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Sciatica, characterized by pain that radiates from the lower back through the buttock and into the leg, is a common ailment that can significantly impact one’s quality of life. While non-surgical treatments are often effective, some cases may require surgical intervention. In this blog post, we will explore the causes of sciatic pain, non-surgical management strategies, and when surgical options might be considered for alleviating unresolved discomfort.

What is Sciatica?

Sciatica occurs as a result of irritation or compression of the sciatic nerve, which originates in the lower back and travels through the buttocks and down the leg. This condition leads to symptoms such as pain, numbness, tingling, and weakness along the nerve’s pathway.

Causes of Sciatica Pain in the Buttock

Herniated Disc: The inner material of a spinal disc can protrude and compress the sciatic nerve, causing pain.

Spinal Stenosis: Narrowing of the spinal canal can put pressure on the sciatic nerve.

Piriformis Syndrome: The piriformis muscle in the buttock can compress the sciatic nerve.

Spondylolisthesis: When one vertebra slips forward over another, it can pinch the sciatic nerve.

Trauma or Injury: An injury to the lower back or buttocks can inflame and pressure the sciatic nerve. This can also come from car accidents/MVA, work related/WC or personal injury (ex. slip and falls)

Non-Surgical Management

Rest and Controlled Movement: Gentle activities are recommended to prevent muscle stiffness. Avoiding strenuous activities that worsen the pain is important.

Hot and Cold Therapy: Applying cold packs during the initial 48 hours, followed by warm compresses, can alleviate pain and muscle tension.

Over-the-Counter Pain Medications: Non-prescription pain relievers can reduce pain and inflammation.

Stretching and Exercises: Healthcare providers may recommend specific stretches and exercises to enhance flexibility, strengthen muscles, and alleviate pressure on the nerve. *Please visit our resources tab and drop down to our exercise tab for more information.

Physical Therapy: Tailored exercise plans from physical therapists can help manage symptoms effectively.

Posture Correction: Proper posture while sitting, standing, and walking can reduce pressure on the sciatic nerve.

Alternative Therapies: Chiropractic care, acupuncture, and yoga might offer relief for some individuals.

Surgical Intervention

Dr. Kakoulides generally considers surgery, when non-surgical approaches fail to provide relief, or if severe symptoms such as muscle weakness, numbness, or impaired bladder/bowel function are present. Surgical options include:

Microdiscectomy: This procedure involves the removal of the portion of a herniated disc that’s pressing against the nerve.

Laminectomy: In cases of spinal stenosis, a laminectomy might be performed to remove a portion of the vertebrae to relieve pressure on the nerve.

Spinal Fusion: This surgery aims to stabilize the spine by fusing vertebrae together to alleviate pain caused by conditions like spondylolisthesis.

When to Seek Medical Attention

Medical evaluation is crucial if:

  • The pain is severe and persistent.
  • Weakness, numbness, or tingling in the leg occur suddenly.
  • Bladder or bowel dysfunction accompanies the symptoms.
  • The pain is due to a traumatic injury.


Sciatica pain in the buttock can be debilitating, but non-surgical treatments and, when necessary, surgical options, offer hope for relief. By identifying the underlying cause and pursuing a comprehensive approach that aligns with your condition’s severity, you can effectively address sciatica and regain control over your comfort and quality of life. Dr. Kakoulides suggests you always consult a healthcare professional for accurate diagnosis and guidance tailored to your individual needs.


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