Conditions we treat
Sciatica
Pain that travels from the lower back into the leg is often a sign of sciatic nerve irritation. Understanding the source is the first step toward lasting relief.
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Overview
What Is Sciatica?
Sciatica describes pain that radiates along the sciatic nerve, which runs from the lower back through the hip and buttock and down each leg. It is not a diagnosis itself but a symptom of an underlying condition compressing or irritating the nerve.
The pain can range from a dull ache to a sharp, burning sensation. It most commonly affects one side and may be accompanied by numbness, tingling, or weakness in the affected leg.
Common symptoms
- Pain radiating from the lower back into the buttock and leg
- Sharp or burning sensation along the nerve path
- Numbness or tingling in the leg or foot
- Weakness in the affected leg
- Pain that worsens with prolonged sitting
- Difficulty standing up or walking comfortably
Causes
What Causes Sciatica
Sciatica occurs when the sciatic nerve or one of the nerve roots that form it is compressed in the lumbar spine. Several structural conditions can produce this compression, and the right treatment depends on which one is responsible.
Common causes
- Herniated disc pressing on a nerve root
- Lumbar spinal stenosis narrowing the nerve canal
- Degenerative disc disease
- Spondylolisthesis shifting a vertebra out of position
- Piriformis syndrome (less common, non-spinal)
A herniated disc is the most frequent cause of sciatica in younger patients.
When to seek evaluation
When It Needs More Than Rest
Many cases of sciatica improve within several weeks with rest and conservative measures. When the pain persists, worsens, or is accompanied by progressive neurological symptoms, a spine evaluation is warranted.
Sciatic nerve compression that goes unevaluated can lead to lasting weakness or numbness.
Schedule a spine evaluation →Consider evaluation if
- Leg pain has persisted for more than 4–6 weeks
- Pain is severe or progressively worsening
- Numbness or tingling is constant or spreading
- You notice weakness in your leg or foot
- Symptoms are not improving with conservative care
- You experience any change in bladder or bowel function
Early evaluation preserves your treatment options.
Diagnosis
How Dr. Varghese Evaluates Your Condition
Dr. Varghese begins by understanding your pain pattern, when it started, and what makes it better or worse. A physical exam includes specific nerve tension tests, reflex assessment, and strength testing to determine which nerve root is involved.
MRI is typically used to confirm the location and cause of compression. Dr. Varghese reviews all findings together with you to ensure the diagnosis is clear before discussing next steps.
Sciatica is a symptom. The goal is to find and treat its cause.
Treatment
Your Treatment Path
Most patients with sciatica improve with non-surgical treatment. The approach is guided by the severity of symptoms, the degree of nerve involvement, and how the condition responds over time.
Surgery is considered when pain is severe and unresponsive to conservative care, or when nerve compression is causing progressive weakness. When Dr. Varghese recommends surgery, it is because it offers the most reliable path to lasting improvement.
Non-surgical options
- Physical therapy and nerve mobilization
- Oral anti-inflammatory or neuropathic medications
- Epidural steroid injections
- Activity modification and guided exercise
Surgical options when indicated
- Microdiscectomy
- Lumbar decompression (laminectomy)
- Lumbar fusion for instability-related compression
- Minimally invasive approaches
Why Dr. Varghese
The Right Spine Surgeon for Sciatica
Fellowship-trained at one of the nation's top spine centers. Conservative when possible. Precise when it counts.
Fellowship
Advanced spine fellowship at Twin Cities Spine Center with focused lumbar and cervical training.
Philosophy
Surgery is recommended only when it offers a clear advantage over non-operative care.
Lumbar expertise
Trained in microdiscectomy, decompression, lumbar fusion, and minimally invasive techniques.
Integrated care
Practices within Synergy Health Partners with coordinated PT, pain management, and imaging.
★ ★ ★ ★ ★
Why Patients Trust Dr. Varghese
"Dr. Varghese listens. It's that simple. He is not quick to cut."
— Patient of Dr. Varghese
"He spends as much time with you as needed and explains everything clearly."
— Patient of Dr. Varghese
"Very glad to have had his second opinion. He is kind, considerate and takes time to teach his patients."
— Patient of Dr. Varghese
Schedule your consultation
Sciatica That Won't Let Up?
Schedule an evaluation to understand the cause of your symptoms and explore appropriate treatment options.
The next step is a conversation. Everything else follows from there.
Prefer to call? (855) 750-5757Accepting new patients · Second opinions welcomed · Most major insurances