Sciatica: Causes, Symptoms, Treatment & Exercises

By Dashvanth Healthcare Medical Team · Reviewed by Dr. Simranjeet Singh, M.Ch Neurosurgery (AIIMS) · East Delhi

What Is Sciatica?

Sciatica refers to pain that radiates along the path of the sciatic nerve — 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 — L4/L5 or L5/S1 level)
• Lumbar canal stenosis (narrowing of spinal canal)
• Degenerative disc disease
• Spondylolisthesis (vertebral slippage)
• Piriformis syndrome (rare — 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 — 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 — highly effective for acute sciatica

Surgery

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