Sciatica

OpenStax Anatomy & Physiology · Public Domain

Sciatica describes pain that travels along the path of the sciatic nerve — from the lower back through the buttock and down the leg, often extending to the foot. It is a symptom, not a diagnosis. The most common cause is lumbar disc herniation compressing an L4, L5, or S1 nerve root. Other causes include lumbar stenosis, spondylolisthesis, piriformis syndrome, or (rarely) a tumor or hematoma.

The pain is often described as burning, electric, or shooting, and is typically worse with sitting, bending, and coughing. Most cases resolve without surgery.

A positive straight leg raise test (pain reproduced between 30–70° of elevation) is sensitive for disc herniation causing L5 or S1 radiculopathy. MRI is the definitive imaging test. EMG/NCS can confirm the level of compression and assess prognosis.

1. Lumbar epidural steroid injection

   Transforaminal ESI at the affected level is the most effective non-surgical intervention for acute sciatica from disc herniation — 70-80% respond.

Surgery helps only a small minority of spine patients — usually those with a specific structural problem plus a nerve issue that isn’t getting better with a structured non-operative trial. When that step is genuinely warranted, OSI coordinates it the same way we coordinate every other part of your care: imaging, records, and the handoff are handled for you, so no part of the process falls on your shoulders.

Emergency. Bilateral leg weakness, saddle numbness, or loss of bladder or bowel control is a surgical emergency — go to the nearest emergency department rather than waiting for a clinic appointment.

External patient-education references and related OSI pages for additional background:

• Britannica — Sciatica
• Britannica — Vertebral column
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language