Neck/Back Pain/Sciatica

Neck Pain

A Reputation for Quality

Our therapists at Dr. Mike Shapow PT Physical Therapy are highly trained to provide quality care for head and neck pain. A thorough initial evaluation helps us identify movement dysfunction that can be addressed with patient education, manual techniques, therapeutic exercises, and modalities. Regular reassessment provides reassurance that we are always working to achieve patient goals in a cost-effective manner.

Priority One – Pain Relief

Severe head & neck pain can be disabling. For this reason, our first priority is pain relief. Treating the underlying causes of identifiable movement dysfunction is the next step toward achieving long-term relief and recovery.

Diagnosing a Pinched Nerve in the Neck

A pinched nerve occurs when your nerve root becomes compressed as it exits your spinal column. A pinched nerve in the neck occurs when a nerve root of the nerves exiting from the spinal cord becomes irritated or compressed. A pinched nerve in the neck is known as cervical radiculopathy. Pain is the most common symptom of a pinched nerve. There may also be weakness and/or mild numbness, tingling, or a burning sensation in nearby areas such as the shoulder, arm, hand, and fingers.

Doctors use several tests to help them diagnose pinched nerves, including

• The Spurling Test - involves the doctor extending your neck, rotating your head from side to side, and applying gentle downward pressure to the top of the head to see if he can elicit symptoms of pinched nerves.
• X-Ray - the X-Ray can't see your nerves, but it does show the alignment of the vertebrae in your neck and demonstrate narrowing of the foramen and disc spacing in the vertebrae. This information can show nerve damage or rule it out as the cause of your neck pain.
• Computerized Tomography (CT) Scan - a more detailed image of the bones, which is why doctors sometimes use this to help diagnose a person with a suspected pinched nerve.
• Magnetic Resonance Imaging (MRI) - an MRI will show the severity of the nerve compression in your neck and determine if a herniated disc is causing it.
• Electromyelography (EMG) - a test that measures the speed of transmitting electrical impulses along a nerve to determine whether a nerve or group of nerves is functioning properly. The EMG can help doctors determine which nerve has become irritated or compressed and where exactly the compression occurs.

A Hands-on Approach

Hands-on techniques, in most cases, are an essential part of a successful head and neck pain treatment program. Our therapists are equipped with cutting-edge manual skills to assist with the recovery of range of motion, reestablish correct movement patterns, and alleviate muscle related pain and tightness. Coupled with patient education and therapeutic exercise, the results can be dramatic and long lasting.

Evidence is Our Guide

Medical research is continuously providing the clinicians at Dr. Mike Shapow PT Physical Therapy with “current best-evidence” guidance so we are equipped to provide the state-of-the-art care to our community members. We look to systematic reviews and random controlled trials to help guide us in the delivery of state-of-the-art care. Coupled with regular attendance to continuing education courses, Dr. Mike Shapow PT Physical Therapy has a reputation for providing a high quality service to those in need of head and neck pain rehabilitation.

Physical Therapy for Neck Pain

Visit our Medical Library for more information on neck pain.

Are you suffering from neck pain?
Call us today to set up an appointment!

Back Pain

It is estimated that 80% of the human race experiences low back pain at least once throughout their lifetime. Fifty percent of the working population admits to experiencing low back pain each year. Each year, 15-20% of the people in the United States have complaints of low back pain. Two percent of the U.S. population is either temporarily or chronically disabled by low back pain. Millions of workers suffer on the job injuries annually which costs 100 billion dollars in lost wages, time, and productivity and medical costs.

While there are a lot of treatment options available, many of these only address the symptoms and don’t target the actual cause of your pain or handle it for the long term.

The three main causes of low back pain and sciatica are

1. Herniated Discs
2. Arthritis
3. Pelvis issues

Without identifying the correct cause of your pain, there is no way to develop the proper treatment plan.

Physical Therapy for Low Back Pain

Visit our Medical Library for more information on low back pain.

Are you suffering from back pain or sciatica?
Call us today to set up an appointment.

Our physical therapists will find the actual cause of your back pain. The goal of effectively resolving your low back pain or sciatica includes…

• Identify the true cause
• Create a unique plan for your specific condition
• Relieve your pain
• Restore your normal motion, flexibility, and mobility
• Strengthen the supporting muscle
• Return to your normal activities

Sciatica

Sciatica is characterized by excruciating pain and paresthesias in the sciatic nerve distribution or associated lumbosacral nerve root and can severely impact the quality of life of those affected.¹ It is not a medical condition but a symptom of a medical problem. The medical term for sciatica is lumbar radiculopathy. It is irritation, inflammation, pinching, or compression of a sciatic nerve root. Sciatica is typically only felt on one side of the body. Symptoms can include pain, weakness, numbness, or tingling in the leg.

What is the sciatic nerve?

The sciatic nerve comprises nerve roots from L4 to S3. With a diameter of up to 2 cm, the sciatic nerve is the body's largest nerve.¹ However, it isn't just a single nerve but rather a bundle of nerves that comes from five nerve roots branching off your spinal cord. The sciatic nerve extends from the back of your pelvis down the back of your thigh down to your knee. You have two sciatic nerves - one on each side of your body.

What is Sciatica?

Sciatic most commonly occurs in people between 30 and 50 years old. The pain can be mild to severe and runs anywhere within the nerves connecting to the sciatic nerve. Symptoms can affect your lower back, hips, buttocks, or legs. Sciatic pain can even run further down, including your lower leg, foot, and toes. It just all depends on which nerve is affected.

What causes sciatica?

A herniated or bulging disc in your spine, typically at L4, L5, or S1, puts pressure on or irritates a lumbar nerve root: sciatica. It can also be caused by disc degeneration, where inflammatory proteins are released that irritate nearby nerve roots. These are only two causes of sciatica. Many other conditions cause sciatica, including obesity, arthritis, diabetes and a weak core.

Treatment of Sciatica

Patient Education²

• Use hot or cold packs for comfort and to decrease inflammation
• Avoid inciting activities or prolonged sitting or standing
• Practice good, erect posture
• Engage in exercises to increase core strength
• Gently stretch the lumbar spine and hamstrings
• Participate in regular light exercises such as walking, swimming, or aqua-therapy
• Use of proper lifting techniques

Medical Therapies^{3, 4}

• A short course of oral nonsteroidal anti-inflammatory drugs (NSAIDs)
• Opioid and nonopioid analgesics
• Muscle relaxants
• Anticonvulsants for neurogenic pain
• If oral NSAIDs are insufficient, oral corticosteroids may be beneficial
• Localized corticosteroid injections
• Spinal manipulation
• Deep tissue massage may be helpful
• Physical therapy consultation
• Surgical evaluation and correction of any structural abnormalities such as disc herniation, epidural hematoma, epidural abscess, or tumor
• Acupuncture⁵

Resources

1. Davis D, Maini K, Taqi M, et al. Sciatica. [Updated 2024 Jan 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
2. Wheeler AH. Diagnosis and management of low back pain and sciatica. Am Fam Physician. 1995 Oct;52(5):1333-41, 1347-8.
3. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007 Jun 23;334(7607):1313-7.
4. Ostelo RW. Physiotherapy management of sciatica. J Physiother. 2020 Apr;66(2):83-88.
5. Ji M, Wang X, Chen M, Shen Y, Zhang X, Yang J. The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2015;2015:192808.