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Sciatica is a widespread cause of chronic back and leg pain that could affect as many as 43% of the population at some point in their lives. Many people use “herniated disc” and “sciatica” as if they mean the same thing, but they don’t. A herniated disc is a structural problem in the spine, while sciatica is a group of symptoms that affect the sciatic nerve.
At Silver Spine & Neurological Center - Interventional Pain Management & Spine Surgery, we help patients identify the true source of their pain. Once we understand what’s happening, we can recommend care that fits your diagnosis, symptoms, and lifestyle.
Your spine contains bones called vertebrae, between which are soft discs that cushion movement. Each disc has a tough outer layer and a softer center. A herniated disc develops when part of that center pushes through a tear or hole in the outer layer.
A herniated disc can develop anywhere in the spine, although the lower back (lumbar spine) and neck (cervical spine) experience this problem most often. Risk factors include:
Some herniated discs cause no symptoms, while others irritate or press on nearby nerves. A lower-back herniated disc may cause back pain, leg pain, numbness, tingling, and muscle weakness. A neck herniation can send similar symptoms into the shoulder, arm, hand, and fingers.
Sciatica describes pain and other nerve symptoms that follow the path of the sciatic nerve. This large nerve extends from its roots in the lower spine, goes through the buttocks, and divides in two, with one branch traveling down each leg.
Sciatica usually affects one side. You may feel sharp, burning, electric, or shooting pain that originates in the lower back or buttock and then travels down the leg. You might also notice pins and needles, numbness, or weakness. Coughing, sneezing, sitting, or certain movements often increase the discomfort.
A herniated disc in the lower back commonly triggers sciatica, accounting for around 90% of cases. However, it isn’t the only cause. Others include:
Other problems can also irritate the nerve roots and contribute to sciatic symptoms.
Think of a herniated disc as a possible cause and sciatica as a potential result. You can have a herniated disc without sciatica, especially when the disc doesn’t touch a nerve connected to the leg. You can also develop sciatica without having a herniated disc.
The location and type of symptoms offer clues. Pain that stays mainly in the lower back may come from a disc, muscle, joint, or another structure. Pain that travels from the buttock down one leg suggests sciatica. However, symptoms alone can’t always identify the exact cause.
We review your medical history and examine your strength, sensation, reflexes, posture, and movement. We may order an MRI or another test when symptoms persist, weakness develops, or the results could influence your rehabilitation options.
Most patients don’t start with surgery for these conditions. We usually recommend:
Long periods of bed rest can increase stiffness and weakness, so we encourage safe, gradual movement.
If pain continues, we may recommend an epidural steroid injection to reduce inflammation around an irritated nerve. This treatment doesn’t repair the disc, but it can create enough relief for you to participate more comfortably in your rehabilitation.
Surgeries such as minimally invasive discectomy or microdiscectomy might help when a herniated disc causes severe or worsening weakness, persistent disabling pain, or serious nerve compression.
Our hybrid approach allows us to consider both nonsurgical pain management and minimally invasive spine surgery. Our double board-certified neurosurgeon, Dr. Viktor Silver, has more than 20 years of experience in outpatient spine surgery and interventional pain management.
Schedule an evaluation with us if you have increasing weakness or numbness, or if your pain:
Get emergency help for loss of bladder or bowel control, numbness around the groin or inner thighs, or sudden severe weakness in both legs. These symptoms may signal cauda equina syndrome, a rare condition that needs urgent treatment.
At Silver Spine & Neurological Center, we don’t assume every case of sciatica comes from a herniated disc. We identify the source, explain your choices, and create a personalized path toward less pain and better movement.
Call us or submit the online inquiry form to get answers about your painful sciatica or disc herniation.