Sciatica is pain that runs from the lower back into the leg, and it usually means a nerve root in the spine is being compressed or irritated. At Halcyon in Hyderabad it is treated with a transforaminal or epidural injection placed under imaging, aimed at the root that is actually irritated rather than at the whole area. The procedure is done under local anaesthetic as day care, and you go home the same day.
What is sciatica?
Sciatica is not a diagnosis in itself but a description: pain following the course of the sciatic nerve, from the lower back or buttock down the back of the leg, sometimes to the foot. It is usually felt in one leg.
It happens when one of the nerve roots that form the sciatic nerve is compressed or inflamed where it leaves the spine. Many episodes ease over some weeks, but pain that persists or is severe deserves assessment.
Common causes of sciatica
Anything that narrows the space around a lumbar nerve root can cause sciatica. The usual causes are:
- A herniated or bulging disc pressing on the nerve root — the commonest cause
- Spinal stenosis — narrowing of the spinal canal or nerve exits, more common in older adults
- Spondylolisthesis — one vertebra slipping forward on the one below
- Age-related disc wear and bony spurs
- Pregnancy, which can bring on or worsen sciatic pain
Symptoms of sciatica
The leg pain is often worse than the back pain, and it can change with posture.
- Pain running from the back or buttock down the leg, often below the knee
- Burning, shooting or electric-shock-like pain
- Tingling, pins and needles or numbness in the leg or foot
- Weakness in the leg or foot
- Pain worse on sitting, coughing or sneezing
How Halcyon finds the cause
At Halcyon’s Kukatpally centre the consultant examines your back and leg to work out which nerve root is involved, since the pattern of pain, numbness and weakness points to a particular level. Bring your MRI or other scan reports; they show where a disc or narrowing is pressing.
Where more than one level could explain the symptoms, a diagnostic block helps prove which root is the source. The treatment then follows from that answer, not from a guess.
Non-surgical treatment options at Halcyon
The usual treatment for sciatica at Halcyon is an injection placed precisely at the irritated nerve root.
Staying as active as the pain allows, and a suitable exercise programme, usually remain part of the plan. Halcyon is a non-surgical centre; if your examination suggests surgery should be considered, you will be told so.
- Transforaminal injection — placed under imaging at the opening where the irritated root leaves the spine
- Epidural injection — placed under imaging into the epidural space at the level the scan and examination have identified
- Diagnostic nerve block — used where needed to confirm which root is responsible before treatment
What to expect on the day and after
The injection is image-guided and done under local anaesthetic, so you stay awake and talking throughout. There is no general anaesthetic and no admission, and most people are home within about two hours.
You leave with aftercare instructions and a review date. How much and how long the pain eases varies with the cause and how long the nerve has been compressed, so the consultant gives you a realistic answer for your case.
When to see a doctor
Book an assessment if leg pain has lasted more than a few weeks, is disturbing sleep, or keeps coming back. Some symptoms need urgent attention at a hospital emergency department — do not wait for an appointment if you have:
- Loss of bladder or bowel control, or difficulty passing urine
- Numbness around the genitals, buttocks or back passage
- Sciatica in both legs, or rapidly worsening weakness or foot drop
- Back and leg pain with fever, or after a fall or accident
Treatments used for sciatica
Which one is right is decided by what the scan shows, not chosen in advance.
Questions about sciatica
Can sciatica be treated without surgery?
In many cases, yes. Sciatica at Halcyon is usually treated with a transforaminal or epidural injection placed under imaging at the irritated nerve root, done under local anaesthetic as day care. Many people also improve with time and activity. If your symptoms suggest surgery should be considered, for example progressive weakness, you will be told so plainly.
What is a transforaminal injection?
A transforaminal injection is placed under imaging at the foramen, the small opening where a nerve root leaves the spine. Because it sits right next to the irritated root, the medicine reaches the place causing the leg pain rather than being spread over the whole area. It is done under local anaesthetic, and you go home the same day.
What is the difference between sciatica and a slipped disc?
A slipped (herniated) disc is a structural problem in the spine; sciatica is the leg pain that results when something presses on a lumbar nerve root. A slipped disc is the commonest cause of sciatica, but narrowing of the spinal canal or a slipped vertebra can cause it too. Not every slipped disc causes sciatica.
Will the injection hurt?
The skin and deeper tissues are numbed with local anaesthetic first, and the needle is guided by imaging, so most people feel pressure rather than sharp pain. You stay awake and talking throughout, with no general anaesthetic. Some people notice a brief flash of their familiar leg pain as the root is reached.
How soon will my leg pain improve?
That varies. Some people notice a change within days, while for others it takes longer, and the result depends on the cause and how long the nerve has been compressed. The consultant will explain what to expect for your case and arrange a review, rather than giving a figure that fits everyone.
When is sciatica an emergency?
Loss of bladder or bowel control, numbness around the genitals or back passage, sciatica in both legs, or rapidly worsening leg weakness can mean severe nerve compression. Go to a hospital emergency department straight away rather than booking a clinic slot. If you are unsure, call Halcyon on +91 77880 91092 and ask.
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