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Conditions We Treat

Sciatica

Pain that runs from your lower back down your leg often means a nerve is being squeezed. Finding out where is the first step to lasting relief.

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Overview

What is sciatica?

The sciatic nerve runs from the lower back through the buttock and down each leg. Sciatica is the name for pain along that path. It is a symptom, not a diagnosis. Something in the spine is usually pressing on the nerve.

The pain can feel like a deep ache, a burning line down the leg, or an electric jolt. It usually affects one side, and it often comes with numbness, tingling, or weakness in the leg or foot.

Common symptoms

  • Pain from the lower back into the buttock and leg
  • Burning or electric pain down the leg
  • Numbness or tingling in the leg or foot
  • Weakness in the leg or foot
  • Pain that gets worse with sitting
  • Trouble standing up or walking comfortably
Causes

What causes sciatica.

Sciatica happens when the sciatic nerve, or one of the nerve roots that form it, gets compressed in the lower spine. The right treatment depends on which structure is doing the pressing. A herniated disc is the most common cause in younger patients.

Conditions that can be responsible

  • Herniated disc pressing on a nerve root
  • Lumbar spinal stenosis
  • Degenerative disc disease
  • Spondylolisthesis
  • Piriformis syndrome (less common, not from the spine)
When to seek evaluation

When rest is not enough.

Many cases of sciatica improve within a few weeks with simple care. Pain that persists, worsens, or comes with growing weakness needs evaluation.

A new change in bladder or bowel control needs medical attention right away.

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Consider evaluation if

  • Leg pain has lasted more than four to six weeks
  • Pain is severe or getting worse
  • Numbness or tingling is constant or spreading
  • Weakness in the leg or foot
  • Symptoms are not improving with conservative care
  • Any new change in bladder or bowel control

An early answer gives you more options.

Diagnosis

How Dr. Pompliano evaluates your condition.

Dr. Pompliano begins with your pain pattern: where it starts, where it travels, and what makes it better or worse. The exam includes nerve tension tests, reflexes, and strength testing to find which nerve root is involved.

An MRI usually confirms where the nerve is being compressed and why. He reviews the images with you so the diagnosis is clear before talking about treatment.

Sciatica is a symptom. The goal is to find its cause and treat that.

A clinician examines a patient's lower back
Treatment

Your path to treatment.

Most people with sciatica get better without surgery. The plan depends on how severe the symptoms are and how the nerve responds over time.

Surgery is considered when pain stays severe despite conservative care, or when the nerve is losing strength. When surgery is the right call, it is often a small, focused procedure.

Non-surgical options

  • Physical therapy and guided exercise
  • Anti-inflammatory and nerve pain medication
  • Epidural steroid injections
  • Activity changes while the nerve calms down

Surgical options when indicated

  • Microdiscectomy
  • Lumbar decompression (laminectomy)
  • Lumbar fusion when instability is involved
  • Minimally invasive approaches
A masked surgeon at work in the operating room
Why Dr. Pompliano

The right spine surgeon for sciatica.

Fellowship-trained. Conservative first. Focused on function.

Fellowship

Fellowship-trained in minimally invasive spine surgery at the San Diego Spine Foundation.

Philosophy

Surgery is recommended only after non-surgical care has had a fair chance.

Nerve expertise

Trained in microdiscectomy and decompression to take pressure off the nerve.

Integrated care

Practices with Columbia Orthopaedic Group, with imaging and pain management in the same group.

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Why Patients Trust Dr. Pompliano

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Schedule your consultation

Sciatica that will not let up?

Schedule an evaluation to find the cause of your symptoms and learn your options.

The first step is a conversation.

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