Pain Center
Sciatica
Radiating leg pain from compression or irritation of the sciatic nerve.
Overview
Understanding sciatica.
Sciatica is one of the most common chief complaints we see — and one of the most commonly misdiagnosed. The word "sciatica" describes a symptom pattern, not a single diagnosis. The vast majority of cases trace back to a specific structural cause that can be identified on imaging and addressed with a targeted plan: a lumbar disc herniation pressing on a nerve root, a stenotic foramen narrowing the space the nerve travels through, or a piriformis-related compression of the sciatic nerve outside the spine.
Most acute sciatica improves with time and conservative care. The minority that persists is what we treat at HTx Pain Institute — patients whose pain has not responded to physical therapy, oral medications, and time, and who need a more decisive intervention before sciatica derails their work, sleep, or function.
Common Symptoms
- Sharp, burning, or electric pain radiating from the back into the leg
- Numbness or tingling in the buttock, calf, or foot
- Weakness with walking, foot lift, or standing on tiptoes
- Pain worse with sitting, coughing, or sneezing
Common Causes
- Lumbar disc herniation compressing a nerve root
- Foraminal or central spinal stenosis
- Piriformis syndrome
- Spondylolisthesis
How we approach sciatica.
Diagnosis & workup
- Detailed history — pattern of pain, what makes it worse and better, neurologic symptoms.
- Focused physical exam — straight-leg raise, neurologic testing, gait, reflexes.
- MRI of the lumbar spine to identify disc herniation, stenosis, or other compressive cause.
- When MRI is inconclusive, selective nerve-root injection serves as both diagnosis and treatment.
- Electromyography (EMG) in selected cases of unclear or chronic radiculopathy.
When to see a specialist
- Sciatic pain that has lasted more than 4–6 weeks despite physical therapy and oral medications.
- Progressive weakness, foot drop, or worsening neurologic symptoms.
- Pain limiting work, sleep, or core daily activities.
- Sciatica plus bowel or bladder changes — this is an emergency, see immediately.
- Repeated episodes that come back every few months.
What to expect over time.
Recovery from sciatica depends on the cause. Most patients with disc-driven sciatica improve with a combination of targeted injections and a graded physical therapy plan over 6 to 12 weeks. Stenosis-related sciatica often responds to MILD or other targeted procedures. For patients with truly refractory radiculopathy, spinal cord stimulation has the strongest evidence and can return function even after failed surgery. We tailor the trajectory to your imaging, your goals, and your response to each step.
Direct answers — no jargon.
If your question isn’t here, ask us at your consultation.
- Most acute sciatica resolves within 6–12 weeks with conservative care. Persistent sciatica beyond that point usually has an identifiable cause we can target. Few patients require permanent management.
How we treat sciatica, differently.
We do not treat sciatica with a one-size-fits-all injection. We diagnose it. Dr. Baumgartner's approach is to identify the specific anatomic cause on imaging, confirm it with a selective diagnostic injection if needed, and then build a stepwise plan — starting with the least invasive option that actually addresses the cause and escalating only when needed.
Other conditions we treat.
See all conditionsHerniated Discs
When the soft inner disc material pushes through the outer wall and irritates a nerve.Learn moreSpinal Stenosis
Narrowing of the spinal canal that compresses nerves and limits walking.Learn moreBack Pain
The most common reason patients come to us — and where we have the most to offer.Learn moreNeuropathic Pain
Burning, electric, or tingling pain caused by injury or irritation of the nerves themselves.Learn moreMedically Reviewed
Reviewed by Edward Baumgartner Jr., MD · Last reviewed . Information on this page is not medical advice. Always consult your physician.
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