Sciatica is nerve pain that radiates from the lower back through the buttock and down the back of the leg, most often caused by a herniated disc compressing a lumbar nerve root. Most cases improve within 4–6 weeks with non-surgical care. When pain persists or is severe, a lumbar epidural steroid injection delivers anti-inflammatory medication directly to the irritated nerve — often bringing relief within days. At Dr. Imran Qureshi’s Katy, TX office, treatment starts with identifying exactly which nerve is compressed and why, then matching the least-invasive effective option to the cause.
Understanding Sciatica
Sciatica is not a condition itself — it is a symptom of pressure on or irritation of the sciatic nerve, the largest nerve in the body, which runs from the lower spine through the buttock and down each leg. Sciatica is very common, and most people recover with non-surgical care — but that statistic is little comfort when every step, cough, or hour of sitting sends electric pain down your leg.
The pattern of your symptoms tells a precise story: which nerve root is compressed, how severely, and what is compressing it. Dr. Qureshi’s evaluation is built around reading that story correctly — because a disc herniation at L5-S1, foraminal stenosis at L4-L5, and piriformis syndrome all cause “sciatica,” yet each calls for a different treatment.
Most sciatica does not require surgery. Even patients with confirmed disc herniations usually improve without an operation. Dr. Qureshi specializes in resolving sciatica with targeted, image-guided injections and structured conservative care — reserving surgical referral for the small minority who truly need it.
What causes sciatica?
The most common causes of sciatic nerve compression seen at our Katy practice include:
- Herniated or bulging discs — the most common cause; disc material presses directly on the nerve root as it exits the spine
- Lumbar spinal stenosis — age-related narrowing of the spinal canal or nerve-exit openings (foramina) that squeezes nerve roots, more common after age 50
- Degenerative disc disease — disc height loss that narrows the space where nerves exit the spine
- Spondylolisthesis — forward slippage of one vertebra that pinches the exiting nerve
- Piriformis syndrome — the piriformis muscle deep in the buttock irritating the sciatic nerve directly, often mimicking spinal causes
- Less common causes — cysts, infections, or tumors compressing the nerve; these are rare but are systematically ruled out during evaluation
What are the symptoms of sciatica?
- Sharp, burning, or electric pain radiating from the lower back or buttock down the back of the leg
- Pain that worsens with sitting, coughing, sneezing, or bending forward
- Numbness or tingling in the leg, foot, or toes
- Leg or foot weakness — difficulty lifting the foot or pushing off when walking
- Typically affects one side, though both legs can be involved
- Low back pain may be mild or absent — the leg pain often dominates
When to See a Pain Specialist
See Dr. Qureshi if your sciatica has lasted more than 4–6 weeks despite rest and over-the-counter care, is severe enough to limit work or sleep, or involves numbness or weakness in the leg. Seek immediate emergency care for progressive leg weakness, numbness in the groin or inner thighs (saddle anesthesia), or new loss of bladder or bowel control — these can signal cauda equina syndrome, a surgical emergency. Learn more about how to tell if your back pain is serious.
How is sciatica diagnosed?
Dr. Qureshi begins with a focused history and physical examination — including provocative tests like the straight-leg raise — and reviews your imaging himself rather than relying solely on radiology reports. MRI is the gold standard for visualizing nerve compression, but imaging findings don’t always match symptoms: many people have disc bulges that cause no pain at all. When the picture is unclear, a diagnostic selective nerve root block can confirm exactly which nerve is generating your pain before committing to a treatment plan.
What non-surgical treatments help sciatica?
Treatment is matched to the cause and severity of your nerve compression:
- Lumbar epidural steroid injections — the workhorse treatment for persistent sciatica; anti-inflammatory medication is delivered under X-ray guidance directly to the compressed nerve root. Read about nonsurgical treatment options for herniated discs
- Selective nerve root blocks — targeted diagnostic and therapeutic injections when a single nerve root is the culprit
- Structured physical therapy — nerve-gliding exercises, core strengthening, and posture correction to decompress the nerve and prevent recurrence
- Piriformis injections — for sciatica originating in the buttock muscle rather than the spine
- Anti-inflammatory and neuropathic medications — short-term symptom control while the underlying compression resolves; Dr. Qureshi’s practice is opioid-free
- Spinal cord stimulation — for the rare patient with chronic, refractory nerve pain after other options are exhausted
Weighing injections against an operation? Learn more about back pain surgery vs. injection therapy.
Why Choose Dr. Qureshi for Sciatica
Dr. Qureshi is fellowship-trained in interventional spine and musculoskeletal medicine with board certification in Physical Medicine and Rehabilitation. He has treated thousands of patients with radiating nerve pain across Greater Houston, performs every spinal injection himself under fluoroscopic guidance, and follows an opioid-free philosophy built on treating the structural cause of pain — not masking it.