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Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. It most commonly occurs when a herniated disc, bone spur, or spinal stenosis compresses part of the nerve. While the pain can be severe, most cases resolve within 6-12 weeks with conservative treatment.

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Symptoms

  • Pain radiating from the lower back down the leg
  • Sharp, burning, or shooting pain in the buttock or leg
  • Numbness or tingling in the leg or foot
  • Weakness in the affected leg
  • Pain that worsens with sitting
  • Pain on one side of the body (rarely both)

When to See a Doctor

See a spine specialist if leg pain is severe or worsening, if you have progressive numbness or weakness, or if symptoms do not improve with 4-6 weeks of conservative care. Seek emergency care for sudden loss of bladder or bowel control.

Treatment Options

Physical therapy

Core strengthening, stretching, and nerve mobilization exercises. McKenzie method and other directional preference exercises can reduce symptoms.

Medications

NSAIDs for inflammation, muscle relaxants for spasms, gabapentin for nerve pain. Short-term oral steroids for acute flare-ups.

Epidural steroid injection

Targeted steroid injection near the compressed nerve root. Provides significant relief in 50-80% of patients. Can be repeated up to 3 times per year.

Microdiscectomy

Minimally invasive surgery to remove the herniated disc material pressing on the nerve. 85-90% success rate for leg pain relief. Recovery in 2-6 weeks.

Recovery Timeline

Most sciatica resolves within 6-12 weeks with conservative treatment. Epidural injection: relief within days. Microdiscectomy: return to desk work in 2-4 weeks, full activity in 6-12 weeks.

Frequently Asked Questions

How long does sciatica last?

Most episodes of sciatica resolve within 6-12 weeks with conservative treatment. About 80-90% of patients improve without surgery. Chronic sciatica (lasting more than 3 months) may require more aggressive treatment including injections or surgery.

What is the best treatment for sciatica?

The best initial treatment combines physical therapy (core strengthening and nerve mobilization), anti-inflammatory medication, and activity modification. Epidural steroid injections help when conservative measures are insufficient. Surgery is considered when symptoms persist or worsen despite 6-12 weeks of conservative care.

What type of doctor treats sciatica?

Orthopaedic spine surgeons, neurosurgeons, physical medicine and rehabilitation (PM&R) doctors, and pain management specialists all treat sciatica. A spine surgeon is recommended when surgery may be needed.

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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.