James M. Leipzig, MD, FACS

Spinal Surgeons located in Roanoke, VA

If you experience pain radiating from your low back into your buttock and down the back of your leg, you may have sciatica. Experienced orthopedic spine surgeon James Leipzig, MD, FACS, provides conservative and surgical sciatica treatment at The Spine Center in Roanoke, Virginia. For expert diagnosis and treatment of sciatica, call the office today or request an appointment online.

Sciatica Q & A

What is sciatica?

Sciatica is pain along the sciatic nerve. Your body’s longest and thickest nerve, the sciatic nerve branches from either side of the spinal cord in your low back, runs through your hips and buttocks, and extends down each leg.

When a herniated disc, bone spur, or other problem compresses part of the sciatic nerve, it can cause pain and sometimes numbness, tingling, or muscle weakness. Pain associated with sciatica can range from mild to severe and usually affects only one side of the body.

Who is at risk for sciatica?

Sciatica is extremely common, affecting about 40% of people at some point in their lives. Certain factors may increase your risk, such as advancing age, diabetes, and cigarette smoking. Careers that involve heavy lifting, prolonged sitting, or twisting movements can also raise your risk of developing sciatica.

What causes sciatica?

Many conditions can cause sciatica, including:

Herniated discs

Discs of cartilage containing a gel-like substance act as cushions between your vertebrae. A herniated disc occurs when part of the soft interior pushes through the outer ring. Sciatica can occur if a herniated disc in your lumbar spine presses on the spinal cord and sciatic nerve roots.


Spondylolisthesis occurs when one vertebra pushes forward over another. When this happens, the extended bone can pinch the sciatic nerve.

Spinal stenosis

Spinal stenosis is a narrowing of the spinal canal, which puts pressure on the spinal cord and nerve roots. Lumbar spinal stenosis can cause sciatica.

Piriformis syndrome

Piriformis syndrome refers to a spasm in the small muscle that connects your lower spine to your thigh. The spasm can create pressure on the sciatic nerve.

How is sciatica diagnosed and treated?

The Spine Center takes a thorough approach, carefully reviewing your symptoms and medical history. Your doctor may order tests, such as X-rays or magnetic resonance imaging (MRI) scans to diagnose sciatica. They may also measure your nerve response with electromyography (EMG).

Most of the time, sciatica improves with conservative treatments like medications and physical therapy. In some cases, your doctor may recommend epidural steroid injections. Alternative therapies like acupuncture and chiropractic care may also help.

If these treatments don’t sufficiently relieve your sciatica, The Spine Center may consider surgery. The most common type of surgery to treat sciatica is a discectomy, which involves removing part of a disc that’s pressing on the sciatic nerve. 

The Spine Center uses minimally invasive surgical techniques like microdiscectomy whenever possible.

For comprehensive sciatica care, call The Spine Center, or request an appointment online today.