Orthopedic · Maui, Molokai and Lanai
Physical therapy for sciatica in Maui, Molokai and Lanai
Sciatica is pain that travels from the back or buttock down the leg along the sciatic nerve. Most cases settle with the right movement and time, and physical therapy shortens that time and lowers the chance of it returning.
- TRICARE, HMSA, and HMSA QUEST in-network
- No state referral requirement; some plans need one
- Video visits anywhere in Maui, Molokai and Lanai
About the condition
Sciatica: what is going on.
The sciatic nerve runs from the lower spine through the buttock and down the back of the leg. When it is irritated, by a disc, by a narrowed opening in the spine, by the piriformis muscle, or simply by sensitivity after a flare, people feel shooting, burning, or electric pain down the leg, sometimes with numbness or tingling in the foot. Sitting and bending often make it worse.
Physical therapy for sciatica identifies what is irritating the nerve, uses positions and movements that reduce the leg symptoms, and then rebuilds the strength and mobility that keep it from coming back. Surgery is reserved for the small minority with progressive weakness or no improvement.
Common experiences
What people with sciatica often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Pain radiating from the buttock down the back of the thigh or calf
Numbness or tingling in the leg or foot
Pain that worsens with sitting or bending forward
Difficulty standing up straight after sitting
Pain that wakes the person at night
Weakness or heaviness in the leg
Treatment
How physical therapy addresses it.
The program uses directional exercises that centralize leg pain back toward the spine, nerve mobility work, positioning for sitting and sleeping, and progressive strengthening of the hips and trunk. Walking is built up in stages. Signs of nerve compromise that need urgent medical care are screened at every visit.
What a video visit looks like
Dr. Shalem uses guided movement tests on camera to find the direction that eases the leg pain and tracks how far down the leg symptoms reach as the main progress marker.
Coverage in Hawaii
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
TRICARE
In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for.
HMSA
In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit.
HMSA QUEST
In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit.
Private pay
Available for any other plan. HSA and FSA cards accepted.
Referrals
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
All of Maui, Molokai, and Lanai are seen by video.
How it works
How a virtual visit works
Dr. Shalem uses guided movement tests on camera to find the direction that eases the leg pain and tracks how far down the leg symptoms reach as the main progress marker.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Sciatica questions in Maui, Molokai and Lanai
How long does sciatica take to improve?
Most people improve substantially within six to twelve weeks. Physical therapy speeds that and reduces recurrence.
Is it a disc?
Often, but not always, and the treatment is similar either way. Imaging is reserved for cases with progressive weakness or no improvement.
When is sciatica an emergency?
New loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly worsening leg weakness need emergency evaluation. Dr. Shalem screens for these at the first visit.
Do I need a referral for physical therapy in Hawaii?
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
What insurance do you take in Hawaii?
TRICARE: In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for. HMSA: In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit. HMSA QUEST: In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit. Private pay: Available for any other plan. HSA and FSA cards accepted.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.