Clinical Guide · Spine Surgery · Pain Management

Sciatica (Lumbar Radiculopathy)

Sciatica is not a diagnosis, but a symptom of nerve compression in the lower back that causes radiating pain to travel down the leg, often past the knee.

Spine & Neurology Education Series

Sciatica: Symptoms, Causes & Expert Treatment Guide
Sciatic Nerve
Longest and largest nerve in the body
90% Success
Most cases resolve without surgery
L4-S3
Spinal levels typically involved
Recovery
Often within 4-8 weeks of therapy

What is Sciatica?

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. It is clinically known as Lumbar Radiculopathy.

Expert Note

True sciatica is distinguished from general back pain by the fact that the leg pain is often more severe than the back pain itself.

While the location of the pain depends on which nerve root is compressed, common patterns include:

Shooting Pain

Sharp, electric-like pain that travels from the buttock down the back or side of the leg.

🦶
Numbness/Tingling

Paresthesia or loss of sensation in the calf, foot, or specific toes.

🦵
Muscle Weakness

Difficulty lifting the foot (foot drop) or pushing off with the toes while walking.

🔥
Burning Sensation

A constant "hot" or searing ache, often worsened by sitting or coughing.

Lumbar Disc Herniation

The most common cause. The jelly-like center of a spinal disc leaks out and chemically irritates or physically compresses the nerve root.

Lumbar Spinal Stenosis

Narrowing of the spinal canal due to age-related bone spurs and ligament thickening, often seen in older adults.

Spondylolisthesis

A condition where one vertebra slips forward over the one below it, pinching the nerve.

Other factors: Obesity, sedentary lifestyle, diabetes (nerve damage risk), and occupations requiring heavy lifting or prolonged sitting.

  • 1

    Clinical Examination: The "Straight Leg Raise" test is a classic diagnostic tool to see if stretching the sciatic nerve reproduces the leg pain.

  • 2

    MRI Scan: The definitive tool for visualizing disc herniations and nerve compression levels.

  • 3

    CT Scan: Often used to evaluate bone structure if surgery is being planned.

Over 80-90% of people with sciatica improve within 6 weeks without surgery.

  • Physical Therapy: Core strengthening and "McKenzie" exercises to centralize the pain (move it from the leg back to the spine).
  • Medications: Anti-inflammatories (NSAIDs), muscle relaxants, or nerve stabilizers (Gabapentin).
  • Epidural Steroid Injections (ESI): Injecting anti-inflammatory medicine directly around the compressed nerve to reduce swelling.
  • Activity Modification: Avoiding prolonged sitting and heavy lifting while remaining as active as pain allows.

Surgery is typically considered if leg pain is debilitating after 6-12 weeks of therapy, or if there is significant progressive weakness.

Microdiscectomy

A minimally invasive procedure where the surgeon removes the specific part of the disc that is pressing on the nerve. This has a high success rate for relieving leg pain.

Red Flag Symptoms

Seek emergency care if you experience "Cauda Equina Syndrome": sudden loss of bowel/bladder control, or numbness in the "saddle area" (inner thighs/groin).

How long does a sciatica flare-up last?
Most acute flares improve significantly within 4-6 weeks with proper rest and physical therapy.

Is walking good for sciatica?
Yes, gentle walking is often encouraged to prevent stiffness, but you should avoid hills or uneven terrain that might aggravate the nerve.

Recovery Exercises

Watch a video demonstration of nerve gliding exercises designed to reduce sciatic nerve tension.

View Exercises →

Medical Disclaimer: This guide is for informational purposes. Sciatica symptoms can mimic other serious conditions. Always consult with a spine specialist for a personalized diagnosis and treatment plan.

Neurosurgery built on experience.

Guided by precision.

Centred on the patient

Contact

+91 9011333841, +91 7720948948

102, Bhagyatara Society, Erandwane, Pune, India

The information on this website is for educational purposes only and does not constitute medical advice. Consult a qualified neurosurgeon for guidance specific to your condition. Read full disclaimer →

Copyright @2025 | Dr. Jaydev Panchawagh | Praavi Medicare