It usually starts in the lower back. Then comes that unmistakable pain, burning, electric, or just relentlessly aching, that travels through the buttock and down the back of the leg. Sometimes it reaches the foot. Sometimes there’s numbness or tingling that will not quit. Sometimes the leg just feels weak and unreliable.

That’s sciatica. And if you have it, you know there’s almost nothing quite like it.

“Sciatica is one of the conditions I treat most often, and one where I consistently achieve positive results. I’ve had patients come in barely able to walk, who are improved even after one targeted injection, achieving lasting relief. The key is finding exactly where the sciatic nerve is being compressed and addressing that specific point precisely.”

Dr. Todd Koppel, MD. ,

What Is Sciatica?

The sciatic nerve is the longest nerve in your body. It originates in the lower back, runs through the hips and buttocks, and branches down each leg. When something compresses or irritates that nerve, it sends pain, numbness, or weakness along the entire path it travels.

Sciatica is a symptom, not a diagnosis on its own. Something specific is pressing on the nerve. The most common causes include:

  • A herniated or bulging disc in the lumbar spine is pushing against a nerve root
  • Spinal stenosis — narrowing of the spinal canal that squeezes the nerve
  • Bone spurs from spinal arthritis are crowding the space where the nerve passes
  • Piriformis syndrome — where a deep buttock muscle compresses the sciatic nerve
  • Sacroiliac joint inflammation irritates the nerve at the base of the spine

Identifying the exact cause matters because the treatment differs depending on what’s actually compressing the nerve.

Herniated disc

Spinal stenosis

Sacroiliac joint

Will Sciatica Go Away on Its Own?

Sometimes, yes. Mild sciatica from a minor disc irritation can ease within four to eight weeks with rest and conservative care. But sciatica that causes significant pain, numbness, or weakness, or that has persisted beyond six weeks, usually needs proper evaluation and treatment.

Even when sciatica eventually improves on its own, it has a high recurrence rate if the underlying cause is never addressed. Treating the root problem gives you the best chance of long-term relief rather than a cycle of flares. With appropriate treatment, most patients see significant improvement within days to a few weeks.

Sciatica Symptoms

  • Shooting, burning, or electric pain from the lower back through the buttocks and down the leg
  • Numbness or tingling in the leg, calf, or foot
  • Muscle weakness in the leg or foot
  • Pain that worsens with sitting, coughing, or sneezing
  • Symptoms predominantly on one side

Treatments for Sciatica at Garden State Pain Management

Epidural Steroid Injections

For most sciatica patients, epidural steroid injections are the effective first treatment. A precisely placed injection delivers anti-inflammatory medication directly around the compressed nerve root. The inflammation subsides, the nerve decompresses, and the pain resolves. The procedure takes about 15 minutes in the office. Most patients feel significant improvement within three to seven days.

Epidural Steroid Injections

Lumbar Injection Therapy

Targeted lumbar injections deliver medication directly to the specific nerve level being compressed, using imaging guidance for precision.

Lumbar Injection Therapy

Radiofrequency Ablation

When sacroiliac joint or facet joint irritation is contributing to the nerve pain, RFA can provide relief lasting a year or longer by interrupting pain signals at the source.

Radiofrequency Ablation

Minimally Invasive Discectomy

For sciatica caused by a disc herniation that has not responded to injections, a minimally invasive procedure removes the disc material pressing on the nerve. Most patients go home the same day.

Minimally Invasive Discectomy

Frequently Asked Questions

Not exactly. A cortisone shot is a general term for a steroid injection. An epidural steroid injection places medication specifically into the epidural space surrounding your spinal cord and nerve roots, right where the nerve inflammation is occurring. That targeted delivery is significantly more effective for sciatica than a general muscle injection.

Most patients are genuinely surprised by how quick and simple it actually is. The skin is numbed first with a local anesthetic. The procedure itself is typically more pressure than pain and takes 10 to 15 minutes. Sedation is available for anxious patients. You will need a driver home, but most patients return to normal activities the following day.

No. Over 95 percent of Dr. Koppel’s sciatica patients achieve significant relief without surgery. Surgery is reserved for cases with progressive neurological loss, such as worsening leg weakness, or for patients who have genuinely exhausted all appropriate non-surgical treatments.

Stay as active as you reasonably can; prolonged sitting increases disc pressure and often worsens sciatica. Gentle walking is generally helpful. Ice or heat on the lower back can provide temporary relief. Anti-inflammatory medications like ibuprofen help some patients if they can take them safely.

Ready to Find Relief?

Don’t let facet joint pain dictate your life. At Garden State Pain Management, Dr. Todd Koppel uses advanced, minimally invasive techniques to target the source of your neck or back pain, not just the symptoms. Whether you’ve been managing chronic stiffness for months or were recently injured, relief may be closer than you think. Patients across New Jersey trust Dr. Koppel for his precision, personalized approach, and proven results. Call (973) 473-5752 today, or book your appointment online at our Clifton or Elizabeth location.

Get In Touch

Clifton Location
1033 Clifton Ave., Suite 209 Clifton, NJ 07013

Elizabeth Location
230 West Jersey Street, Suite 306, Elizabeth, NJ 07202

Open Hours
Mon – Wed: 8:30am – 4:30pm
Thursday: 10:00am – 6:30pm
Friday: 8:30am – 4:30pm