Back pain is one of the most common and debilitating medical conditions worldwide, and sciatica is one of its most recognizable forms. Sciatica occurs when the sciatic nerve becomes irritated or compressed, causing pain that radiates from the lower back through the buttocks and down the leg. While treatments like physical therapy, medications, or surgery can help, they do not always provide lasting relief. Interventional pain medicine offers a more targeted approach.

This field focuses on identifying the exact source of nerve irritation and treating it with minimally invasive techniques, helping many patients reduce pain and regain mobility.

What Causes Sciatica?

Sciatica is a symptom of an underlying issue affecting the spine or nearby structures.

Common causes include:

• Herniated or bulging discs
• Degenerative disc disease
• Spinal stenosis
• Sacroiliac (SI) joint dysfunction
• Piriformis syndrome

Low back pain can originate from multiple structures, making an accurate diagnosis essential.

“There could be six or seven different anatomical structures around the lower back area which could manifest as low back pain, but weeding them out is super important,” states Dr. Akhil Shori with Riverside Orthopedic Specialists.

Contributing risk factors include:

• Aging-related muscle loss and decreased bone density
• Sedentary lifestyle or prolonged sitting
• Poor posture or workstation ergonomics
• Prior surgeries affecting gait

Recognizing the Symptoms

Sciatica symptoms can vary in severity and often worsen without treatment.

Common symptoms include:

• Sharp or shooting pain down one leg
• Burning or tingling sensations
• Numbness in the leg or foot
• Muscle weakness
• Pain that worsens with sitting or bending

Lifestyle habits play a significant role in symptom development.

“If you’re not doing stretches in between your work, you’re just sitting all day, your muscles will get really, really tight,” cautions Dr. Shori. “So, stretching those muscles, taking breaks in between, going for walks, and even using a standing desk is great if you’re working at a computer for a long time. Those things can really help delay this process and keep you in check.”

When to Seek Care

Early evaluation can prevent symptoms from worsening.

See a healthcare provider if:

• Pain lasts more than two to three weeks
• Symptoms do not improve with over-the-counter medications
• Pain interferes with daily activities
• Weakness or numbness increases

“If you have any pain that is affecting your quality of life and that pain is lingering on more than two to three weeks, that’s when it is the ideal time to see a professional to mitigate and manage the pain,” encourages Dr. Shori.

Treatment Options

Treatment depends on the underlying cause and severity.

Conservative approaches include:

• Physical therapy
• Stretching and strengthening exercises
• Anti-inflammatory medications
• Activity and ergonomic adjustments

When needed, interventional pain medicine provides targeted relief.

Minimally invasive options include:

• Image-guided steroid injections
• SI joint or piriformis injections
• Nerve-focused procedures using X-ray guidance

These treatments help reduce pain, allowing patients to participate in rehabilitation.

“The big cornerstone for all these modalities is to get you some pain relief so you can participate in physical therapy. We want those muscles to get stronger so they can offload the joint around the SI,” shares Dr. Shori. “That’s where the physical therapy piece of it comes in. If you continue doing the exercises, making those muscles stronger, and we take away your pain, it goes a long, long way.”

“If the pain is bothering you significantly and affecting your quality of life, it’s time to see a professional to get it checked and find out what the right solution is for your needs,” he adds.

To learn more about Riverside Orthopedic Specialists and interventional pain medicine options at Riverside, visit ChooseRiversideOrtho.com or call (815) 802-7090.