Understanding Sciatica: What It Is and How to Manage It

Sciatica can be a painful and challenging condition, but understanding the sciatic nerve, its importance, and the causes of sciatic pain can help you take the first steps toward relief. Pain management doctors are experts in diagnosing and treating sciatica, offering a range of treatments from medications to injections. In this article, Christopher Woolley, M.D., D. ABA, discusses this condition and treatment options.

What is the Sciatic Nerve?

The sciatic nerve is one of the most important nerves in your body. It starts in your lower back as spinal nerve roots coming from the L4 to S3 level and runs all the way down to your feet. It’s the longest and largest nerve in your body and is responsible for connecting your spinal cord with your leg and foot muscles.

Why Is It Important?

The sciatic nerve plays a crucial role in your ability to walk, run, and even stand. Here is why:

Movement: It controls the muscles in the buttock, back of your leg, your knee and lower leg.

Sensation: It allows you to feel sensations in the back of your thigh, part of your lower leg, and the sole of your foot.

Reflexes: It helps with the reflexes in your lower body. If something goes wrong with your sciatic nerve, it can cause a lot of problems. That is why understanding this nerve is so important.

Causes of Sciatic Pain and Where the Pain Can Be Located

Sciatica is the name for pain caused by irritation or compression of the sciatic nerve. In fact, according to Harvard Health up to 40% of people will experience it in their lifetime, and the chances of experiencing this pain increases as people age. But what causes this pain, and where can you feel it?

4 Common Causes

Herniated Disc: This is the most common cause of sciatica. A herniated disc occurs when one of the discs in your spine is damaged and presses on the roots of the sciatic nerve.
Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the roots of the sciatic nerve.
Piriformis Syndrome: The piriformis muscle, located in the buttock region, can sometimes press down on the sciatic nerve if the muscle spasms or tightens.
Injury: A direct injury to the lower back or buttocks can damage the sciatic nerve.

Where Can You Feel Sciatic Pain?

The pain can be felt in various parts of your body, depending on where the nerve is affected.
Here is a breakdown:

  • Lower Back: Often, the pain starts in the lower back.
  • Buttocks: The pain can radiate from the lower back to the buttocks.
  • Legs: You might feel pain down one or both legs, sometimes extending to the foot.
  • Feet: In severe cases, the pain can reach your feet and toes.

The pain can be sharp, burning, or even feel like an electric shock. It can also cause numbness, tingling, or muscle weakness in the affected leg or foot.

How a Pain Management Doctor Can Help You

Dealing with sciatic pain can be a daily challenge. The good news is that a pain management doctor can help with diagnosing and treating all types of pain, including sciatica. “As a pain management physician, we have lots of options for treating leg pain like sciatica,” says Christopher Woolley, MD, D. ABA. “There are procedures such as epidural steroid injections that can be done in our office that are performed at the level of the spine that may be causing the problem. If someone has tried epidural steroid injections but has not found relief (or has only gotten short term relief with these), we have other non-surgical interventions like spinal cord stimulation that can help with sciatica symptoms. Aside from interventional options, we have many different nerve pain medications or types of physical therapy we can recommend that are helpful with sciatic nerve pain. “

What Does a Pain Management Doctor Do?

  • Diagnosis: The first step is to find out what is causing your pain. The doctor will ask about your symptoms, perform a physical exam, and might order imaging tests such as an MRI or X-ray.
  • Treatment Plan: Once they know the cause of your pain, they will create a treatment plan tailored to your needs.

Treatments for Sciatic Pain

Here are some common treatments that a pain management doctor might recommend:


  • Pain Relievers: Over-the-counter or prescription pain relievers can help reduce pain.
  • Anti-inflammatory Drugs: These can help reduce inflammation around the sciatic nerve.
  • Muscle Relaxants: If muscle spasms are causing the pain, these can help.

Physical Therapy:

  • Exercises: Specific exercises can strengthen the muscles around your spine and improve flexibility.
  • Stretches: Stretching exercises can help relieve pressure on the sciatic nerve.


  • Steroid Injections: These can reduce inflammation and provide relief from pain.
  • Nerve Blocks: These injections can block pain signals from the affected nerve.

Lifestyle Changes:

  • Weight Management: Maintaining a healthy weight can reduce pressure on your spine.
  • Posture: Improving your posture can help prevent sciatic pain.
  • Exercise: Regular exercise can keep your back strong and flexible.

In most cases, sciatica can be treated without surgery. However, if the pain is severe and does not improve with other treatments, surgery might be an option. A pain management doctor can refer you to a surgeon if needed.

By working with a pain management doctor, you can find the right treatment plan and get back to enjoying your life without pain. If you are dealing with sciatic pain, do not hesitate to set up an office visit with us at 775-323-2080.