Sciatica is a pattern of nerve-related pain that radiates from the lower back into the leg, typically caused by compression of a spinal nerve. Common underlying causes include disc herniation, spinal stenosis, or degenerative changes in the spine.
Aqib Zehri, MD, is a fellowship-trained neurosurgeon specializing in complex spine conditions. He provides comprehensive evaluation to determine the cause of sciatica and develops a treatment plan tailored to each patient, ranging from conservative care to surgical intervention when needed.
Sciatica refers to pain that radiates along the path of the sciatic nerve, typically from the lower back into the buttock and down the leg. It is a form of lumbar radiculopathy, meaning it results from irritation or compression of a nerve root in the lumbar spine.
The sciatic nerve is the largest nerve in the body and travels from the lower spine through the hips and into each leg. When a nerve root is compressed, it can disrupt normal nerve signaling and lead to radiating pain.
Common causes include:
Herniated disc
Spinal stenosis
Degenerative disc disease
Identifying the underlying cause is essential, as sciatica is a symptom of nerve compression rather than a diagnosis itself.
Symptoms typically affect one side of the body and can range from mild discomfort to severe pain.
Common symptoms include:
Sharp, burning, or shooting pain radiating into the leg
Numbness or tingling in the leg or foot
Muscle weakness in the affected leg
Pain that worsens with sitting
Difficulty standing or walking
Symptoms may be intermittent or persistent and often follow the distribution of the affected nerve.
Diagnosis begins with a detailed history and physical examination, including neurologic assessment.
Evaluation typically includes:
Strength testing
Reflex assessment
Sensory examination
Imaging is used to identify the underlying cause of nerve compression:
MRI to evaluate discs, nerves, and soft tissues
CT scans when additional detail of bony structures is needed
These studies help guide treatment decisions based on the source of nerve irritation.
Treatment depends on symptom severity and the underlying cause.
Non-surgical treatment may include:
Activity modification
Anti-inflammatory medications
Physical therapy
Targeted injections when appropriate
Many patients improve without surgery. However, surgical treatment may be considered when:
Symptoms persist despite conservative care
There is significant nerve compression on imaging
Weakness or functional limitation is present
Surgical options are designed to relieve nerve compression and may include:
Discectomy
Minimally invasive or endoscopic decompression
The goal is to relieve pain, restore nerve function, and improve mobility.
Most cases of sciatica are not emergencies and can be managed with conservative treatment. However, certain symptoms may indicate more serious nerve compression and require urgent evaluation.
Seek immediate medical attention if you experience:
Progressive weakness in the leg or foot
Difficulty walking or loss of coordination
Loss of bowel or bladder control
Numbness in the groin or saddle area
These symptoms may be signs of severe nerve compression, including conditions such as cauda equina syndrome, which require prompt diagnosis and treatment.
In these situations, early intervention is critical to protect nerve function and prevent long-term complications.
If you are experiencing persistent leg pain, numbness, or weakness, a comprehensive evaluation can help determine the underlying cause and appropriate treatment.
Call the office or request an appointment online to get started.