Sciatica is a symptom — not a diagnosis — describing pain that travels along the sciatic nerve from the low back through the buttock and down the leg, sometimes as far as the foot. It is almost always caused by a herniated disc or spinal stenosis compressing the nerve root, and it responds well to treatment when the underlying cause is correctly identified.
What are the symptoms?
- Sharp, shooting, or burning pain traveling from the low back into the buttock, thigh, and calf
- Leg pain that is often worse than the associated back pain
- Numbness or tingling in the leg, calf, or foot
- Weakness in the leg, particularly with foot dorsiflexion (foot drop in severe cases)
- Pain that worsens with sitting, standing for long periods, or coughing and sneezing
- Pain relieved by lying down or walking short distances in some patients
What causes it?
- Lumbar disc herniation: The most common cause — a disc fragment compresses the nerve root in the lumbar spine (most often at L4–L5 or L5–S1)
- Lumbar spinal stenosis: Narrowing of the spinal canal or the foramen through which the nerve exits, compressing the nerve
- Spondylolisthesis: Vertebral slippage that pinches the exiting nerve root
- Piriformis syndrome: Irritation of the sciatic nerve by the piriformis muscle in the buttock — less common and a diagnosis of exclusion
How is it diagnosed?
The clinical history — pain radiating in a specific dermatomal distribution combined with the pattern of weakness and reflex changes on examination — points to the affected nerve root. MRI of the lumbar spine confirms the structural cause and its relationship to the painful nerve. Electrodiagnostic studies (EMG/nerve conduction) may be used when the clinical picture is unclear or when the duration of symptoms suggests possible nerve injury.
Your Non-Surgical Roadmap — Surgery Is the Last Step
Most patients with this condition get better without surgery. Here's the path Dr. Chavarria follows before an operation is ever on the table:
- 1
Start conservative
Physical therapy, activity changes, anti-inflammatory or nerve medication, and time — the first line for nearly every spine condition.
- 2
Add targeted relief
If symptoms persist, image-guided injections (epidural or nerve blocks) can calm inflammation and pinpoint the source of pain — often avoiding surgery entirely.
- 3
Re-evaluate together
Dr. Chavarria reviews your progress and imaging with you, honestly, and explains exactly where you stand — no pressure, no rush to the OR.
- 4
Surgery — only if it's truly the best option
Reserved for severe or worsening nerve compression, instability, or when conservative care has had a fair chance. When it is right, you'll understand why and what to expect.
Treatment Options in Reno, NV — Conservative Care First
Most sciatica from a lumbar disc herniation resolves with 6–12 weeks of conservative care including anti-inflammatory medications, physical therapy, and epidural steroid injections. For patients with persistent, severe, or neurologically progressive sciatica, Dr. Chavarria offers minimally invasive lumbar microdiscectomy — which removes the compressing disc fragment and provides relief of leg pain in over 90% of patients. Stenotic sciatica is treated with decompression (laminectomy) when conservative measures fail.
Treatment Procedures
Lumbar Microdiscectomy
Lumbar microdiscectomy is one of the most effective and commonly performed spine surgeries. Through a small incision, the herniated portion of the disc that is pressing on a nerve is removed — typically providing immediate relief from leg pain, numbness, and weakness. Most patients are discharged home within a few hours.
Learn More →Laminectomy & Decompression
Laminectomy is a decompression procedure that removes the back portion of a vertebra (the lamina) to enlarge the spinal canal and relieve pressure on the spinal cord or nerve roots caused by spinal stenosis. It is the most commonly performed surgery for lumbar spinal stenosis and offers excellent results in restoring the ability to walk and stand without leg pain.
Learn More →Minimally Invasive Spine Surgery
Minimally invasive spine surgery uses specialized instruments and a small incision — often less than an inch — to treat many spine conditions with less muscle disruption than traditional open surgery. Most patients go home the same day and return to daily activities in weeks rather than months.
Learn More →