Sciatica is one of the most common reasons patients visit our clinic. The sharp, shooting pain that radiates from the lower back down through the buttock and into the leg can be debilitating — but the good news is that most sciatica resolves without surgery.
The sciatic nerve
The sciatic nerve is the largest nerve in your body, running from the lower spine through the buttock and down each leg. When something compresses or irritates this nerve at its origin in the spine, you feel pain along its entire path — even though the problem is in your back, not your leg.
Common causes
Herniated disc: The most frequent cause of sciatica. The soft inner material of a spinal disc pushes out and presses on a nerve root. This often occurs in the L4-L5 or L5-S1 levels of the lumbar spine.
Spinal stenosis: Narrowing of the spinal canal, usually from age-related arthritis, that compresses the nerve roots. More common in patients over 60.
Degenerative disc disease: As discs lose height and hydration with age, the space for nerves narrows. This can cause chronic, low-grade sciatica that worsens over time.
Spondylolisthesis: When one vertebra slips forward over the one below it, the misalignment can pinch nerve roots.
Treatment options
At Restore Orthopedics & Spine, we follow a "preservation over procedure" philosophy. Most sciatica patients improve with conservative treatment:
Epidural steroid injections deliver anti-inflammatory medication directly to the compressed nerve. Dr. Eric Chang and Dr. Andrew Germanovich perform these under fluoroscopic guidance for precise targeting.
Physical therapy strengthens the core muscles that support the spine and improves flexibility, reducing pressure on the nerve.
When conservative care fails after 6–8 weeks, minimally invasive surgery such as microdiscectomy or endoscopic decompression can provide rapid, lasting relief. Dr. Gregory Carlson and Dr. S. Samuel Bederman specialize in these procedures.
Most sciatica resolves without surgery
With consistent conservative care — including epidural injections, physical therapy, and anti-inflammatory medication — the majority of sciatica patients improve within 6–12 weeks. Surgery is reserved for those who don't respond, or who develop weakness or bowel/bladder changes.
Experiencing these symptoms? We can help.
Same-week appointments. Most insurances and Medicare accepted.
Call (714) 598-1745