Dr. Sean McCance is a sciatica diagnosis specialist located on the Upper East Side in NYC. The top rated sciatica doctor has successfully treated thousands of sciatica patients at his NYC medical practice (non-surgically and surgically). Sciatica is a generic term commonly used to describe pain in the low back, buttocks, or leg. While sciatic pain can have many causes, the most serious situation occurs when the spinal nerves that make up the large sciatic nerve are irritated or pinched by a herniated disk or bone spur – this is when sciatica surgery may become necessary.

“Dr. Sean McCance and his staff helped me survive crippling acute sciatica, and he removed a lumbar cyst that was literally choking off some crucial spinal nerves. I was better immediately, began to have feeling again in the leg, and the sciatica disappeared. That was in 2012. Since then, I have had (unrelated) other serious spinal issues (former dancer, athlete and gymnast), and he has steadfastly worked with me to find alternatives to spinal fusion until such time as I really cannot avoid it. I recommend him highly.” ~ RateMDs

The sciatic nerve is formed from the lumbar and sacral nerve roots, located in the lower segments of the lumbar spinal canal. It is the largest peripheral nerve in the body. This nerve travels from the lower back through the buttocks and down the back of the leg to the foot (like a large electrical cable), delivering signals from the spine to the leg muscles.

Causes of Sciatica that the NYC Sciatic Specialist Surgeon Can Diagnose

  • Herniated disk
  • Degenerative disk disease
  • Spinal stenosis
  • Scoliosis
  • Spondylolisthesis
  • Spine fracture
  • Bone spurs
  • Irritation of the nerve roots that join outside the spine to make up the sciatic nerve
  • Fractures that put pressure on the nerves
  • Cancerous spine tumors growing into the nerves
  • Sacroiliac joint irritation
  • Piriformis syndrome
  • Hip disease
  • Fibromyalgia
  • Ankylosing spondylitis

Risk Factors for Sciatica

  • Age: People 30 to 50 are most at risk for herniated discs, those over age 60 are at risk for spinal stenosis
  • Sitting for long periods puts considerable pressure on the lumbar disks, which can cause irritation
  • Lifting heavy loads and twisting the spine repeatedly
  • Family history or genetic predisposition
  • Sedentary lifestyle
  • Driving for long hours
  • Smoking
  • Stressful activities, such as lifting
  • Obesity
  • Arthritis
  • Pregnancy
  • Diabetes
  • Other factors which may negatively influence back pain include:
    • Psychological factors, such as low job satisfaction
    • Fatigue or sleep deficit
    • Drug or alcohol abuse
    • Stress / anxiety / depression

Symptoms of Sciatica

  • A radiating pain, tingling, or numbness from the buttock, down the leg
  • A stabbing, knife-like pain in the lower back or buttock
  • A cramping sensation of the thigh
  • Muscle weakness
  • Pins and needles in the feet or legs
  • A burning sensation in the leg

Medical Diagnosis of Sciatica

  • The best in class top rated sciatica surgeon will ask about your symptoms and review your medical history.
  • A physical exam including a neurological exam will be performed.
  • Your spine will be examined.
  • The movement, strength, and reflexes of your arms and legs will be tested.
  • Additional medical diagnostic tests may be necessary such as X-Rays, MRIs, CT scans, etc.
Treatment Options for Sciatica Offered by the NYC Sciatica Specialist
  • Medications
  • Muscle relaxants for muscle spasm (not recommended when you need to be alert, such as driving or operating machinery)
  • Short-term narcotics (Vicodin, Percocet, Codeine)
  • Oral steroids (Medrol dose pack)
  • Cortisone injections / pain blocks
  • Antidepressants may also be prescribed for chronic low back pain
  • Ultrasound treatments or electrical stimulation
  • Physical therapy
  • Chiropractic, focusing on relief of spasm and mobilization of the spine, pelvis, and leg muscles.
  • Spinal injections, which can include trigger point injections, facet blocks, or epidurals.
  • Acupuncture

Sciatic Surgery Offered by the NYC Spinal Surgeon

Surgery becomes necessary if patients develop chronic symptoms that don’t respond to treatment and consistently interfere with the quality of life or functionality. It may also be indicated if nerve problems develop or other treatments fail to provide relief. Common procedures are diskectomy, laminectomy, and spinal fusion. The choice of these procedures, and the techniques used to perform these procedures, depends on the particular cause of the pain.

Of the people who suffer from sciatica, 80% will fully recover without surgery. Patients who are going to recover usually experience significant improvement of symptoms within the first 3-6 weeks. Surgery becomes necessary if patients develop chronic symptoms that don’t respond to treatment and consistently interfere with the quality of life or functionality. It may also be necessary if nerve problems develop.

Surgery for sciatica frequently becomes necessary if the sciatic pain is due to a significant herniated disk in the spine and becomes chronic, or leads to neurological symptoms.

If you undergo treatments for 6 to 12 weeks and still have symptoms, surgery to allow more room for the nerve in the area being compressed is considered. This can mean removing the ruptured disc that is compressing the spinal nerve (micro-discectomy), removing the bone spur that is pinching the nerve, or a combination of both.

If you experience significant weakness, severe numbness, or intractable pain, surgery becomes more urgent.

When Should You Contact the NYC Sciatica Specialist

  • Your sciatica pain is severe or gets significantly worse and spreads down your legs
  • Is associated with:
    • Numbness, weakness, or tingling legs, buttocks, or genitals
    • Loss of bowel or bladder control
    • Difficulty with urination
    • Fever, unexplained weight loss, or other signs of illness
  • Has not started to improve within 7 to 10 days
  • Causes difficulty walking, standing, or moving
  • Is worse at night, or worse when you lie down

Our best in class, Upper East Side, NYC back & neck pain diagnosis & surgery practice, Spine Associates, is honored to provide you with highly personalized and comprehensive care. Our philosophy of direct management of your case by an expert spine surgeon has made us one of the most trusted and respected spine surgery practices on the Upper East Side in NYC and the world. Feel free to contact the back & neck pain diagnosis and spine surgery specialist today to discuss your unique sciatica condition and start yourself on the road to recovery.

Dr. Sean McCance
1155 Park Avenue, Suite E
New York, NY 10128
(212) 360-6500