The sciatic nerve is the largest in the body. Problems with this nerve can cause sciatica (lumbar radiculopathy)—pain, tingling, numbness or weakness that travels down the lower back and into the leg or extremity. Sciatica treatment at Weill Cornell Medicine helps eliminate or reduce sciatica symptoms.

Sciatica is not a disease; it is a symptom of an underlying medical condition. It most commonly occurs when a herniated disc or narrowed spinal area (spinal stenosis) compresses part of the sciatic nerve. This causes pain to radiate from the lower back. Often, sciatica pain travels behind the thigh and below the knee to the ankle or foot. When the sciatic nerve is compressed in the piriformis muscle in the buttock area, it is called piriformis syndrome.

Additionally, nearby bone, muscle, tumors, infections, injury or bleeding can irritate the sciatic nerve and cause sciatica.

Symptoms of Sciatica

Sciatica symptoms vary based on the location of the pinched nerve and may include:

Constant pain on one side of the buttock or leg
Leg pain that feels like burning or tingling
Loss of bowel or bladder control
Pain that worsens when sitting or radiates down the leg and possibly into the foot and toes (radiculitis)
Weakness, numbness or difficulty moving the affected leg, foot or toes (radiculopathy)

Sciatica Treatments

Sciatica treatment typically begins with conservative measures. Your care team may prescribe one or more of the following:

Application of heat or ice to the hurting area
Exercise and physical therapy to relieve pressure on the sciatic nerve
Massage therapy
Muscle relaxants
Oral corticosteroids (anti-inflammatory drugs)
Over-the-counter pain relievers

Mild sciatica often resolves through a combination of these conservative therapies. However, severe pain may require additional care. In these cases, epidural corticosteroid injections or other nerve blocks (sciatic nerve block) may benefit you. Your provider injects powerful anti-inflammatory medication into the area outside your spine with a thin needle using image guidance such as an X-ray or ultrasound. The goal is to help relieve inflammation and swelling of a herniated disc, which reduces nerve irritation and sciatica symptoms.

In some cases, targeted stimulation (spinal cord or peripheral nerve) may benefit longer-lasting cases. These are often tried when surgery may not be appropriate or a less invasive approach is warranted.

If symptoms continue, your team may recommend surgery. During radiculopathy surgery, the spinal surgeon decompresses the sciatic nerve to bring pain relief and restore full use and motion of affected limbs. When surgery is appropriate, our surgeons take the least invasive approach possible. This leads to positive results, a quick recovery and reduced scarring.

Why Choose Weill Cornell Medicine

The team in the Weill Cornell Medicine Division of Pain Management specializes in diagnosing and treating sciatica. We work with a broad team of specialists to help you regain independence and functionality and enjoy an improved quality of life.

After assessing your case, we tailor a treatment plan that may include medication, pain management and physical therapy. We explain all treatment options and empower you to control your health journey. If you require surgery, we discuss your procedure and the expected outcome.

In addition, Weill Cornell Medicine engages in clinical trials, giving you access to new treatments offered at few locations. Learn more about Pain Management's current clinical trials.

Turning to Weill Cornell Medicine also gives you access to a multidisciplinary team of sciatica experts. At the Och Spine at NewYork-Presbyterian at the Center for Comprehensive Spine Care and Och Spine at NewYork-Presbyterian/The Spiral, your care teams may include providers from the following disciplines: