Sciatica is pain that radiates along the path of the sciatic nerve: from the lower back, through the buttock, and down the back of one leg. It is a symptom, not a diagnosis: in most cases it is caused by a herniated disc or narrowed spinal canal pressing on a nerve root in the lower spine. Around 80-90% of cases improve without surgery, typically within four to six weeks of the right treatment.
What sciatica feels like
Sciatica has a distinctive pattern that separates it from ordinary back pain. It almost always affects one side of the body, and the leg pain is often worse than the back pain itself.
- Sharp, burning or electric-shock pain running from the lower back into the buttock and down the leg
- Pain that worsens when you sit for long periods, cough, sneeze or strain
- Numbness, pins and needles, or a "dead" feeling in the calf, foot or toes
- Weakness in the leg or foot, such as difficulty lifting the front of the foot when walking
- Relief when lying down or walking short distances, then a return on sitting
Pain that affects both legs equally, or that stays entirely in the lower back, usually points to a different cause. That distinction matters, because it changes the treatment completely.
Seek emergency care immediately if you have
These symptoms can indicate cauda equina syndrome, a rare but serious condition that needs treatment within hours, not days.
- Loss of control over your bladder or bowels
- Numbness around the inner thighs, buttocks or genital area
- Rapidly worsening weakness in one or both legs
- Severe pain following a fall, accident or injury
What causes sciatica
The sciatic nerve is formed by nerve roots leaving the lower spine. Anything that compresses or irritates those roots can produce sciatic pain.
| Cause | What happens | Typical age group |
|---|---|---|
| Herniated (slipped) disc | The soft centre of a spinal disc pushes out and presses on a nerve root. The most common cause by a wide margin. | 30-50 |
| Spinal stenosis | Age-related narrowing of the spinal canal squeezes the nerves. Pain often eases when leaning forward. | 55+ |
| Spondylolisthesis | One vertebra slips forward over the one below, narrowing the space the nerve passes through. | Any |
| Piriformis syndrome | A deep buttock muscle irritates the sciatic nerve directly. Often mistaken for a disc problem. | Any |
| Degenerative disc disease | Discs lose height and hydration with age, reducing the space available for nerve roots. | 40+ |
Long hours of sitting, driving, being overweight and heavy manual work all increase risk, but they are contributors, not the cause. Identifying which nerve root is affected is what determines the treatment, and that requires examination, not just a scan report.
How we diagnose it
An MRI on its own is not a diagnosis. Studies consistently find disc bulges on scans of people with no pain at all, so the scan has to be matched to what we find on examination.
- Clinical examinationStraight-leg raise testing, reflexes, muscle power and sensation mapping to identify the specific nerve root involved.
- Review of your historyHow the pain started, what makes it better or worse, what treatments you've already tried and how you responded.
- Targeted imagingMRI where it will change the plan. We correlate the findings with your examination rather than treating the scan.
- Diagnostic nerve blockWhere the source is unclear, a small anaesthetic injection at a specific nerve root confirms the pain generator before any definitive treatment.
How sciatica is treated without surgery
We work up a ladder, starting with the least invasive option that is appropriate for your diagnosis. Most patients never need to reach the top of it.
Medication and activity modification
Anti-inflammatory medication and nerve-specific drugs reduce the inflammation around the compressed root. Complete bed rest is not recommended. Staying gently active speeds recovery in most cases.
Structured physiotherapy
Targeted strengthening of the core and gluteal muscles, nerve gliding exercises and posture correction. Supervised programmes consistently outperform generic exercise sheets.
Image-guided epidural or transforaminal injection
A precisely placed anti-inflammatory injection delivered under C-arm guidance directly to the affected nerve root. This is a day-care procedure taking 15-30 minutes under local anaesthetic. You walk in and go home the same day.
Advanced options for persistent nerve pain
When sciatic pain persists despite injections and rehabilitation, advanced day-care options such as neurolytic blocks and neuromodulation techniques can calm the overactive pain pathway, without open surgery, a general anaesthetic, or a hospital stay.
When surgery is the right answer
Surgery becomes appropriate when there is progressive neurological weakness, cauda equina syndrome, or when several months of appropriate non-surgical treatment has genuinely failed. If you have been advised surgery and want to be certain it's necessary, a second opinion costs you one consultation.
What recovery usually looks like
| Timeframe | What to expect |
|---|---|
| 24-72 hours after injection | Noticeable reduction in leg pain for most patients as inflammation begins to settle |
| Week 1-2 | Return to light daily activity and desk work; rehabilitation programme begins |
| Week 3-6 | Full benefit of treatment develops; strength and walking distance improve steadily |
| Beyond 6 weeks | Focus shifts to preventing recurrence through strength, posture and work-setup changes |
Recovery timelines vary with the underlying cause, how long the nerve has been compressed and your general health. Your specialist will give you a realistic timeline for your specific diagnosis at consultation.
Coming to AIKYA from across Bangalore and nearby towns
Because the sciatica procedures we perform are day-care under local anaesthetic, treatment rarely needs more than one visit after your consultation. Patients reach us from every part of Bangalore, and regularly from Hosur, Tumakuru, Kolar and towns beyond the city.
If you are travelling in, tell our coordinator when you book. We schedule your examination, imaging review and, where appropriate, your procedure so the trip is planned as a single day, with your follow-up handled by phone and a scheduled review visit only when it is genuinely needed.
Frequently asked questions
How long does sciatica take to go away?
Most episodes of sciatica improve substantially within four to six weeks with appropriate treatment. Pain that persists beyond six to eight weeks, or that comes with weakness, should be assessed by a specialist rather than managed with painkillers alone.
Can sciatica be cured permanently?
Sciatica caused by a disc herniation often resolves completely once the inflammation settles and the disc material shrinks naturally. Preventing recurrence depends on core strength, posture and work setup, which is why rehabilitation is part of the treatment rather than an optional extra.
Is walking good for sciatica?
Generally yes. Gentle walking maintains circulation and prevents the stiffness that comes with prolonged rest. Stop if walking sharply increases your leg pain or causes numbness, and mention it at your consultation, since that pattern can point to spinal stenosis.
Do I definitely need an MRI for sciatica?
Not always. Many patients improve with treatment before imaging becomes necessary. An MRI is genuinely useful when symptoms persist, when there is neurological weakness, or when we are planning a targeted injection or procedure.
Is an epidural injection for sciatica safe?
Image-guided epidural injections have a strong safety record when performed by a trained specialist under C-arm or ultrasound guidance. The procedure is done under local anaesthetic, takes 15 to 30 minutes, and you go home the same day. Your specialist will explain the specific risks in your case before you consent.