What Is Sciatica?

Sciatica refers to pain caused by irritation or compression of the sciatic nerve. The sciatic nerve is the largest nerve in the body and forms from several nerve roots that exit the lower spine between the L4 and S3 vertebrae in the lumbar and sacral spine. These nerves join in the pelvis and travel through the buttock and down the back of each leg.

When pressure affects one or more of these nerve roots, it can disrupt normal nerve signals and cause pain, numbness or weakness along the path of the nerve. This nerve root irritation is medically known as lumbar radiculopathy.

Sciatica usually affects only one leg and may range from mild discomfort to severe shooting pain. Men between the ages of 30 and 50 are somewhat more likely to develop sciatica.

Symptoms of Sciatica and Nerve Pain

Symptoms of nerve compression in the lower back can vary depending on the severity and location of the affected nerve. Common symptoms include:

• Pain in the lower back, buttock or hip
• Shooting pain that travels down the back of the leg
• Burning or tingling sensations in the leg or foot
• Numbness in the leg, calf or foot
• Muscle weakness in the leg or foot
• Pain that worsens when sitting, coughing or sneezing

Symptoms of sciatica may worsen with certain movements such as bending, twisting the lower back, raising the affected leg or straining during a bowel movement. The pain from sciatic nerve compression can range from mild tingling to a severe burning sensation.

In severe cases, nerve compression can lead to loss of muscle control or difficulty walking. If symptoms include loss of bladder or bowel control, immediate medical attention is necessary.

What Causes Sciatica?

Sciatica occurs when a spinal nerve becomes compressed or inflamed. Several spine conditions can contribute to this nerve irritation. Risk factors for sciatica include improper spine mechanics and certain daily activities such as prolonged sitting, heavy lifting or repetitive twisting.

Herniated Disc

A herniated disc is one of the most common causes of sciatica. Spinal discs act as cushions between the vertebrae. When a disc bulges or ruptures, it can press against nearby nerve roots, causing pain that radiates down the leg.

Degenerative Disc Disease

As the spine ages, the discs between vertebrae can lose hydration and height. This can narrow the spaces where nerves exit the spine, increasing the risk of nerve compression.

Spinal Stenosis

Spinal stenosis occurs when the spinal canal narrows and places pressure on the nerves. When narrowing occurs in the lumbar spine, it can irritate the nerve roots that form the sciatic nerve.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward over another. This shift can narrow the spinal canal or nerve openings and compress nearby nerves.

Piriformis Syndrome

The piriformis muscle in the buttock lies near the sciatic nerve. If this muscle becomes tight or inflamed, it can irritate the nerve and cause symptoms like sciatica.

Injury or Trauma

Falls, sports injuries or heavy lifting can damage spinal structures and lead to nerve compression.

Diagnosing Sciatica

Proper diagnosis is important because sciatica is often a symptom of an underlying spine condition rather than a condition itself.

During your evaluation, a spine specialist may perform:

• A review of your medical history and symptoms
• A physical examination to evaluate nerve function and identify possible causes of pain
• Strength, reflex and mobility testing

Imaging studies may also be recommended to identify the cause of nerve compression. These may include:

• X-rays to evaluate spinal alignment
• MRI scans to view discs, nerves and soft tissue structures
• CT scans for detailed images of spinal bones
• Electromyography (EMG) or nerve conduction studies to evaluate nerve function

Identifying the source of nerve irritation helps determine the most effective treatment plan.

Preventing Sciatica

Taking steps to protect your spine can help reduce the risk of developing sciatica. Maintaining a healthy weight and staying physically active helps support the spine and reduce pressure on the sciatic nerve. Regular exercise, especially activities that strengthen the core and lower back, can improve spinal stability and flexibility.

Using proper lifting techniques is also important. Bending at the knees and keeping the back straight when lifting heavy objects helps avoid excessive strain on the spine.

Avoiding prolonged sitting or standing can also help reduce stress on the lower back. If your work requires long periods of sitting, taking regular breaks to stand, stretch and walk may help prevent stiffness and nerve irritation.

Maintaining good posture and wearing supportive footwear may also reduce pressure on the spine and help prevent nerve compression. If you experience persistent or worsening symptoms such as muscle weakness, numbness or severe pain, seeking medical evaluation can help identify the underlying cause and prevent complications.

Non-Surgical Treatment for Sciatica

Most patients with sciatica improve with non-surgical treatments. Conservative care focuses on reducing nerve inflammation, relieving pain and restoring mobility.

Common non-surgical treatments include:

Physical Therapy

Targeted exercises strengthen the muscles supporting the spine, improve posture and reduce pressure on the nerves.

Medication

Anti-inflammatory medications and muscle relaxants may help relieve pain and inflammation.

Activity Modification

Adjusting certain activities, improving body mechanics and avoiding movements that irritate the nerve can help reduce symptoms.

Spinal Injections

Epidural steroid injections or nerve blocks may be used to reduce inflammation around the affected nerve root and provide pain relief.

Many patients experience improvement within several weeks to a few months with these treatments.

Surgical Treatment for Sciatica

Surgery may be considered if conservative treatments fail to relieve symptoms or if significant nerve compression is causing muscle weakness or progressive nerve damage.

Common surgical procedures used to relieve nerve pressure include:

• Microdiscectomy – removal of part of a herniated disc pressing on a nerve
• Laminectomy – removal of part of the vertebral bone to create more space for nerves
• Spinal fusion – stabilization of the spine when instability contributes to nerve compression

Many procedures can be performed using minimally invasive techniques, which may result in smaller incisions and faster recovery.

When to See a Spine Specialist

You should consider seeing a spine specialist if you experience:

• Persistent lower back pain that radiates down the leg
• Numbness or tingling in the leg or foot
• Muscle weakness in the leg
• Pain that interferes with daily activities
• Symptoms that do not improve after several weeks

If symptoms are severe, include numbness or weakness in the leg or involve changes in bladder or bowel control, immediate medical evaluation is necessary.

Early evaluation can help prevent nerve damage and improve treatment outcomes.

Sciatica and Nerve Pain Treatment at OrthoTexas

The spine specialists at OrthoTexas provide comprehensive care for sciatica and nerve pain caused by spinal conditions. Our team focuses on identifying the underlying cause of nerve compression and developing a personalized treatment plan that may include non-surgical care, interventional pain management or advanced spine surgery when necessary.