Understanding Sciatica: Causes, Symptoms, and the Latest Treatment Options

Sciatica is a common cause of leg pain that can be sharp, burning, or electrical in quality. It often follows the path of the sciatic nerve from the lower back through the buttock and down the back of the leg. While many episodes of sciatica improve with conservative care, some cases persist and interfere with daily life. This guide explains what causes sciatica, how to recognize it, and the modern treatment options that pain specialists offer to restore function and comfort.

At Southern Pain Clinic we tailor treatment plans to each patient, combining conservative care with targeted interventional options when needed. Our approach emphasizes finding the source of pain and using state of the art therapies to improve outcomes. 

What is sciatica and what causes it

Sciatica refers to symptoms produced by irritation or compression of the sciatic nerve. The most common structural causes include lumbar disc herniation and lumbar spinal stenosis. Disc herniation occurs when the soft center of a spinal disc bulges or ruptures and compresses nearby nerve roots. Spinal stenosis is a narrowing of the spinal canal that can compress nerves, often related to degenerative changes.

Other causes can include spondylolisthesis, where one vertebra slips forward on another, and less commonly tumors or infection. Muscle tightness in the buttock, such as from piriformis syndrome, can also mimic sciatica symptoms.

Typical symptoms

Sciatica often presents with one or more of the following:

• Sharp or burning pain that travels from the lower back through the buttock and down one leg.
  • Numbness, tingling, or pins and needles in the leg or foot.
  • Weakness in the leg or foot, which may make it hard to lift the foot.
  • Pain that worsens with sitting, coughing, or sneezing.
  • Difficulty walking or standing for long periods.

If you have progressive weakness, numbness in the saddle area, or new bladder or bowel dysfunction, you should seek immediate medical attention.

How sciatica is diagnosed

Diagnosis starts with history and physical exam. The provider will assess your symptoms, any recent injuries, and how your pain affects function. The neurological exam will test strength, reflexes, and sensation.

Imaging such as MRI is often used to visualize the discs and nerves. X rays may be ordered to evaluate alignment and degenerative changes. At Southern Pain Clinic we integrate clinical exam findings with imaging and other tests to develop a clear picture of the pain source and possible treatment pathways. 

Conservative treatments

Many cases of sciatica improve with non operative care.

• Activity modification. Avoiding provocation while keeping gentle movement is usually advised.
  • Physical therapy. A tailored program can address flexibility, posture, and core strength to reduce nerve tension and support the spine.
  • Medications. Nonsteroidal anti inflammatory drugs, oral steroids in select cases, and neuropathic agents can relieve pain while other treatments take effect.
  • Epidural steroid injections. These injections can reduce inflammation around the nerve root and provide meaningful relief for some patients.

Conservative care is the initial approach for most patients unless there are significant neurological deficits or progressive symptoms.

Interventional and surgical options

If symptoms persist despite conservative care or if there is significant nerve compression with neurological compromise, additional options are available.

• Targeted injections. Selective nerve root injections or transforaminal epidural injections can be both diagnostic and therapeutic. These are performed under image guidance to ensure precision.
  • Radiofrequency ablation. For some patients with facet related pain contributing to radicular symptoms, radiofrequency ablation can be considered.
  • Spinal cord stimulation. For chronic neuropathic leg pain that is not amenable to other therapies, spinal cord stimulation offers a reversible, adjustable option to reduce pain and improve function.
  • Surgery. In cases of a large disc herniation causing persistent weakness or severe, disabling pain, surgical options such as microdiscectomy may be recommended by a spine surgeon.

Our clinic provides a range of interventional therapies performed with imaging guidance and tailored to each patient after careful evaluation. The focus is on minimally invasive treatments designed to relieve pain and restore activity. 

What to expect from injections and procedures

When injections are recommended, the procedure is explained in detail, including the expected benefits, risks, and recovery. Image guidance such as fluoroscopy or ultrasound ensures accurate placement. Many injections provide immediate relief for some patients and longer term benefit for others. A clear plan is outlined that may include repeat injections, physical therapy, and other supportive care.

At Southern Pain Clinic we strive to deliver exceptional patient care and to involve patients in shared decision making about the most appropriate interventions. 

Tips for managing sciatica at home

• Maintain gentle movement. Walking and prescribed exercises can prevent stiffness.
  • Use heat or ice for symptom control. Heat can relax muscles and improve circulation. Ice can reduce acute inflammation.
  • Practice good posture and ergonomic adjustments when sitting or driving.
  • Avoid heavy lifting and sudden bending motions.
  • Follow a graded exercise program to restore strength and flexibility.

When to see a specialist

See a specialist if your pain is not improving after several weeks of conservative care or if your pain is severe enough to limit daily activities. See a specialist immediately if you experience progressive weakness, new bowel or bladder dysfunction, or numbness in the saddle area. Early evaluation can reduce the risk of long term nerve damage and help you return to normal activity sooner.

Sciatica can be painful and frightening, but many patients improve with a thoughtful plan that addresses the underlying cause. If conservative care is not enough, targeted interventional options exist to reduce inflammation and nerve compression while preserving function. If you are living with persistent leg pain that affects your life, a tailored evaluation can point the way to relief.

To learn more about how we approach diagnosis and treatment, request an appointment and our team will work with you to build a personalized care plan. Our mission is to provide state of the art pain control that helps patients regain mobility and improve their quality of life.