral discs of these two levels also have the highest rate of disc degeneration and herniation. The L5 vertebra is the most common site of spondylosis and spondylolisthesis. The most common lumbar nerves that get pinched or entrapped are the L4, L5, S1 levels. Entrapment of these nerves may lead to a condition called Sciatica.
The spinal nerves are the electrical wires of the body. They originate at the spinal cord and exit the spinal column through the intervertebral foramen. Nerves exiting the lumbar spine area provide sensation and motor control to the back, buttocks, legs, and down to the foot. Damage or interference with the transfer of information of these nerves can cause neurological problems such as pain, weakness, abnormal sensations, numbness, and changes in spinal reflexes. These symptoms may occur in the back, leg, and down to the foot.
What Are the Causes of Sciatica?
Anything that encroaches on or puts pressure on the sciatic nerve can be considered a cause of sciatica. Leading specialists suggest that the common lumbar radiculopathy causes include:
- Herniated discs that place pressure on the nerve, in addition to inflammation that irritates the nerve.
- Degenerative joint disease resulting in bony spurs on the facet joints can narrow the intervertebral space placing pressure on the exiting nerve.
- Trauma or muscle spasms can put pressure on the peripheral nerve, producing symptoms along with that nerve’s distribution.
- Degenerative disc disease that results in wear on the intervertebral disc and a reduction in disc height may result in loss of space at the intervertebral foramen compressing on the exiting nerve.
- Tightness of the piriformis muscle resulting in compression on the sciatic nerve underlying the muscle.
Sciatica is especially prevalent in athletes participating in sports that require frequent twisting, bending, or lifting. Contrarily, a sedentary lifestyle can also lead to sciatic nerve compression. Our sciatica doctors will locate the precise source of the nerve compression to treat sciatica symptoms properly.
What Are the Symptoms of Sciatica?
Sciatica symptoms will be located along the path the sciatic nerve travels. The most common signs are listed below:
- Pain in the back or radicular to the buttock, into the leg, and extending down behind the knee, to the foot depending on the nerve involved and the severity of the encroachment.
- Pain and tenderness localized at the level of the involved nerve.
- Muscle spasm and changes in posture in response to the injury.
- Pain with excess activity and relief with rest.
- Pain and tenderness localized at the level of the involved nerve.
- Loss of motion like the inability to bend backward, move sideways to the affected side or stand erect for extended periods of time.
- Sitting, standing, and walking can be difficult if the irritation is severe.
- Impairment of normal reflexes in the lower extremity.
- Numbness tingling may be experienced from the low back to the foot, depending on the distribution of the affected nerve.
- Muscle weakness may occur on any muscle that is innervated by the pinched nerve. Long-term pressure on the nerve can produce atrophy or wasting of that particular muscle.
If you experience any of the aforementioned sciatica signs, you should not wait any longer and seek medical assistance promptly. The sciatica specialists at Redefine Healthcare are tremendously experienced in treating all kinds of sciatica symptoms. We pride ourselves on providing a wide range of treatments to get you out of pain as fast as possible.
How Is the Condition Diagnosed?
Our top sciatica doctors in New Jersey are immaculately trained in determining the precise cause of mild to excruciating sciatica pain. Sciatica diagnosis begins with a review of your full medical history. It includes an examination of the following factors:
- The locations of your pain
- Pain level
- Whether you have had any recent injuries
Your doctor will also need to know what makes the condition better and what makes it worse, as well as when and how it started.
The next step is the physical examination. It involves testing your muscle strength and reflexes. Your healthcare provider can also ask you to perform some moving exercises, and sciatica stretches. These exercises will help determine the activities that cause more pain. To determine the root cause of the problem, your doctor also performed imaging tests, and the most common ones used to come up with a diagnosis are:
- CT scans
- Spinal X-rays (regular X-rays are not able to provide a complete view of sciatic nerve damage)
Your physician can also order a CT myelogram. A doctor will inject a special dye into your spine to help create clearer pictures of your nerves and spinal cord to perform this test. A correct diagnosis is essential to achieve the best sciatica treatment. Additional diagnostic tests may be required if the symptoms are exceptionally severe and don’t subside with rest.
Sciatica Treatment in NJ
Sciatica pain treatment will depend on the severity of the condition and the underlying cause of the nerve damage. Our New Jersey sciatica doctors can determine the most appropriate pain relief option based on how the body heals and responds.
When treating acute back problems, you can make use of the following recommendations:
- Rest. Avoid the activities that produce the pain (bending, lifting, twisting, turning, bending backward, etc.).
- Anti-inflammatory drugs and other sciatic nerve pain medications.
- Apply ice in acute cases to the lumbar spine to help reduce pain and associated muscle spasms. Apply ice right away and then at intervals for about 20 minutes at a time. Do not apply directly to the skin.
- An exercise regiment designed specifically to address the cause of the symptoms associated with sciatica and improve joint mobility, spinal alignment, posture, and range of motion.
- Steroidal medication to reduce inflammation in moderate to severe conditions.
- Lumbar nerve or epidural injections
- Physical therapy for back and disc problems must remain conservative at the beginning to avoid aggravating the condition. Your therapist should emphasize rest, reducing the inflammation, and increasing the blood circulation for healing. Once the initial inflammation has been reduced, a program of stretching and strengthening should be initiated to restore flexibility to the joints and muscles involved while improving the strength and stability of the spine. Each program will be based on the structure causing the problem and its symptoms. A program not tailored to the specific problem may aggravate symptoms.
Our doctors in NJ offer the most advanced and the best treatment for sciatica pain.
In mild cases, patients found that rest, ice, and medication were enough to reduce the pain. Specialists at Redefine Healthcare recommended physical therapy to develop a series of postural, sciatic nerve stretches and strengthening exercises to prevent the reoccurrence of the injury. Return to activity should be gradual to prevent a return of symptoms.
Moderate to Severe Cases
If the problem persists, consult with your local pain management health care provider or our best-rated sciatica treatment doctors and specialists of Redefine Healthcare in New Jersey. Our physician will perform a thorough evaluation to determine the possible cause of your symptoms, the structures involved, the severity of the condition, and the best course of treatment.
In addition to performing a thorough examination, your local sciatica doctor or experienced pain management doctors in New Jersey of Redefine Healthcare may order the following tests to make a more concise diagnosis:
- X-ray to determine any joint degeneration, fractures, bony malformations, arthritis, tumors, or infection present.
- MRI to determine any soft tissue involvement, including visualization of the discs, spinal cord, and nerve roots.
- CT scans, which can give a cross-section view of the spinal structures.
Medications to consider
Our pain relief doctors and sciatica specialists of pain management clinics of New Jersey may recommend several medication options individually or reduce the pain, inflammation, and muscle spasms that may be associated with sciatic nerve irritation.
- Over-the-counter medications for mild to moderate pain.
- If over-the-counter medications are not effective, your physician may prescribe stronger pain medication.
- Anti-inflammatory drugs or prescription NSAIDs (non-steroidal anti-inflammatory drugs) to reduce inflammation following acute injury.
- Muscle relaxers to reduce acute muscle spasms.
- Injections like facet injections, nerve blocks, or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.
Severe or Non-responsive Conditions
In the case of conditions that do not respond to conservative care, surgery may be indicated. If you continue to experience some of the following symptoms:
- Increase in radiating or radicular pain
- Pain or nerve irritation that gets worse
- Weakness with muscle atrophy
- Associated disc involvement
If symptoms continue to worsen, talk to our doctor, surgery may be indicated to release entrapment and remove the degenerative changes that compromise the nerve.
Injections like facet injections, nerve blocks, or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation caused by irritating the nerve roots of the Sciatic Nerve. Our specialists have more than enough competencies to perform these procedures:
- Caudal Epidural Injections
- Interlaminar Caudal Epidural Steroid Injections
- Transforaminal Epidural Injections
- Selective Nerve Root Blocks
Surgical Procedures to address the structures that contribute to the compression on the nerve roots of the sciatic nerve:
- Endoscopic Decompression
- Endoscopic Foraminotomy
- Percutaneous Decompression
- IDET Intradiscal Electrothermal Therapy
- Selective Endoscopic Discectomy
- Spinal Cord Stimulator
- Epidural Lysis of Adhesions
- Laser Facet Arthrotomy
The team of sciatica treatment doctors led by Dr. Freeman, the best pain relief doctor, can determine the accurate diagnosis and establish the correct sciatica pain care and rehabilitation plan.
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