Pain Symptom
Sciatica
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Pain shoots from your buttock down the back of your leg, sometimes to your foot. It may burn, tingle, go numb or feel like a deep toothache in the thigh. Sitting makes it worse, and so does bending. Sciatica describes where the pain travels, not what is causing it, and the cause is not always in your spine.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Sciatica
The sciatic nerve is the largest nerve in the body. It forms from nerve roots in the lower spine, passes through the buttock beneath or through the piriformis muscle, and runs down the back of the thigh to the lower leg and foot. Sciatica is pain along this path.
The most familiar cause is a herniated disc or narrowing in the spine pressing on a nerve root. But sciatic-type pain also comes from the buttock, where the piriformis and other deep rotators can compress the nerve, from sacroiliac joint irritation, and from trigger points in the gluteal muscles that refer pain down the leg without involving the nerve at all. Many people have more than one source.
Your physician should evaluate red flags and may order imaging if symptoms are severe. Dr. Gordon traces the pain to its source, whether spine, buttock or muscle referral, and treats the nerves and muscles involved.
Sciatica at a Glance
Also called
Sciatic nerve pain, lumbar radiculopathy when from the spine
Where it is felt
Buttock, back of the thigh, calf, and sometimes the foot
Common sources
Disc herniation, spinal narrowing, piriformis compression, SI joint, gluteal trigger points
Common aggravators
Sitting, bending, coughing or sneezing, driving
Key point
Sciatica describes the path of pain, not its cause
The Gap in Care
What Tests Check, and What They Can Miss
Sciatica is often assumed to be a disc problem. When imaging is normal or does not match the symptoms, the buttock and muscle sources are often overlooked.
What routine testing is looking for
- Disc herniation compressing a nerve root
- Spinal stenosis
- Severe nerve compression with weakness
- Other spinal disease
What often keeps symptoms going
- Piriformis and deep rotator compression of the nerve
- Gluteal trigger points that refer down the leg
- Sacroiliac joint irritation
- Hamstring tension along the nerve
- Nerve sensitivity that lingers after a disc heals
These are found by tracing the nerve from the spine to the leg, which is how Dr. Gordon approaches sciatica.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Shooting pain down the leg
Electric or shooting pain from the buttock into the leg.
Burning or tingling
Burning, pins and needles or numbness in the leg or foot.
Deep buttock ache
A deep ache in the buttock on one side.
Worse with sitting
Pain building while seated or driving.
Pain with bending or coughing
Pain increasing with bending forward, coughing or sneezing.
Leg weakness
A heavy or weak feeling in the leg.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Spinal nerve root irritation
A disc or narrowing in the spine can press on a nerve root.
Piriformis and deep rotators
Tight buttock muscles can compress the sciatic nerve as it passes through.
Gluteal trigger points
Trigger points in the gluteus minimus and medius refer pain that mimics sciatica.
Nerve sensitivity
An irritated nerve becomes sensitive to stretch and pressure along its whole length.
Your First Visit
How Dr. Gordon Evaluates Sciatica
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
- 1
Records and history review
Dr. Gordon reviews your imaging, physician or physical therapy notes, medications and past treatments so he knows what has been ruled out and what has already been tried.
- 2
Nerve tracing
Dr. Gordon follows the sciatic nerve from the lower back through the buttock and down the leg to find points that reproduce your symptoms.
- 3
Neurological screen
Dr. Gordon checks strength, reflexes and sensation to understand how the nerve is affected.
- 4
Buttock and hip assessment
Hands-on assessment of the piriformis, gluteals and deep hip rotators.
- 5
Plan and coordination
A clear plan, plus communication with your physician, orthopedist or physical therapist when that helps your care.
When to see a physician first
- New weakness, numbness or tingling that is spreading or getting worse
- Numbness in the saddle area or loss of bladder or bowel control
- Back pain with fever, chills or unexplained weight loss
- Pain after a significant fall or accident
- Back pain with a history of cancer
- Severe pain at night that does not change with position
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for sciatica, chosen from your exam findings.
Orthopedic Dry Needling
Dr. Gordon has used dry needling for more than 18 years. Treatment targets the piriformis, gluteal and deep rotator muscles that compress or refer pain along the sciatic nerve, and the back muscles guarding the spine.
See all servicesNeuro-Functional Acupuncture
Electro-acupuncture along the lumbar and sciatic nerve pathways to calm nerve irritation.
See all servicesNerve Care & Team Coordination
Guidance on sitting, movement and nerve-friendly activity, coordinated with your physician or physical therapist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
One week ago I walked into Dr. Anthony Gordon's office ... with chronic low back pain, bilateral hip pain, tingling along my left thigh, right knee pain and left shoulder pain. ... After one treatment I found myself standing straighter with decreased back, hip and knee pain and no tingling to my left thigh.Estrellita Ammirati, Google Review
Sciatica Questions
Answers About Sciatica
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Before You Book
General Questions
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioFurther Reading
Dry Needling vs Acupuncture: What Is the Difference?
From the blog: how dry needling and acupuncture use the same needles in different ways, and why Dr. Gordon often combines them for chronic pain.
Is It Sciatica or Piriformis Syndrome? How to Tell the Difference
From the blog: Buttock pain that runs down the leg is not always a disc. How piriformis syndrome differs from spine-related sciatica, and how an exam tells them apart.
Hamstring Strains in Runners: Why Running Through It Backfires
From the blog: Running through a hamstring strain often means a longer layoff and a repeat injury. What rehab should include, when it is a nerve, and where dry needling fits.
Book an Evaluation for Sciatica
Book a full evaluation with Dr. Gordon and trace your leg pain to its source.
Early morning, evening and weekend appointments available. Free on-site parking.
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