What Is Sciatica? Causes, Symptoms & Treatments

Sciatica is one of the most widely misunderstood and commonly misdiagnosed conditions affecting the lower back and legs. The term “sciatica” does not refer to a diagnosis in itself but rather to a collection of symptoms caused by irritation or compression of the sciatic nerve — the longest and widest nerve in the human body.

Understanding sciatica — including what causes it, how to recognize it, and what treatment options are available — can help you make informed decisions about your spine health.

What Is the Sciatic Nerve?

The sciatic nerve originates in the lower lumbar spine (L4–S3 nerve roots) and travels through the buttocks, down the back of each leg, and into the feet. Because it branches throughout so much of the lower body, compression or irritation of this nerve can produce a wide range of symptoms across a large area.

Common Causes of Sciatica

Sciatica is most often the result of a structural problem in the lumbar spine. The most frequent causes include:

Herniated Lumbar Disc

When the soft inner material of a spinal disc pushes through its outer wall, it can press directly on a nerve root. A lumbar disc herniation is the leading cause of sciatica, particularly at the L4-L5 or L5-S1 levels.

Lumbar Spinal Stenosis

Spinal stenosis refers to a narrowing of the spinal canal. As the canal narrows — often due to age-related degenerative changes — nerves can become compressed, triggering sciatic symptoms, especially during walking or standing.

Degenerative Disc Disease

Over time, spinal discs lose their height and hydration. This degeneration can reduce the space available for nerve roots, leading to irritation and sciatic pain.

Piriformis Syndrome

In some cases, the sciatic nerve passes through or near the piriformis muscle in the buttocks. Tightness or spasm in this muscle can compress the nerve and mimic classic sciatica.

Spondylolisthesis

This condition occurs when one vertebra slips forward over another, narrowing the opening through which nerves exit the spine.

Recognizing the Symptoms of Sciatica

Sciatica typically affects only one side of the body. Common symptoms include a sharp, burning, or shooting pain that travels from the lower back through the buttock and down one leg, numbness or tingling in the leg, calf, or foot, muscle weakness in the affected leg, pain that worsens with prolonged sitting, standing, coughing, or sneezing, and a feeling of electric shock or jolting pain with movement. Symptoms can range from mild and intermittent to severe and debilitating.

Diagnosing Sciatica

Proper diagnosis requires more than just a description of symptoms. A spine specialist will perform a detailed physical examination, assess reflexes and muscle strength, and order diagnostic imaging — typically an MRI — to identify the root cause of nerve compression. Accurate diagnosis is essential for choosing the most effective treatment.

Treatment Options for Sciatica

The good news is that most cases of sciatica improve with non-surgical treatment. However, treatment should always be guided by the underlying cause.

Conservative Treatments

Physical therapy with targeted stretching and strengthening exercises reduces nerve pressure and improves lumbar stability. Anti-inflammatory medications such as NSAIDs can reduce inflammation around the nerve. Hot and cold therapy can provide short-term pain relief. Epidural steroid injections — corticosteroids injected near the affected nerve root — can significantly reduce inflammation and pain for weeks to months.

Surgical Treatment

When conservative treatments fail after six to twelve weeks, or when symptoms include progressive neurological deficits such as severe weakness or loss of bladder/bowel control, surgery may be recommended. Common surgical options include microdiscectomy — removal of the portion of a herniated disc pressing on the nerve — and laminectomy, which removes part of the vertebra to widen the spinal canal and relieve nerve compression.

Living With Sciatica — What You Can Do

While professional treatment is essential, lifestyle adjustments play an important role in managing and preventing sciatica recurrence. Maintaining a healthy weight, practicing good posture, staying physically active, and avoiding prolonged sitting are all proven strategies for protecting your lumbar spine.

Get Expert Care for Sciatica in New York

If you are experiencing symptoms consistent with sciatica, Dr. Han Jo Kim, MD offers comprehensive evaluation and a full spectrum of treatment options — from conservative care to advanced minimally invasive surgery. Schedule your consultation today and take the first step toward lasting relief.

Related reading: 10 Warning Signs Your Back Pain Needs a Doctor | Herniated Disc: Symptoms, Diagnosis & Treatment | Why You Have Lower Back Pain When Sitting Down