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Sciatica

Sciatica is not a condition on its own. It describes pain caused by compression or irritation of the sciatic nerve or the nerve roots that form it. Pain usually begins in the lower back and radiates through the hip and buttock and down the leg, sometimes with numbness, tingling, or weakness. Most sciatica improves with conservative care, and minimally invasive treatment can relieve the pressure when it does not.

What Is Sciatica?

The sciatic nerve is the longest and widest nerve in the body. It forms from the L4 through S3 nerve roots in the lower back, runs through the buttock, and travels down the back of each leg, controlling muscles and supplying sensation to the leg and foot.
 
Sciatica is a form of lumbar radiculopathy. When one of those nerve roots is pinched, most often by a herniated disc, pain and other symptoms follow the nerve into the leg. Medical experts estimate that as many as 40 percent of people will experience sciatica at some point in their lives.

Treatments For Sciatica

Your physician will determine whether sciatica is acute or chronic. Treatment ranges from self-care to minimally invasive procedures.

Non-surgical care

  • Heat or cold packs. Ease pain and muscle spasm.
  • Exercises and stretches. Reduce pressure on the nerve.
  • Physical therapy. Strengthens the core and improves mobility.
  • Pain medication. Anti-inflammatory and nerve pain medication.
  • Steroid injections. Calm the inflamed nerve root.
  • Nerve root blocks. Target the specific nerve.

Minimally invasive procedures

Most procedures are performed same-day, on an outpatient basis. Your surgeon will recommend the least invasive option appropriate for your condition.

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How Sciatica is Diagnosed

Evaluation begins with a clinical history and an examination of strength, reflexes, sensation, and a straight-leg raise test, which stretches the sciatic nerve. MRI shows which nerve root is compressed and why. X-rays can show alignment and slippage, and nerve studies can help in unclear cases.
 
If you already have MRI imaging, you can sign up for our free MRI review. Our team of highly trained staff will examine your imaging, answer all of your questions, and help point you towards the path of effective, minimally invasive treatments.
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Illustration of an annular tear in a lumbar disc highlighted in red

What Causes Sciatica?

Sciatica may develop with age or after trauma such as a car or work accident, sports injury, or fall. The primary cause is a nerve pinched by a herniated disc. Other common causes include:

Herniated or bulging disc

Disc material presses on a lumbar nerve root.

Bone spurs

Osteophytes from spinal arthritis narrow the nerve's path.

Spinal stenosis

Narrowing of the canal or nerve openings.

Spondylolisthesis

A slipped vertebra pinches the nerve root.

Piriformis irritation

A tight buttock muscle can irritate the sciatic nerve outside the spine.

Injury

Falls, accidents, and sports injuries.

Where Sciatica Pain Travels

The nerve root involved shapes where symptoms are felt in the leg.

L4 root

L3-L4 level

Front of the thigh and inner shin.

L5 root

L4-L5 level

Outer leg and top of the foot; may weaken the big toe or cause foot drop.

S1 root

L5-S1 level

Back of the calf, heel, and outer foot.

See also foot drop, which can accompany L5 compression.

Frequently Asked Questions

What is sciatica?

Sciatica describes pain that travels along the sciatic nerve, from the lower back through the buttock and down the leg. It is a symptom of an underlying problem, most often a compressed nerve root in the lower back.

How long does sciatica last?

Many episodes of sciatica improve within four to six weeks with conservative care. Symptoms that persist longer, keep returning, or include weakness should be evaluated.

What is the most common cause of sciatica?

A herniated disc pressing on a lower lumbar nerve root, usually at L4-L5 or L5-S1, is the most common cause. Spinal stenosis, bone spurs, and spondylolisthesis are other causes.

Can sciatica affect both legs?

Sciatica usually affects one leg. Symptoms in both legs can point to central spinal stenosis or a large disc herniation and should be evaluated promptly.

When is sciatica an emergency?

Seek immediate care for sciatica with progressive leg weakness, foot drop, numbness in the groin or inner thighs, or any loss of bladder or bowel control, which can signal cauda equina syndrome.

Does sciatica require surgery?

Most sciatica improves without surgery. A procedure such as endoscopic discectomy is considered when pain persists despite conservative care or when there is significant or progressive weakness.

What helps sciatica at home?

Short walks, gentle stretching, heat or ice, and over-the-counter anti-inflammatory medication help many people. Avoid prolonged bed rest and long periods of sitting.

Are sciatica procedures done same-day?

Most minimally invasive and endoscopic procedures for sciatica at Total Spine and Orthopedics are performed on a same-day, outpatient basis. To schedule an evaluation in Melbourne, Orlando (Lake Nona), or Titusville, call (321) 499-4646.

Symptoms Of Sciatica

Sciatica usually affects one side of the body. Common symptoms include:

  • Low back pain that may be mild compared with the leg pain.
  • Pain in the buttock or leg, often worse with sitting.
  • Shooting or stabbing pain that travels down the leg.
  • Burning or tingling in the leg or foot.
  • Numbness or weakness in the leg or foot, or hip pain.
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Related Conditions

Herniated Discs

Chances are you’ve heard of a herniated disc. If you have been diagnosed with a herniated disc, you are likely also familiar with the pain and symptoms often caused by this condition. As you begin to research the treatment options available to help you find pain relief, it’s important to understand what causes a herniated disc to develop in the first place.

Radiculopathy

Radiculopathy is a pinched spinal nerve root causing pain, numbness, or weakness that radiates into an arm or leg. Learn the causes and minimally invasive treatments.

Pinched Nerves

Pinched nerves are one of the most common causes of chronic neck and back pain. A nerve becomes “pinched” when it is placed under pressure from an external source, such as an out of place bone or soft tissue from a herniated disc.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that can crowd the nerves and cause back pain and leg pain when standing or walking.

Bulging Discs

Bulging discs, also known as disc protrusions, are a very common occurrence in people of all ages. The spine is made up of small, round bones (vertebrae) that are cushioned by shock-absorbing discs. These discs feature a tough, fibrous shell and a soft, gel-like core. The outer fibrous portion of our discs can weaken due to factors such as daily wear and tear, sudden injury, and the body’s natural aging process. Pressure from the inner core of the disc can then stretch to the outer rim, causing the disc to “bulge” outward in one direction.

Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward over the one below it, which can strain joints and compress nerves.

Drop Foot/Foot Drop

Dropped foot or foot drop is a common condition that can be treated with minimally invasive techniques.

Back Pain

If you are experiencing back pain, you are not alone. Back pain affects 80 percent of Americans at some point in their lives, and, in fact, low back pain is one of the most prevalent causes of disability in people under the age of 45. There are many causes of back pain, with some more serious than others.

Sacroiliac (SI) Joint Pain

If you’ve heard of SI Joint Pain, you may know that it is one of the most common causes of chronic back pain. According to some estimates, as much as 24% of back pain originates from the SI Joint and related issues. The actual causes of this SI-Joint originating pain can vary greatly from age related issues to injury, or spinal abnormalities.

When Sciatica Needs A Procedure

The Minimally Invasive Advantage

How ultra-minimally invasive and endoscopic procedures compare with traditional open surgery, and why most patients recover faster.

Traditional open surgeryMinimally invasive / endoscopicOur specialty at Total Spine
IncisionA lengthy incision is required to expose the spine.A tiny incision, smaller than a dime, is used.
Muscle and soft tissueMuscle is cut and dissected to reach the spine.Muscle is preserved and gently moved aside, supporting a quicker recovery.
Hospital stayTypically an overnight or multi-day hospital stay.A same-day procedure; most patients return home within hours.
Blood loss and infection riskGreater blood loss and a higher risk of infection.Minimal blood loss and a lower risk of infection.
Postoperative painMore pain, often requiring stronger medication for longer.Markedly less pain for most patients, with lighter use of pain medication.
Return to daily activityA lengthy recovery, often weeks to months before normal activity.A faster recovery; many patients resume light activity within days.
ScarringLeaves a larger, more noticeable scar.Leaves only a small scar.

When sciatica needs a procedure, endoscopic and minimally invasive techniques mean less pain, a smaller scar, and a faster return to everyday life.

Our Patients Stories

Hear our patients share their experience with us, All in their own words.

Why Choose Total Spine and Orthopedics

Expert, ultra-minimally invasive spine and orthopedic care, close to home.

  • Ultra-minimally invasive and endoscopic techniques

    We specialize in procedures performed through incisions smaller than a dime, sparing muscle and supporting a faster recovery.

  • Same-day, outpatient procedures

    Most patients walk in and return home within hours, rather than facing an overnight hospital stay.

  • Board-certified, fellowship-trained surgeons

    Our team includes early leaders in endoscopic spine surgery.

  • A complimentary MRI review

    Understand your diagnosis and options from a board-certified specialist before committing to any treatment.

  • Trusted by our community

    More than 1,100 patient reviews at a 4.6-star average, and over 50,000 patients treated.

  • Treating the cause, not just the leg pain

    We find which nerve root is compressed and why, then relieve the pressure with the least invasive option.

  • Comprehensive spine and orthopedic care

    From injections to advanced procedures, your full continuum of care is handled in one place.

  • Convenient locations across the Space Coast and Orlando

    Care close to home in Melbourne, Orlando (Lake Nona), and Titusville.

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