Sciatica Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Sciatica follows the sciatic nerve down the leg

Sciatica describes pain that radiates along the path of the sciatic nerve,[1] which branches from the lower back through the hips and buttocks and down each leg. It typically affects only one side of the body and is most commonly caused by a herniated disc, bone spur, or spinal stenosis compressing part of the nerve. The pain can range from a dull ache to a sharp, burning sensation or excruciating discomfort, sometimes accompanied by numbness, tingling, or muscle weakness in the affected leg. Our interventional pain specialists at IPC are experts in pinpointing the exact level and cause of sciatic nerve irritation using fluoroscopic-guided diagnostic injections, then treating it with targeted epidural steroid injections, nerve blocks, or minimally invasive decompression procedures.

Lumbar radiculopathy is one cause of sciatica, not a different name for every kind of back pain. It involves a nerve root in the lower spine;[2] our radiculopathy guide also explains nerve-root problems in the neck. Sciatica names the leg-pain pattern, and the evaluation identifies its cause.

Symptoms of sciatica

Sciatica describes pain traveling along the path of the sciatic nerve, most often caused by a disc pressing on a nerve root in the lower back. It is a description of a symptom pattern rather than a diagnosis in itself.

• Pain running from the low back or buttock, down the back of the thigh, and below the knee — the extension below the knee is what most distinguishes it from ordinary referred back pain
• Almost always one-sided
• A sharp, burning or electric quality rather than a dull ache, sometimes described as a jolt down the leg
• Numbness, tingling or pins and needles in the calf, foot or toes
• Symptoms worsened by sitting, and by coughing, sneezing or straining
• Sometimes leg pain that is considerably worse than the back pain itself
• Weakness in the leg or foot, such as difficulty lifting the toes when walking

Many episodes improve over several weeks. Symptoms persisting beyond that, or involving weakness, warrant assessment.

When to see a pain specialist about sciatica

Arrange an evaluation if leg pain has persisted beyond about six weeks, if it is severe enough to disturb sleep or prevent work, if it keeps recurring, or if numbness or weakness is present.

The aim of the assessment is to establish which nerve root is affected and why, because that determines treatment. Transforaminal epidural steroid injections placed under live X-ray guidance target the inflamed nerve root directly, and are frequently used both to relieve pain and to confirm the level. Most people with sciatica improve without surgery, and interventional treatment is often what makes that possible.

Seek same-day emergency assessment for new difficulty controlling your bladder or bowels, numbness in the area that would contact a saddle, or weakness in both legs. A foot that is newly dropping, or weakness that is progressing, should also be assessed promptly rather than waiting for a routine appointment.

Treatment options for sciatica

Most people with sciatica improve without surgery, and the options below are aimed at that path — settling the inflammation around the nerve root first, with decompression considered if it does not resolve.

References

Clinical sources for this page.

1. Sciatica. StatPearls [Internet], National Library of Medicine; updated January 4, 2024. Back to first citation ↑
2. American Academy of Physical Medicine and Rehabilitation. Lumbar Radiculopathy. Back to first citation ↑