Sciatica Specialist
Up to 40% of people suffer from sciatica at some point in their lives, with the likelihood of a painful episode increasing with age. Symptoms range from a mild throbbing in the leg or foot to severe pain that prevents walking or standing. At the Pacific Heights Spine Center, Dr. Ray Oshtory conducts full physical and medical history evaluations to discover what’s causing your sciatica pain and plans a course of treatment that gets you moving freely again. If you’re in the San Francisco area, call the office or request an appointment online today.

Sciatica Q & A

What is sciatica?

Sciatica is the name given to pain originating in the sciatic nerve. These nerves — around the thickness of your little finger at their largest point — run from your lower spine, through your buttocks, and down your legs where they branch out and end in your toes.

If the sciatic nerve or the spinal nerve roots that form it are pinched or irritated in any way, the pain in your leg can range from a dull throb to a searing, electric-like pain that make it impossible to move. Sciatica can be a constant pain or a flare up from time to time. It’s felt in one or both legs, and is oftentimes worse when you’re standing and walking.

What causes sciatica pain?

Sciatica is often caused by a herniated or slipped disc in your spine, which shifts out of place and puts pressure on the nerve root. Or it can be caused by degeneration of the spine that leads to bone spurs pinching the nerves. This problem rarely results from an injury or lifestyle choices. It much more commonly happens spontaneously or slowly over time as a result of normal degenerative changes in the spine.

Other medical conditions such as hip arthritis or piriformis syndrome can affect the sciatic nerve, trapping it against bones or pinching it between muscles. Inherited spinal conditions and stress fractures can also cause sciatica issues. No two cases are the same, so Dr. Oshtory conducts a full evaluation to pinpoint the source of your pain in particular.

Who is at risk for sciatica?

If you have had a disc herniation or sciatica before, then you may have a heightened risk of recurrent sciatica, as something amiss in your spine can affect your sciatic nerve. Anything that puts added pressure on your spine, such as pregnancy (which shifts your center of gravity), a spinal tumor, or injury increases the risk. The biggest predictor of sciatica is having a family member who has had sciatica, spinal stenosis, disc herniation, or a history of spine surgery.

How can sciatica be treated?

There are many treatment options available for sciatica, and Dr. Oshtory helps you decide which one is best for you. Some people respond within a few weeks to a combined regimen of pain management and strengthening and stretching exercises that relieve the cause of stress on the nerve. Dr. Oshtory also frequently recommends chiropractic manipulation, acupuncture, or epidural injections to manage the pain and restore function.

Persistent sciatica sometimes needs a surgical solution.  Dr. Oshtory performs minimally-invasive procedures called microdiscectomy and lumbar microdecompression to relieve pressure on the spinal cord or nerves.





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