Sciatica

Sciatica is pain that runs along the path of the sciatic nerve — starting in your lower back, traveling through your buttock, and shooting down the leg, sometimes all the way to the foot. It's a description of the pain, not a diagnosis on its own — something has to be irritating the nerve. The most common cause is a lumbar disc herniation — a soft spinal disc bulging out and pressing on one of the nerve roots in your lower back. Other causes include narrowing of the spinal canal (lumbar stenosis), one vertebra slipping forward on another (spondylolisthesis), tightness in the muscle the nerve passes under (piriformis syndrome), or — rarely — a tumor or blood clot pressing on the nerve.

Patients usually describe it as burning, electric, or shooting — distinct from the dull ache of muscle pain. It typically gets worse with prolonged sitting, bending, and coughing. The good news: the vast majority of cases settle down without surgery.

• Shooting, burning, or electric pain running from your lower back or buttock down the back or outside of one leg — sometimes all the way to the foot
• Numbness or tingling along the same path, often in the calf or sole of the foot
• Weakness in the leg or foot — a foot that slaps the ground when you walk, or difficulty pushing up on your toes
• Pain that worsens with prolonged sitting, bending forward, coughing, or sneezing
• Relief when walking or lying flat compared to sitting
• Symptoms almost always affect one side — bilateral sciatica is uncommon and warrants urgent evaluation

On exam, your provider does the straight leg raise — slowly lifting your straight leg while you lie on your back. If that reproduces your shooting leg pain in the first 30 to 70 degrees of lift, it strongly suggests a disc is pressing on a nerve root. An MRI is the definitive test — it shows the disc, the nerve, and exactly where the pinch is happening. Nerve-conduction studies (EMG/NCS) can pinpoint which nerve is compressed and give some sense of how much damage there is.

Surgery helps only a small minority of spine patients — usually those with a specific structural problem plus a nerve issue that isn’t getting better with a structured non-operative trial. When that step is genuinely warranted, OSI coordinates it the same way we coordinate every other part of your care: imaging, records, and the handoff are handled for you, so no part of the process falls on your shoulders.

Emergency. Bilateral leg weakness, saddle numbness, or loss of bladder or bowel control is a surgical emergency — go to the nearest emergency department rather than waiting for a clinic appointment.

External patient-education references and related OSI pages for additional background:

• Britannica — Sciatica
• Britannica — Vertebral column
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language