Sciatica: Causes, Symptoms & Advanced Treatment.

Learn causes, symptoms, treatments, and daily tips for sciatica. Precision Pain & Spine Institute offers same-week care.

What Is Sciatica?

Sciatica is a common nerve pain condition affecting millions of adults. The term refers to symptoms caused by irritation or compression of the sciatic nerve—the longest nerve in your body. The sciatic nerve originates in the lower spine (lumbar region), passes through the buttocks, and travels down the back of each leg. When this nerve is compressed or inflamed, it can produce pain, tingling, or numbness anywhere along its pathway, most often affecting just one side of the body.

Other names for sciatica include “sciatic nerve pain,” “radiculopathy,” or “lumbar nerve root compression.”

Why It Happens

Sciatica results when the sciatic nerve is pinched, inflamed, or irritated. Common causes and risk factors include:

Herniated disc: A bulging or ruptured disc in the lower spine presses against the nerve root.
Degenerative disc disease: Wear-and-tear changes in the spine can narrow nerve passages.
Lumbar spinal stenosis: Age-related narrowing of the spinal canal reduces space for nerves.
Spondylolisthesis: A vertebra slips out of place, pressing on the nerve.
Piriformis syndrome: A tight piriformis muscle deep in the buttock compresses the nerve.
Trauma or injury: Falls, car accidents, or sports injuries may directly damage the nerve or spinal structures.
Tumors or infections: Rarely, these can put pressure on the sciatic nerve.

Risk Factors

Age over 40
Repetitive heavy lifting, bending, or twisting at work
Long periods of sitting (desk jobs, driving)
Diabetes (increases risk of nerve damage)
Obesity, which places extra stress on the spine

Signs & Symptoms

Sciatica symptoms can vary from mild discomfort to disabling pain. Common signs include:

Pain: Sharp, shooting, or burning pain radiating from the lower back or buttock down the back of one leg. The pain can be constant or come and go, and is often worse with sitting, coughing, or sneezing.
Numbness or tingling: “Pins and needles” or a loss of sensation in the leg, calf, or foot.
Weakness: Muscle weakness in the affected leg or foot, sometimes causing the foot to “slap” the ground (foot drop).
Movement changes: Difficulty walking, standing, or getting up from a chair due to pain or weakness.

Red-Flag Warnings (Seek Immediate Medical Care):

Sudden, severe leg weakness
Loss of bowel or bladder control
Numbness in the groin or “saddle” area

These could indicate cauda equina syndrome—a rare but serious emergency requiring urgent treatment.

Diagnosing Sciatica

At Precision Pain & Spine Institute, we take a detailed and individualized approach to diagnosing sciatica:

History & Physical Exam: We review your symptoms, work and lifestyle, prior injuries, and overall health. During the exam, we check your strength, reflexes, and sensation in the legs. Simple movements, such as raising your leg while lying down, can help pinpoint the irritated nerve.
Imaging: If your symptoms are severe, persistent, or atypical, we may recommend imaging. An MRI provides the best view of discs, nerves, and soft tissues. X-rays or CT scans may be used to look for bone problems.
EMG/Nerve Conduction Studies: If there’s concern about nerve damage or if diagnosis remains unclear, electrodiagnostic testing helps assess how your nerves and muscles are functioning.

At your first visit, expect a thorough evaluation, a clear explanation of your condition, and a personalized plan.

Treatment Options

The vast majority of people with sciatica improve without surgery. Our philosophy is to use the least invasive, most effective therapies based on your diagnosis and lifestyle.

Conservative (Non-Surgical) Treatments

Physical Therapy: Core strengthening, targeted stretches, and posture training to relieve nerve pressure and restore movement. Physical therapy can also teach you safe ways to lift, bend, and sit to prevent recurrence.
Medications: Non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or nerve pain medications to reduce pain and inflammation.
Activity Modifications: Light activity (not bed rest) is encouraged, but avoid movements that trigger symptoms. Ergonomic adjustments at home or work are often recommended.

Interventional and Image-Guided Procedures

Epidural Steroid Injections: Anti-inflammatory medication is injected near the affected nerve root to reduce swelling and pain.
Myofascial/Trigger Point Injections: For patients with significant muscle spasm, these injections target tight bands of muscle that worsen nerve pain.
Chiropractic Care: Gentle spinal adjustments may help relieve nerve compression from spinal misalignment or muscle tension.

Surgical Treatments (Last Resort)

Surgery may be considered for severe cases involving progressive weakness, loss of bladder or bowel control, or pain that does not improve after several months of conservative treatment. Procedures may include microdiscectomy (removal of the herniated disc portion) or decompression to relieve pressure on the nerve.
Surgical intervention is rare and usually reserved for patients with significant neurological deficits or emergencies.

Living With Sciatica

Coping with sciatica can be frustrating, but daily routines and lifestyle changes can help you manage symptoms and reduce the risk of flare-ups.

Stay active: Walking and gentle stretching are usually better than prolonged rest. Avoid heavy lifting, twisting, or sitting for long periods during flare-ups.
Ergonomic support: Use supportive chairs with proper lumbar support at work and at home. Place a cushion or rolled towel behind your lower back if needed.
Footwear: Wear shoes with good arch support to reduce strain on your back and legs.
Weight management: Maintaining a healthy weight can reduce pressure on the spine.
Sleep position: Try sleeping on your side with a pillow between your knees, or on your back with a pillow under your knees to reduce nerve irritation.
Mental health: Chronic pain can affect mood and sleep. Prioritize stress management techniques such as mindfulness, relaxation exercises, or talking with a counselor if needed.

Prevention Tips

While not all cases of sciatica can be prevented, these strategies can reduce your risk:

Regular exercise: Focus on core and lower back strengthening, hamstring stretches, and general fitness.
Proper posture: Sit and stand tall. Use lumbar support and avoid slouching.
Safe lifting: Always lift with your legs, not your back. Hold objects close to your body.
Frequent breaks: Stand, stretch, and walk if your job involves long hours of sitting or driving.
Footwear: Choose shoes that provide cushioning and stability, especially if you are on your feet much of the day.
Healthy weight and diet: Balanced nutrition helps reduce inflammation and maintain spinal health.

How We Can Help

At Precision Pain & Spine Institute, you’ll be cared for by a collaborative team of board-certified pain management physicians, orthopedic surgeons, spine specialists, physical therapists, and chiropractors. We use state-of-the-art diagnostics—including MRI, EMG, and advanced imaging—and the most up-to-date treatment options.
You don’t have to wait weeks to be seen; we offer same-week and even same-day appointments.

Book your consultation today to start your personalized path to relief.

Frequently Asked Questions

1. How long does sciatica usually last?

Most cases improve within four to eight weeks. If symptoms persist longer, further evaluation and targeted therapy are recommended.

2. Can I work or exercise with sciatica?

Yes, gentle activity is better than bed rest. Physical therapy can help you learn which movements are safe and which to avoid.

3. Do I need surgery for sciatica?

Surgery is rarely needed and is reserved for severe or emergency cases. Most patients recover with non-surgical care.

4. Will sciatica come back after treatment?

It’s possible, but staying active, maintaining good posture, and following your therapy plan greatly reduce recurrence.

5. When should I see a doctor for sciatica?

See a specialist if your pain lasts more than two weeks, worsens, or is associated with weakness, numbness, or loss of bowel/bladder control.

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