Sciatica Treatment in Union Square, New York City

Dr. Monisha Mallik, Chiropractor in Union Square Specializing in Holistic Sciatica Treatment

Everyone’s sciatica is different and your symptoms might include a combination of several different types which are typically classified based on their duration, location, and underlying causes. This is why in a first session we’ll talk about your level of pain, the duration, and stressors that seem to produce your sciatica. With an understanding of your circumstances we’ll develop a course of treatment.

There are several non-pharmacological, non-surgical treatments for sciatica, with the best fitting approach depending on the severity of your symptoms and the underlying cause of your sciatica. I specialize in Dry Cupping, Myofascial Release, Active Release Therapy and Chiropractic Adjustments to treat your sciatica, brief descriptions of each are below.

Sciatica is classified based on its duration, location, and underlying causes.

Acute Sciatica describes the emergence of sciatic nerve pain usually lasting for 4 to 8 weeks. Chronic Sciatica describes persistent sciatic nerve pain lasting for more than 8 weeks. Pain in the lower back (lumbar spine) is the most common type of sciatica and typically caused by herniated discs, spinal stenosis (a condition where the spaces within your spinal canal narrow, putting pressure on your spinal cord and the nerve roots that branch off it), or bone spurs. A less common type of sciatica pain (Piriformis Syndrome) can surface when the piriformis muscle, located deep in the buttock, compresses or irritates the sciatic nerve.

Generally sciatica affects one side of the body and leg at a time, however Bilateral Sciatica is when both legs are being affected simultaneously. Something called Alternating Sciatica is when the nerve pain affects both legs but in an alternating pattern. Lastly something called Neurogenic Sciatica is when direct irritation of the sciatic nerve itself leads to not only sharp pain but also potential sensory changes including numbness, tingling, and altered temperature perception or reflex changes such as diminished or absent reflexes in the knee or ankle, and muscle weakness in the leg.

Sciatica Treatment with Holistic Therapies

What is Sciatica?

Sciatica is a type of pain that radiates along the path of the longest nerve in your body, the sciatic nerve, branching from your lower back through your hips and buttocks and traveling down each leg to your foot. When this nerve is compressed or in some way irritated, Sciatica often emerges.

When sciatica strikes it can vary in intensity and in how it is experienced depending on the severity and location of the nerve irritation or compression. Symptoms can range from a:

Sharp, shooting electric shock-like sensation that travels down the back of the leg.
Burning, tingling, or feeling of pins-and-needles along the nerve pathway.
Numbness in the affected leg, foot, or toes.
Difficulty moving or lifting the leg (muscle weakness).
A persistent pain in the lower back, buttock, or leg.

The pain can sometimes make it difficult for you to stand, walk, sit or even sleep comfortably and be quite debilitating

How to Tell if You Have Sciatica

If you’re experiencing the following symptoms you might have sciatica:

A sharp, burning, or like electric shock-like pain radiating from your lower back or buttock and traveling down one leg. This pain worsens with coughing, sneezing, sitting or other types of commonplace movements.
Numbness, tingling, or weakness in your leg, foot, or toes. Perhaps a loss of reflexes in your leg.

Beyond the physical pain, sciatica can also lead to several mental and emotional symptoms, primarily due to the chronic nature of the pain and its impact on daily life. An increased sense of stress and anxiety due to the uncertainty about the condition and its duration is common, especially when it interferes with life. Sleep is often disrupted leading to insomnia, irritability, frustration, and more.

What Triggers Sciatica?

Sciatica is usually triggered by irritation or compression of the sciatic nerve, which is most commonly caused by a herniated disc. When a disc in your lower back ruptures or bulges, it can press on your sciatic nerve root, leading to pain. Also, any narrowing of your spinal canal (spinal stenosis) can put pressure on your spinal cord and nerve roots, including your sciatic nerve.

Any bony growth such as bone spurs on the spine can sometimes compress the sciatic nerve. It is also possible a muscle (piriformis) deep in the buttocks spasms or tightness irritating the sciatic nerve. The sciatic nerve, due to its proximity to the spine, is vulnerable to compression or ‘pinching’ when one vertebra ever so slightly slips out of place onto the one below it, a condition called Spondylolisthesis, that can produce pain in the lower back, buttocks, or legs. For women during pregnancy it’s not unusual to have their growing uterus place pressure on the sciatic nerve thereby generating sciatic pain. Also, natural degenerative changes in the spine are common with aging and make the sciatic nerve more vulnerable to compression. Excess weight can place added stress on the spine, as can heavy lifting, twisting, or prolonged sitting – all can increase your risk of triggering sciatica.

Does Walking Help Sciatica?

Walking can help cope with sciatica and ideally starting with short walks on flat, unpaved surfaces (grass or trails). Walking can help with sciatica as it promotes blood flow and circulation, which can help in reducing your inflammation (and pain) around the sciatic nerve. Walking also strengthens the muscles in your back, legs, and core, providing better support to your spine and reducing pressure on the sciatic nerve. Walking can help improve the flexibility and range of motion in your hips and lower back, easing nerve compression. The key, though, is to always listen to your body and start a walking regimen slowly. If walking causes increased pain, stop and seek out someone like me for guidance on appropriate exercises and activity levels based on your specific condition.

What’s the Best Way to Sleep with Sciatica?

The best sleeping position for sciatica is generally considered to be on your back on a supportive mattress with a pillow under your knees as it helps to maintain the natural curve of your spine, keeping the spine in alignment and reduces pressure on the sciatic nerve. If you prefer to sleep on your side, placing a pillow between your knees can help keep your spine, hips, and pelvis aligned. Sleeping on your stomach is best to be avoided as it can put extra pressure and stress on your lower back worsening sciatica pain.

What Should I Avoid if I Have Sciatica?

There are certain things you should avoid if you’re coping with sciatica to prevent exacerbating the pain and delaying recovery. While rest is important, inactivity can lead to muscle atrophy (weakening) and decreased flexibility, particularly in the core and back muscles that support the spine. This can worsen postural imbalances and increase pressure on the sciatic nerve, exacerbating pain. Movement helps pump blood and nutrients thereby promoting healing, whereas a lack of activity can lead to reduced blood flow, hindering the body’s natural repair process.

Heavy lifting, strenuous exercise, bending, twisting, running, jumping or anything that puts excessive stress or strain on your back as it can irritate the sciatic nerve, worsen nerve compression and increase inflammation. Extended sitting can increase pressure on the sciatic nerve so it is important to sit in a supportive chair with good lumbar support, take frequent breaks to stand and move around.

Sciatica Treatment with Cupping

Cupping therapy involves placing special cups on your skin to create suction, which facilitates healing by increasing blood flow, softening scar tissue, and decreasing muscle pain.

“Hijama [Cupping Therapy] was found to be very effective in relieving the pain due to sciatica without causing any adverse effects. Hence it may highly be recommended for patients suffering from sciatica to avoid adverse effects by the continuous use of NSAIDs (Nonsteroidal anti-inflammatory drugs) and to make an attempt before going for surgery which is seldom successful and possesses high risk. – Therapeutic Effectiveness of Hijama [Cupping Therapy] in Sciatica Pain, Study/Research

Cupping therapy treats sciatica by having the suction created by the cups increase blood circulation in the lower back, buttocks, and legs, thereby reducing inflammation and loosening tight muscles and their tension in exasperating sciatica pain.

Your lymphatic system plays a key role in your body’s immune response and waste removal, which helps clear excess fluid, cellular debris, and toxins from tissues, all of which drive Sciatica’s inflammation. And while the lymphatic system and the blood circulatory system are separate, they are interconnected and influence each other. Thus the improved blood flow from Cupping can reduce your inflammation by optimizing your body’s natural lymphatic drainage of your inflammation.

Cupping therapy can also help identify and release trigger points, which are knots of muscle tension that can refer pain to other areas, including the leg and foot, as seen in sciatica. Once identified I apply myofascial release therapy to relieve the muscle tension (and pain) which directly addresses fascia, the connective tissue surrounding muscles.

Sciatica Treatment with Myofascial Release Therapy

Myofascial release therapy is a hands-on technique where I use my hands to feel for areas of tightness or “knots” under your skin and in your fascia, the connective web-like sheath surrounding and supporting all structures throughout the body. Once I identify a muscular knot I slowly stretch and manipulate the fascia to release tension and restore its natural fluidity. Healthy fascia is pliable; however, due to injury, inflammation, or chronic stress, it can develop restrictions that limit blood flow and oxygen delivery to the muscle, leading to metabolic changes and muscle fiber dysfunction and eventually causing trigger points.

Sciatica often involves tightness and trigger points in the muscles and fascia surrounding the sciatic nerve, such as the piriformis muscle, hamstrings, and lower back muscles. Myofascial Release involves the gentle but sustained application of pressure to these areas helping to release restrictions, improve blood flow, and reduce nerve compression. By targeting trigger points and areas of muscle imbalance or tightness, myofascial release helps relax the muscles, alleviating pain and promoting better nerve function. This also improves flexibility and mobility of the muscles and fascia, allowing for a greater range of motion and reducing the likelihood of a pinched nerve. The return of muscle and fascia flexibility and mobility enables greater range of motion while reducing the likelihood of a pinched nerve.

Sciatica Treatment with Chiropractic Care

“Patients receiving active manipulations [chiropractic adjustments] enjoyed significantly greater relief of local and radiating acute lower back pain (including sciatica), spent fewer days with moderate-to-severe pain, and consumed fewer drugs for the control of pain”. – Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.

Chiropractor care involves applying manual manipulation to provide relief to the spine and corresponding joints, particularly in the lower back and pelvis in regards to treating Sciatica. By treating spinal misalignments (the underlying musculoskeletal dysfunction), muscle tension, and postural issues, chiropractic adjustments reduce pressure (compression) on the sciatic nerve and reduce the painful symptoms of sciatica.

Misalignments can also occur in the pelvic region, affect the sciatic nerve and lead to painful symptoms. The piriformis muscle can tighten or spasm, putting pressure on the sciatic nerve and triggering pain. The sacroiliac joints can cause inflammation and pain that can radiate along the length of the sciatic nerve.

Pelvic misalignments can also affect your lower back and increase pressure on the sciatic nerve roots resulting in pain. Lastly, pelvic misalignments can affect overall posture, and be the origin of any muscle imbalances and chronic tension in the lower back, hips, and legs – exacerbating sciatica pain.

Treating sciatica also involves assessing and correcting postural imbalances that may be stressing your lower back and contributing to your pain. Decreasing any excess pressure on the spine comes through increasing the strength of the supporting core or postural muscles, thereby offsetting the load placed on any herniated disc. Improving or restoring movement and function of your lower back, pelvis and hip region with specific well targeted stretches can often provide quick relief. Two common stretches are:

The Sciatic Mobilizing Stretch, also known as Sciatic Nerve Flossing or Nerve Gliding. This is a gentle exercise designed to improve the mobility of the sciatic nerve and reduce pain and irritation associated with sciatica. It involves a series of controlled movements that encourage the nerve to glide smoothly within its surrounding tissues, promoting blood flow, reducing inflammation, and alleviating nerve compression. The Sciatic Mobilizing Stretch can be a helpful tool for managing sciatica pain and improving nerve function. It’s often recommended as part of a comprehensive treatment plan that may also include other exercises, stretches, and therapies.

The Supine Piriformis Stretch is a gentle stretching exercise designed to target the piriformis muscle, a small muscle located deep in the buttock. This muscle can sometimes become tight or irritated, leading to compression of the sciatic nerve, which causes pain, numbness, or tingling sensations along the nerve’s pathway (a condition known as piriformis syndrome). The Supine Piriformis Stretch helps relax and lengthen the piriformis muscle, easing pressure on the sciatic nerve and alleviating associated pain. This stretch increases the flexibility and range of motion in the hip joint, contributing to better overall movement and reducing the risk of further nerve compression. Stretching the piriformis muscle promotes blood circulation to the area, aiding in healing and reducing inflammation.

Sciatica Treatment with Active Release Techniques (ART)

Active Release Techniques (ART) can be an effective treatment for sciatica as it focuses on addressing the underlying soft tissue restrictions that can contribute to sciatica pain. Sciatica pain often arises from tightness, adhesions, or scar tissue in the muscles, tendons, ligaments, or fascia surrounding the sciatic nerve. ART involves applying precise pressure and tension to the affected area while you’re actively moving the involved body part. This movement, combined with the applied pressure helps break down adhesions and scar tissue, improving tissue mobility and reducing nerve compression.

ART helps relax tight and spasmed muscles, further alleviating pressure on the sciatic nerve and reducing pain. By releasing soft tissue restrictions, ART can improve the gliding and movement of the sciatic nerve, reducing irritation and inflammation. This allows the nerve to function optimally and reduces pain signals. By improving tissue mobility and reducing muscle tension, ART can increase range of motion in the affected areas, including the lower back, hips, and legs. This can help prevent further nerve impingement and improve overall function.