Sciatica Specialist
Sciatica refers to pain that radiates from the back down the buttocks and into the leg.
Sciatica Q&A?
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What is sciatica?
Sciatica refers to pain that radiates from the back and down the leg. Most commonly this is in the buttocks but it can also be in the groin or thigh. Often pain caused by sciatica can radiate down to the feet. The term sciatica comes from the sciatic nerve, which is a large nerve that runs in the buttock and posterior thigh.
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What happens during a sciatica evaluation?
Dr. NaPier specializes in the evaluation and treatment of sciatica. When you arrive at Dr. NaPier’s office he will listen to your concerns and perform a physical examination to assess the health of your spine and nerves.
He will then review relevant imaging including X-Ray, CT scan, and MRI to determine the cause of your sciatica. Dr. NaPier will then work together with you to develop a customized plan to help you feel better.
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How is sciatica treated?
The treatment of sciatica varies and depends on the cause of sciatica. Often the symptoms of sciatica will improve with nonsurgical treatment including anti-inflammatory medications and physical. In cases of sciatica that do not respond to nonsurgical treatment, Dr. NaPier may recommend surgery to treat your sciatica. Dr. NaPier is an expert in the most minimally invasive techniques to take pressure off your nerves and help you enjoy a faster recovery with less post operative pain.
Related Services
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Degenerative disc disease (DDD) is extremely common with >50% of asymptomatic patients over age 40 and >95% of asymptomatic patients over age 65 demonstrating signs of DDD on MRI. DDD in itself does not require surgery. However, which DDD leads to collapse of nerve root tunnels, spinal instability, or spinal deformity causing significant disability then surgery can provide significant relief of symptoms.
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Disc herniation occurs when the nucleus pulposus or gelatinous inner filling of an intervertebral disc herniates through a defect or crack in the annulus fibrosis or outer crust. Herniated disc material can cause nerve pain by direct mechanical compression and also through chemical inflammation surrounding nerve roots. Most disc herniations can be treated nonsurgically and those that do not improve with conservative treatment can be removed with a minimally invasive, outpatient microdiscectomy.
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The facet joints on the back of the spine are lubricated by joint fluid or synovial fluid. In cases of spinal instability or aberrant motion of these facet joints, the synovial fluid may bulge out of the facet joint capsule and create a cyst that causes nerve root pain and irritation by direct compression and also mechanical inflammation. Facet cysts have a tendency to scar onto the dura or nerve root sac, causing severe pain. Facet cysts that do not improve with nonsurgical treatment can be removed surgically.
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Lumbar radiculopathy refers to pain that radiates down the hip, thigh, leg, or foot due to nerve root compression in the lumbar spine. This phenomenon is known as referred pain.
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Spondylolisthesis or slipped vertebrae refers to a slip of one vertebra forward in relation to neighboring vertebrae. This can cause back pain and compression of the spinal canal or the nerve root tunnels. Degenerative spondylolisthesis typically occurs at the L4-5 level due to degeneration and failure of the lumbar facet joints. Isthmic or lytic spondylolisthesis usually occurs at the L5-S1 level due to a defect in the pars interarticularis. Patients with spondylolisthesis should see Dr. NaPier for evaluation.
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The sports with the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing and snowboarding, rugby, cheerleading, and baseball. A common mechanism of injury for all at-risk sports is an axial compression force to the top of the head with the neck slightly flexed.
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Many common spine injuries such as disc herniation or spine fracture can occur as a result of work-related injuries. It is important to seek medical care in order to determine the extent of these injuries and whether there may be any lasting consequences of the injury.
Dr. NaPier is an expert in the diagnosis and treatment of work related injuries.
He offers several innovative, minimally invasive techniques that allow for faster return to work and less postoperative pain. These techniques include: