Sciatica
At Unique Pain Medicine of New York, our board certified physicians are experts in the diagnosis and treatment of Sciatica.
We offer Sciatica treatments in our Manhattan and Brooklyn locations.
Sciatica – Pain, numbness or weakness that starts from the low back and travels into the leg and foot.
The cause of Sciatica is usually a herniated disc in the lumbar spine. This type of nerve pain usually starts from the back or the buttock and travels into one or both legs. Patients typically experience shooting pain, numbness and weakness of the involved extremity. The pain can be severe, making it difficult to walk, sleep or work. Sitting may be more painful than standing. Sciatica can be extremely painful and treatment should be initiated when symptoms appear.
A bulging disc happens when a weakened or deteriorated disc shifts outside of its normal place between the bones of the spine. Usually this occurs slowly over a long period of time as we age, or as a result of an acute injury such as lifting a heavy object. Bulging discs are common. When a disc is acutely displaced, nerves frequently become pinched and inflamed, causing pain and numbness in the buttock, leg and foot.
Sciatica is a treatable condition. Proper treatment and rehabilitation usually results in resolution of symptoms and full recovery. If symptoms are severe or have lasted for more than 2 weeks, please see a physician as soon as possible.
Herniated disc causing a nerve to become “pinched” and inflamed
FAQ
Sciatica usually occurs because of bulging and herniated discs in the lumbar spine. Herniated discs become inflamed and frequently “pinch” nerves that are traveling from the pelvis into the leg. When these nerves become irritated, patients will typically experience shooting pain and numbness in leg and foot.
A normal disc lies between the bones of the spine. When a disc herniates, it leaves its normal location and is pushed backwards or to the side. The nerves that typically travel along the bones of the spine become irritated and “pinched” by the herniated disc.
An MRI is the test of choice if sciatica is suspected. An MRI will show which discs are involved and to what degree.
Treatment should be initiated once sciatica is diagnosed. The choice of treatment will depend on the patients’ symptoms and the MRI findings.
Treatments for Sciatica include:
- Physical Therapy and rest
- Anti-inflammatory and nerve pain medication
- Epidural steroid injection – Transforaminal Epidural or Lumbar Epidural Steroid Injection
Yes, weak bones can lead to compression fractures resulting in severe low back pain.
What is an epidural injection?
If sciatica is causing symptoms and more conservative approaches have failed, an epidural steroid injection should be attempted. The doctor will place an anti-inflammatory steroid medication around the inflamed nerves. This causes rapid pain relief and decreases the swelling around pinched nerves and damaged discs. The procedure is generally not painful and is done in the office setting. There is no downtime after. Pain relief can be dramatic, allowing the patient to return to normal activities.
During the procedure, the doctor uses imaging guidance, such as fluoroscopy, to ensure the needle is placed accurately and safely. This step helps the medication reach the irritated nerve roots without affecting nearby structures. Most patients describe only mild pressure during the injection, and the entire process usually takes less than 15 minutes.
The steroid medication helps reduce swelling and inflammation, while a small amount of anesthetic may be used to provide immediate comfort. For some patients, the effects build gradually over several days as the steroid begins to work. Relief can last anywhere from weeks to months, depending on the underlying condition and individual response.
Epidural injections can also be part of a broader treatment plan. Many patients combine them with physical therapy, stretching, lifestyle changes, or ergonomic adjustments to maintain long-term improvement. While the injection itself often provides powerful relief, pairing it with supportive measures can help prevent symptoms from returning and improve overall spine health.
Epidural steroid injection for spinal pain
FAQ
Side effects are very rare and tend to be mild and easy to manage. Some possible side effects include temporary facial flushing, small increase in blood pressure, increased appetite, menstrual changes in women, and elevated blood sugar in diabetics.
An epidural injection is minimally uncomfortable and very well tolerated. They can be done with local anesthesia or IV sedation if desired. If you have a fear of needles and would rather not feel the injection, you will be given the option to receive IV sedation, which makes the procedure painless. Your doctor will discuss this option with you.
There is no specific number of injections that is recommended in all cases. Every patient and situation is different. We start with 1 injection and wait two weeks to see how the patient improves. If 1 injection alleviates all symptoms, no other injection is recommended. Some patients will require 2 injections for full pain relief. A limited number of patients may require 3 injections. Every patient is evaluated two weeks after an epidural injection to determine the next best course of action.
If properly treated, your symptoms should resolve within 4-6 weeks.
Once a disc is herniated, it will not go back to its original location. However, there are many people living with bulging discs and do not even know about it. Once the acute episode is resolved and inflammation controlled, the symptoms should gradually resolve.
If sciatica is properly diagnosed and treated, surgery is rarely necessary. We recommend that patients with sciatica be evaluated and treated as soon as possible in order to prevent progression of the disease. If patients experience neurologic compromise, or if pain cannot be controlled using more conservative approaches, surgery may be needed.
The diagnosis and treatment of sciatica is covered by all health insurance plans.
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