Neurosurgery & Spine

Sciatica: Causes, Symptoms, Treatment & Exercises

By Dashvanth Healthcare Medical Team Β· Reviewed by our specialists Β· East Delhi

What Is Sciatica?

Sciatica refers to pain that radiates along the path of the sciatic nerve β€” from the lower back through the buttock and down one leg. It is a symptom, not a diagnosis. The underlying cause is usually compression of a nerve root in the lumbar spine.

Common Causes

  • Lumbar disc herniation (most common β€” L4/L5 or L5/S1 level)
  • Lumbar canal stenosis (narrowing of spinal canal)
  • Degenerative disc disease
  • Spondylolisthesis (vertebral slippage)
  • Piriformis syndrome (rare β€” sciatic nerve irritated by piriformis muscle)

Symptoms

  • Pain: sharp, burning, shooting from buttock down leg (usually one side)
  • Numbness and tingling in leg and foot
  • Weakness β€” difficulty walking on heels or tiptoe
  • Pain worsened by sitting, coughing, sneezing, long drives

Effective Treatments

Physiotherapy (First Line)

  • McKenzie exercises (extension-based for disc herniation)
  • Core strengthening and spinal stabilisation
  • Neural mobilisation ("sciatic nerve flossing")

Medications

  • NSAIDs, muscle relaxants
  • Gabapentin or pregabalin for neuropathic pain component
  • Short course oral steroids for acute flares

Interventions

  • Transforaminal epidural steroid injection β€” highly effective for acute sciatica

Surgery

Microdiscectomy for persistent neurological deficit or failed conservative care. 90%+ success rate for leg pain relief.

How long does sciatica last?

Acute sciatica from disc herniation: 90% improve within 6–12 weeks with conservative care. Persistent or recurrent sciatica despite treatment warrants specialist evaluation.

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