What is Sciatica?
Perhaps you’ve heard someone groan, “Oh, my sciatica!” It may sound as if they’re talking about a condition, or disease, but what they mean is that they have a problem with their sciatic nerve — the largest single nerve in the human body. The nerve starts from the base of your spine, and is composed of individual nerve roots that start inside the spinal chain. It then branches: one side of the nerve travels down your left buttock and leg; the other, your right. This common complaint, which affects, in varying degrees, about three million people in the US every year, can be caused by several different conditions.
Because the sciatic nerve divides the way it does, it is common to experience symptoms only on one side or the other. The condition sometimes presents as pain — which can be felt anywhere along the nerve pathway, although it usually starts in the lower back and travels down the leg. Sometimes it’s felt as a mild ache; sometimes, as a sharp, burning feeling; sometimes as an intense jolt. In other cases, it manifests as numbness, tingling, weakness, or “pins and needles;” in fact, it can feel like that in one place while there’s pain in a different section. Severe cases, which should be immediately brought to the attention of a physician, involve loss of bladder or bowel control or a sudden or acute pain or weakness. Additionally, if the pain has come about abruptly or seems to be the result of a violent injury, seek immediate medical attention.
The reason sciatica presents in so many different ways is that it can have multiple causes, which affect different parts of the nerve. Sciatic conditions can be caused by a herniated disc or a bone spur on the spine that compresses the nerve; spinal stenosis can also show up as sciatica. These conditions can be caused, rarely, by disease or tumor; they can also be affected by pregnancy, depending on where the weight is being carried. Age (the condition is more prevalent as you get older), obesity (because of stress on the spine), and occupation (if you sit for long periods of time, or use twisting motions often in your work) are also factors.
“Luckily, sciatica often resolves itself within six to twelve weeks,” says Christopher Castro DO, a physiatrist at The Orthopedic Institute of New Jersey (OINJ). “Home remedies like over-the-counter pain relievers, ice, or heat can help if the condition is minimal. We look to non-operative solutions first, especially in mild cases. We’ll probably do a series of physical tests that involve you moving around, or taking different positions, to see if we can locate the causal factor. For example, if walking on your toes or heels results in pain, it means one thing; if squats cause the pain, it means something else.”
“Along with that,” adds Michael Gutkin, MD, another physiatrist at OINJ, “we’ll ask you questions about positions that make you feel better or worse, the severity of your pain, and the length of time you’ve had it. A course of anti-inflammatories, muscle relaxants, or steroids might be prescribed. These can help in two ways: they’ll have a direct affect by allowing pain relief — and because the pain is relieved, you’ll be better able to complete exercises that will aid in recovery by helping you get stronger and more flexible.”
For severe conditions, says Dr. Gutkin, “We would have some tests done. MRIs, x-rays, and CT scans can be helpful. There’s even a special test, called an EMG (electromyograph), that measures the electrical impulses produced by your nerves as well as the response of your muscles to those impulses.”
Exam, evaluation, and diagnosis will lead you to the right treatment for your condition.
Why Choose The Orthopedic Institute of New Jersey
At OINJ, board certified physicians work collaboratively to come up with the best solutions for you. Using innovative techniques and the most up-to-date research and technologies available, our specialists have one goal: to get you back into the best of orthopedic health. We work with each other, as well as with other partners in your care, to develop the treatment plan that will work for you.
Our multiple office locations that can be reached by one centralized call center make it easy to schedule and get to appointments, and we treat patients of all ages with injuries and orthopedic conditions of all kinds.
Christopher Castro, DO – Physiatrist
As a physiatrist, Dr. Castro has expertise in non-operative spinal care, interventional spine procedures, pain management, occupational medicine, and electrodiagnostic studies. Board certified by the American Board of Physical Medicine and Rehabilitation, Dr. Castro incorporates medications, therapies, injections and lifestyle changes to help his patients improve function.
Dr. Castro completed an advanced fellowship at University of Medicine and Dentistry of New Jersey (UMDNJ); held his residency at the Sinai Hospital Physical Medicine and Rehabilitation program in Baltimore; and received his medical degree from the New York College of Osteopathic Medicine. His undergraduate degree in chemistry was earned at Fairfield University in Connecticut.
Michael S. Gutkin, MD – Physiatrist
Dual board certified by the American Board of Physical Medicine and Rehabilitation in sports medicine as well as physical medicine and rehabilitation, Dr. Gutkin is a physiatrist whose areas of expertise include interventional spinal and joint injection, pain management, rehabilitation, and spinal injuries. He is a partner at The Orthopedic Institute of New Jersey.
Dr. Gutkin completed his residency at The Rusk Institute at NYU Medical Center, and received his medical degree from St. George’s University Medical School. His undergraduate degree in biology was earned at Ithaca College in New York.
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The Orthopedic Institute of New Jersey is a premier multi-disciplinary center offering complete orthopedic care, rehabilitation and pain management services to patients of all ages and activity levels using a customized treatment plan to fit individual needs.