Sciatica pain is very common among the society. First pain will be started as Low back pain. If patient is not taking proper treatment of Low back pain then they will ended with Sciatica.
Sciatica pain usually describe as Pain start from Lower back which is going up to leg and foot. It occurs due to pinching or irritation of nerve while traversing through spinal foremen. If it is due to mechanical compression of nerve then patient also feel tingling or numbness like sensation in leg.



  • Low Back Pain
  • Slipped disc
  • Herniated disc
  • Chemical irritation of nerve due to annular tear of disc
  • Compression of nerve in buttocks (Piriformis syndrome)


Sciatica pain initially started with Low back pain which spread up to leg and foot. Initially it may be due to chemical irritation of nerve by inflammatory mediators release from annular tear of degenerative disc. When this stage is not properly treated then patient may develop slipped disc or herniated disc. Due to herniation of disc content nerve passing through foremen will mechanically compress and causing pain and tingling in leg.
Even this slipped disc not treated properly then patient may further develop Lumber Canal Stenosis. In which not only nerve but passing Spinal Cord also compressed. Due to stenosis patient will develop new symptoms like Neurological Claudication (Not able to walk long distance)


1. Evaluation of Patient
Pain physician should thoroughly take history and examine patient clinically to find out suffering of patient. Which give clue that patient having mechanical or chemical cause of nerve root pain.

2. X-RAY Lumber Spine
Though x-ray is not confirmatory but it may give information in form of reduction of disc space.

3. MRI Lumber Spine
MRI always considers a Gold standard test for confirmation of Sciatic Pain. We can differentiate the cause of sciatica pain. It will give all information about mechanical or chemical cause of pain. Exact size of herniated disc can be measured with condition of disc can be diagnosed also.



1. Conservative Treatment
This consists of medication and exercise with avoidance of precipitating factor causing sciatica pain.
If conservative trial fails then patient should move for interventional procedure.


2. Spinal Injection
Lumber Transforaminal or Interlaminar injection can be the first choice in chemical irritation of nerve root causing sciatica pain.
This also help is slipped or herniated disc in early phase. If mechanical compression is more, then effect of spinal injection may not be long lasting.


3. Disc Fx Procedure
This procedure is the Best Treatment Option in patient suffering from moderate to severe degenerative disc disease.
This procedure done under Local Anaesthesia so does not having any risk to patient in form of major surgery and General anaesthesia related life threatening complication.

In Disc fx procedure we insert 3.3 mm cannula in the degenerative disc under x-ray guidance. We removed small fragments of degenerative disc. Give saline wash to reduce inflammation, doing Bipolar Radiofrequency Tissue ablation with shrinkage and come out after giving Anti-inflammatory injection.


4. Endoscopic Discectomy
Spine endoscopy is most advanced and recent procedure which is done under Local anaesthesia to remove disc fragments which cause mechanical compression of nerve.

Endoscopic discectomy is performed by highly skilful Pain Physician. This required very costly machine and instruments.


Basically concepts of endoscopy are to visualise the fragments of disc which cause nerve root compression and removed with help of instruments. Removal of disc fragment will reduce the mechanical compression and patient will be pain free.



  • Proper and enough bed rest required for healing of disc. For Disc Fx procedure it required 15 days and for Endoscopic discectomy it required 1 month rest.
  • Patient can do his personal daily activity normally, but sitting and standing not allow more than 30 min for 4 times a day.
  • After completion of resting period patient should start Lumber Strengthening exercise and should be continue for long time to prevent future recurrence of pain.

For more detail information and appointment please talk on


Impulse Pain Clinic, Ahmedabad.


M.B.B.S. , M.D.( B.J.M.C., Ahmedabad ) Fellow In Pain Management ( Aesculap Academy, Kolkata )