What Is Sciatica?
Sciatica refers to pain that travels along the path of the sciatic nerve — the longest nerve in your body, running from your lower back through your hips and buttocks and down each leg. The term "sciatica" describes a symptom (radiating leg pain) rather than a diagnosis in itself.
Most people with sciatica feel pain on only one side of the body. The pain can range from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it feels like a jolt or electric shock. It can worsen when you cough, sneeze, or sit for long periods.
Symptoms of Sciatica
- Pain radiating from the lower back through the buttock and down one leg
- Numbness, tingling, or weakness in the leg or foot
- A sharp, burning, or shooting pain that worsens with movement
- Difficulty standing, walking, or sitting for extended periods
- In severe cases, loss of bowel or bladder control (seek emergency care immediately)
Common Causes
Sciatica is usually caused by compression of the sciatic nerve. The most common causes include:
- Herniated or bulging disc — the most frequent cause; disc material presses on the nerve root
- Lumbar spinal stenosis — narrowing of the spinal canal that compresses nerve roots
- Degenerative disc disease — worn discs that have lost their cushioning ability
- Spondylolisthesis — a vertebra that has slipped forward over another
- Piriformis syndrome — the piriformis muscle in the buttock spasms and irritates the sciatic nerve
- Bone spurs — bony growths that compress nerve roots
Risk factors include age, obesity, prolonged sitting, and occupations involving heavy lifting or twisting.
How Dr. Rubin Treats Sciatica
Dr. Rubin takes a non-narcotic, minimally invasive approach to sciatica. Most patients respond well to one or more of the following treatments:
Epidural Steroid Injections
Corticosteroid medication is delivered directly into the epidural space around the inflamed nerve root, reducing inflammation and providing significant pain relief. Results typically last several months and can be repeated.
Lumbar Nerve Root Blocks
A targeted injection directly at the irritated nerve root — both diagnostic (identifying the exact source) and therapeutic (reducing inflammation).
Lumbar Transforaminal Epidural Injections
A more targeted approach than a standard epidural, delivering medication directly to the site of nerve compression through the neuroforamen.
Radiofrequency Ablation (RFA)
For patients with facet-mediated sciatica, RFA uses heat to disable the pain-transmitting nerves, providing long-lasting relief (typically 12–24 months).
Spinal Cord Stimulation
For patients with chronic, treatment-resistant sciatica, spinal cord stimulation (SCS) modulates pain signals before they reach the brain.
Physical Therapy Coordination
Dr. Rubin works collaboratively with physical therapists to address muscle imbalances and postural issues that contribute to sciatic nerve compression.
FAQs About Sciatica
How long does sciatica last? Acute sciatica often resolves within 4–6 weeks with conservative treatment. Chronic sciatica lasting more than 3 months typically requires interventional management.
Does sciatica always require surgery? No. The vast majority of sciatica cases respond to non-surgical treatments. Surgery is reserved for cases with severe weakness, loss of bowel/bladder control, or failure of all conservative options.
Can Dr. Rubin treat sciatica without opioids? Yes. Dr. Rubin's philosophy emphasizes non-narcotic approaches first — interventional procedures, anti-inflammatories, and physical therapy.
How many epidural injections will I need? Most patients benefit from 1–3 injections per year, depending on the severity and duration of their sciatica.
What insurance covers sciatica treatment? Most major insurance plans including Medicare, Aetna, Cigna, and United Healthcare cover interventional treatments for sciatica when conservative treatments have been tried first.
Treating Sciatica on Long Island
Dr. Rubin sees patients at two convenient Long Island locations — Lake Success and Garden City — and performs procedures at four surgical centers including NYU Long Island and Northwell Health. Call 516-492-3100 to schedule your evaluation.