Sciatica is a symptom, not a diagnosis. The useful question is what is compressing or irritating the nerve.
What it is
Pain travelling from the low back or buttock down the back of the leg, following the sciatic nerve.
The usual cause is a disc herniation pressing on a nerve root, most often at L4-5 or L5-S1. Spinal stenosis produces a similar picture in older patients.
Piriformis and deep gluteal syndromes can mimic it, which is why examination matters.
How it usually presents
- Sharp, electric or burning pain down the leg, often past the knee.
- Numbness or pins and needles in a specific strip of skin.
- Weakness — difficulty raising the foot or standing on tiptoe.
- Worse with sitting, coughing or sneezing.
How we treat it
- Establish the level involved by examination and, where needed, EMG and nerve conduction testing.
- Epidural steroid injection targeted at the affected root.
- Physical therapy once the acute inflammation is controlled.
- Surgical referral where there is progressive weakness or a failure to respond.
To be assessed, call (314) 310-5577 or request an appointment. If this began with a crash or a fall, see accident and injury care.
Common questions
Will it resolve on its own?
Many disc-related sciaticas improve over six to twelve weeks. Progressive weakness changes that calculation and needs prompt assessment.
Is sciatica always a disc?
No. Stenosis, the sacroiliac joint and deep gluteal compression all produce leg pain, and they are treated differently.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.