Sciatica (lumbar radiculopathy)

Sciatica is the everyday name for pain that travels from the low back into the leg. Physicians often call the same pattern lumbar radiculopathy when a nerve root is irritated.

What it feels like

Pain may start in the buttock and travel down the thigh, calf, or foot, sometimes with numbness, tingling, or a sense of weakness.

Sitting, coughing, or bending forward can flare it for some people. Others hurt more with standing or walking if stenosis is involved.

Symptoms can be sharp, burning, or electric. The exact path often hints at which nerve root is irritated.

What is going on

A lumbar nerve root can be irritated by disc herniation, inflammation, or foraminal narrowing.

True sciatica follows a nerve-root pattern. Buttock pain alone is not always sciatica; facets and the SI joint can refer nearby.

Most acute radicular flares improve over time, but progressive weakness or cauda equina warning signs need urgent care.

How we evaluate

We map the pain path, check strength and reflexes, and review provocative maneuvers.

Imaging is interpreted against the exam, not in isolation. Prior MRIs are welcome; new studies are ordered when they change decisions.

We also look for hip and SI contributions that can mimic or add to leg pain.

What we may offer

Time, activity modification, and coordinated rehab are foundational when neurologic status is stable.

For significant radicular pain, epidural steroid injections may calm the irritated root and improve function.

Refractory pain or progressive deficit prompts surgical discussion with the right specialist at the right time.

Is sciatica always a herniated disc?

A herniated disc is a common cause, but stenosis and other root irritants can produce the same pattern.

When should I worry about weakness?

New or worsening foot drop, major leg weakness, saddle numbness, or bowel or bladder change should be evaluated promptly.

Can an epidural help sciatica?

For selected radicular patterns, yes. It reduces inflammation around the nerve root. It does not remove a large disc fragment on its own.

How is sciatica different from SI joint pain?

Sciatica typically travels farther down the leg in a nerve distribution. SI pain is more often buttock-centered with less distal radiation.