Sciatica Symptoms, Causes, and Treatments

Sciatica is a common and often painful condition caused by pressure on the sciatic nerve. It falls under a broader category of nerve root irritation known as radiculopathy. Your sciatic nerve is the largest nerve in the body, formed by several spinal nerve roots in the lower back. It runs through your hips and buttocks, down each leg, and into the feet. When this nerve is compressed or inflamed, the result is often sharp, radiating pain—what we call sciatica.

What Causes Sciatica?

Some of the more common causes of sciatica include:

• Herniated discs (HNP): A herniated disc occurs when the soft inner material of a spinal disc protrudes through its outer layer, compressing nearby nerves, including the sciatic nerve.
• Spinal stenosis (narrowing of the spine): Spinal stenosis is the narrowing of the spinal canal, which can compress spinal nerves and cause sciatic pain.
• Bone spurs: Bone spurs are bony projections that can form on the spine and irritate or compress nearby nerves, including the sciatic nerve.
• Degenerative disc disease: Degenerative disc disease is the breakdown of spinal discs over time, which can lead to nerve compression and sciatic pain.
• Trauma or instability in the lumbar spine: Trauma or instability in the lumbar spine can lead to abnormal movement or alignment that compresses the sciatic nerve.

Sciatica is not a condition itself but a symptom of an underlying spinal issue. At Southern California Orthopedic Institute (SCOI), our back and spine specialists are experts in identifying the root cause and developing a plan that works for you.

Watch our short video overview on what causes sciatic nerve pain and how it’s treated:

What Are the Key Symptoms of Sciatica?

Sciatica symptoms can vary from annoying to severe. For some, it is a dull ache that flares with movement. For others, it is a shooting pain that makes walking, sleeping, or sitting difficult.

Specific symptoms of sciatic nerve pain may include:

• Pain in the lower back, buttocks, and down one leg
• Burning, tingling, or numbness in the affected leg
• Muscle weakness
• Pain that worsens with sitting, coughing, or standing
• Difficulty moving or controlling the leg or foot

Sciatica most often affects just one side. If symptoms are sharp, ongoing, or worsen over time, it may be time to see one of our spine specialists.

How Is Sciatica Diagnosed?

At SCOI, we take a clear, step-by-step approach to diagnosing sciatica. Our orthopedic spine specialists begin with a detailed discussion of your symptoms and medical history.

The diagnostic process may include:

• Physical exam: Testing strength, reflexes, and flexibility
• Imaging: High-resolution MRI or CT scans to view disc and nerve structures
• Electrodiagnostic testing (if needed): To assess nerve function

Because sciatica is a symptom of a larger issue, pinpointing the exact source is essential. Is it a herniated disc? A bone spur? A structural change in the spine? Our spine doctors use on-site, state-of-the-art imaging and clinical exams to find the real cause.

How Is Sciatica Treated?

Treatment depends on what’s causing your sciatica and how severe it is. At SCOI, we always begin with conservative care unless your symptoms are severe or rapidly worsening.

Conservative Treatments

Many cases of sciatica improve with time, movement, and guided care. Our nonsurgical options include:

• Anti-inflammatory medications
• Physical therapy to stretch and strengthen the spine
• Targeted pain injections, such as epidural steroid injections
• Heat or ice therapy
• Bracing (if instability is an issue)

This type of conservative care can reduce inflammation, improve nerve mobility, and strengthen your core to prevent future flare-ups.

Pain Management

For patients with moderate to severe chronic sciatica, our team may recommend pain management, such as:

• Lumbar epidural steroid injections: Lumbar epidural steroid injections deliver anti-inflammatory medication into the epidural space around the spinal nerves to reduce inflammation and relieve sciatic pain.
• Selective nerve root blocks: Selective nerve root blocks involve injecting an anesthetic and steroid near a specific spinal nerve root to diagnose and reduce pain from nerve compression.
• Sacroiliac joint injections: Sacroiliac joint injections involve administering medication into the sacroiliac joint to reduce inflammation and pain that may mimic or contribute to sciatica.
• Radiofrequency ablation (for long-term nerve pain relief): Radiofrequency ablation uses heat generated by radio waves to disrupt pain signals by targeting specific nerves, providing longer-term relief from chronic nerve pain.

These procedures are performed under imaging guidance by SCOI’s board-certified interventional pain specialists.

Surgical Options

If pain doesn’t respond to conservative care—or if there’s significant nerve compression, weakness, or loss of control—surgery may be the best option. SCOI spine surgeons perform:

• Microdiscectomy – Removing part of a herniated disc to relieve pressure
• Laminectomy – Removing bone or tissue to create more space in the spinal canal
• Spinal fusion – Stabilizing a spine segment using bone grafts and implants

Minimally invasive spine surgery is often used when appropriate, offering faster recovery and less downtime.

At SCOI, we treat sciatica daily and help patients get back to work, hobbies, and life. Our integrated team includes orthopedic spine surgeons, physiatrists, pain specialists, and physical therapists, all working together under one roof. Whether you’re facing new pain or chronic sciatica, we’re here to help.

Request an appointment today with a back or spine expert at SCOI and take the first step toward real relief.