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Institute of Function

Conditions · Nassau County, NY

Back pain &
sciatica.

At a glance

Back pain can come from muscles, joints or discs, while sciatica is pain traveling into the leg along a nerve. Institute of Function starts with diagnosis and rehabilitation, considering the least invasive effective option and procedures only when examination supports them. Dr. Benjamin (Ben) Klyachman, D.O., board-certified in pain medicine and physical medicine and rehabilitation, leads care at Institute of Function in Nassau County, NY, which welcomes patients from across Long Island, New York City and beyond.

Lower back pain may arise from muscles, joints, discs or nerves, and more than one source can contribute at the same time. Sciatica describes pain that travels along a nerve distribution into the leg; it is a symptom, not a complete diagnosis. Identifying the source and checking for neurological changes helps distinguish a rehabilitation problem from one that needs a different level of care.

Medically reviewed by Dr. Ben Klyachman, D.O. · Updated October 21, 2026

Common causes

  • Muscle strain or reduced tolerance for lifting and prolonged sitting.
  • Disc irritation or a disc herniation affecting a nearby nerve.
  • Arthritis in the small facet joints of the spine.
  • Narrowing around spinal nerves, sometimes called spinal stenosis.
  • Sacroiliac joint pain or altered movement around the hips.

How we evaluate

Evaluation starts with the pattern of pain, any leg symptoms, previous care and how daily movement has changed. A hands-on osteopathic and physiatric examination considers strength, sensation, reflexes, joint motion and the relationship between the spine, pelvis and hips. Prior imaging is reviewed in context rather than assuming that every visible change explains the symptoms, and diagnostic ultrasound or EMG/NCS nerve testing may be considered when a specific clinical question warrants it. The findings guide whether additional assessment, coordinated referral or a nonprocedural plan is appropriate, without committing every patient to the same tests.

Treatment options
we may discuss.

  • Performance Health / rehabilitation

    An activity and rehabilitation plan may address graded movement, trunk and hip strength, lifting mechanics and pacing. Exercise selection depends on the examination and current tolerance, with adjustments when symptoms change rather than a standard routine for every spine problem. Most back pain and sciatica can be managed without surgery; a surgical opinion is sought only when neurological findings or a structural problem truly warrant it.

  • Regenerative & Cell-Based Medicine

    When appropriate, PRP or prolotherapy may be discussed for a clearly identified joint, tendon or ligament contributor to back pain. Evidence varies by target, and these are not routine treatments for sciatica. Cell-based and biologic options require a separate review of evidence, risks and applicable law, alongside rehabilitation and established alternatives.

  • Targeted Pain Management

    Medication review and precise, image-guided, nerve-targeted procedures may be discussed for an identified pain source. Facet or medial branch blocks and radiofrequency ablation may be considered after appropriate diagnostic assessment. Benefits, limitations and risks are weighed alongside rehabilitation. When it's needed, an image-guided epidural steroid injection can also calm an inflamed nerve root. Procedures are image-guided, using ultrasound or X-ray guidance depending on the target.

Related treatments

From the Journal

Related conditions

Common
questions.

When to seek
care urgently.

Seek emergency care for new bladder or bowel dysfunction, numbness around the groin, rapidly worsening weakness, or severe back pain with fever.

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This page is general information, not medical advice. Individual results vary. Medical Disclaimer

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