What is sciatica?
The sciatic nerve is the largest nerve in the body. It forms from roots in the lower spine and runs through the buttock and down the leg. When a herniated disc, bone spur, or narrowed canal presses on one of those roots, the whole nerve line can light up with pain.
That is why sciatica usually follows a clear path: from the lower back or buttock, down the back of the thigh, and sometimes past the knee into the calf and foot.
Sciatica symptoms
- Burning, shooting, or electric pain from the lower back into one leg
- Numbness or tingling along the path of the nerve
- Weakness in the leg or foot
- Pain that worsens with sitting and eases with walking or standing
When to seek care right away
Get urgent help for any of these
- Loss of bowel or bladder control, or numbness in the saddle area. These can signal cauda equina syndrome, a surgical emergency. Go to the emergency room.
- Leg weakness that is spreading or getting worse day over day
- Sciatica on both sides at once
- Pain following a significant fall or accident
Everything else on this page can wait for an appointment. These signs cannot.
What causes sciatica
The most common cause is a lumbar herniated disc. Spinal stenosis, bone spurs, and spondylolisthesis can also compress a nerve root and produce the same leg pain.
Sciatica frequently follows a lifting injury or a fall on the job. Long hours of driving or sitting can also aggravate a nerve that is already under pressure. When the trigger is work, the return-to-work plan is part of the treatment.
How Dr. Merola diagnoses sciatica
Dr. Merola pinpoints which nerve root is involved through examination and by reading your MRI and any nerve studies himself. Matching the level of compression to your exact symptom pattern is what makes targeted treatment possible.
Every patient meets with Dr. Merola directly. He reads your imaging himself.
Sciatica treatment: conservative care first
Non-surgical care first
- Structured physical therapy to reduce nerve tension and rebuild support around the spine.
- Image-guided epidural or selective nerve-root injections when the pain is severe or slow to settle.
- Activity modification and a clear plan for what to do during a flare.
When surgery is indicated
- When leg pain persists despite a fair trial of conservative care, or when weakness is progressing, surgery to relieve the pressure on the nerve is considered.
- The procedure is chosen to match the cause, most often a microdiscectomy for a herniated disc or a lumbar decompression for stenosis.
Recovering from sciatica: what to expect
Recovery depends on what is irritating the nerve, how long symptoms have been present, whether weakness or numbness is present, and how the condition responds to treatment.
Work status after treatment is individualized. Restrictions and progression depend on symptoms, neurologic function, healing, and the physical demands of the job.
If this happened on the job
Sciatica is one of the most common reasons injured workers end up off the job. The classic story is a lifting injury or a fall that herniates a lumbar disc, followed by weeks of leg pain that make a physical job impossible.
Dr. Merola is an authorized New York Workers' Compensation Board provider (authorization 189354-4).
Work status and activity restrictions are based on the examination, imaging, diagnosis, treatment plan, and the demands of the individual job. Tell the office that the condition may be work-related when scheduling so the visit can address those clinical questions.
The New York Workers' Compensation Board publishes official guidance for injured workers at wcb.ny.gov. Questions about filing deadlines, benefits, coverage, or a claim's status should be directed to the Board or a qualified legal professional.
Physical therapy, injections, surgery: how the ladder actually works
Sciatica treatment is a ladder, and surgery is the top rung, not the first step.
The first rung is targeted therapy and time. Specific exercises reduce nerve tension, the core and hips take load off the spine, and a meaningful share of sciatica cases settle within weeks. Flare management matters as much as the exercises: what to do at 2 AM, how long to sit, when walking helps.
The second rung is an injection, when pain outruns therapy. An image-guided epidural or selective nerve-root injection places anti-inflammatory medication right where the nerve is pinched. Some patients get enough relief to finish therapy. Others learn from a weak response that the nerve is more compressed than hoped, which sharpens the surgical conversation.
The third rung is surgery, microdiscectomy in most disc cases, reserved for pain that will not settle, weakness that is progressing, or a foot that is going numb. On that rung, Dr. Merola performs the operation himself.
Wondering which rung you are on? That is exactly what a consultation answers. Call the office and bring your questions.
Why patients choose Dr. Merola
- More than 30 years and over 20,000 patients treated across cervical, thoracic, and lumbar spine care
- Every patient meets Dr. Merola in person. He reads your imaging himself and performs every operation personally
- Conservative care first. Surgery is reserved for clear indications
- Castle Connolly Top Doctor, Fellow of the Scoliosis Research Society, affiliations with NewYork-Presbyterian and Weill Cornell
- Authorized New York Workers' Compensation Board provider, authorization 189354-4
Procedures used for sciatica
Brooklyn and Manhattan patients bring him this problem regularly, and most of them do not end up in an operating room.
One visit settles most of the worry. If your symptoms read like the ones on this page, reach out through the contact page or call the office directly.
Frequently Asked Questions
How long does sciatica take to go away?
There is no single timeline. Recovery depends on the cause, duration of symptoms, neurologic findings, and response to treatment. Progressive weakness or changes in bowel or bladder control require prompt evaluation.
Can sciatica be treated without surgery?
Yes, in most cases. Physical therapy and targeted injections resolve or control the majority of sciatica. Surgery is reserved for pain that does not respond or for progressing weakness.
What causes sciatica at work?
A lifting injury or a fall that herniates a lumbar disc is the classic work cause. Prolonged sitting and driving can aggravate an already compressed nerve.
Will Dr. Merola treat my sciatica himself?
Yes. He examines you, reads your imaging directly, and stays involved through your recovery.
Is sciatica surgery outpatient?
A microdiscectomy for sciatica is commonly performed as a same-day, minimally invasive procedure. Your specific plan depends on the cause and your health.
Can I keep working with sciatica?
That depends on the neurologic findings, pain, treatment plan, and demands of the job. Dr. Merola can discuss individualized activity restrictions and work status after an evaluation.
Where can I find guidance if the sciatica followed a work injury?
The New York Workers' Compensation Board publishes official information for injured workers at wcb.ny.gov. Coverage and claim questions should be directed to the Board or a qualified legal professional.
When is sciatica an emergency?
Rarely, but certain signs mean same-day care: loss of bladder or bowel control, numbness in the saddle area, or leg weakness that is worsening quickly. Those findings can indicate cauda equina syndrome, a surgical emergency. Ordinary sciatica, painful as it is, is not in that category.
Does sciatica always come from a herniated disc?
Usually, but not always. A narrowed canal, a slipped vertebra, a cyst, or a bone spur can press the same nerve roots and produce the same leg pain. That is why treatment starts with finding the actual cause rather than assuming the disc.
Can sciatica affect both legs?
Usually it is one leg, because one nerve root is compressed on one side. Sciatica in both legs at once, especially with numbness in the saddle area or any bladder or bowel change, is a warning sign that needs same-day evaluation rather than a wait-and-see.
What medications are used for sciatica pain?
Commonly a short course of anti-inflammatory medication, and sometimes medications developed for nerve pain. What fits you depends on your health, your other medications, and the cause of the sciatica, which is why the visit starts with the cause and not a prescription.
Is there a permanent fix for sciatica?
The honest answer is that treatment fixes the cause, and the cause can come back. A microdiscectomy relieves the pressure on the nerve, and conditioning work reduces the odds of a repeat. No surgeon can promise a lifetime guarantee, and anyone who does should prompt a second opinion.
Additional reading
Trusted sources for going deeper. These sites are independent of the practice.
- Cleveland ClinicSciatica
A thorough patient guide to sciatic nerve pain and its causes.
- National Institute of Neurological Disorders and StrokeSciatica
The federal research institute's page on sciatica.
- WebMDSciatica Pain Relief Options
An overview of self-care and medical options for sciatica pain.
- New York Workers' Compensation BoardInformation for Injured Workers
Official NY guidance on reporting an injury and filing a claim.
References
- Sciatica. American Academy of Orthopaedic Surgeons, OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/sciatica/
- Sciatica. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/sciatica.html
Educational content prepared July 2026, reviewed October 2026 by Andrew A. Merola, MD. This page is educational and does not create a doctor-patient relationship.