Sciatica Treatment in NJ

Sciatica affects millions of Americans every year, causing debilitating pain that shoots from the lower back down through the leg. If sciatica is disrupting your life, Dr. Alok Sharan, MD, MHCDS at Awake Spinal Fusion in Edison, NJ offers comprehensive treatment options — from conservative care to advanced minimally invasive surgery — to get you back to living pain-free.

What Is Sciatica?

Sciatica refers to pain that radiates along the path of the sciatic nerve, the longest and thickest nerve in your body. The sciatic nerve runs from your lower back through your hips and buttocks, then branches down each leg to the feet.

When this nerve is compressed or irritated — usually by a herniated disc, bone spur, or spinal stenosis — it causes inflammation and pain along the nerve pathway. Sciatica typically affects only one side of the body.

It’s important to understand that sciatica is a symptom of an underlying condition, not a diagnosis in itself. Identifying and treating the root cause is essential for lasting relief.

Symptoms of Sciatica

Sciatica symptoms can range from mild to severe and may include:

Radiating pain: A sharp, burning, or shooting pain that travels from the lower back through the buttock and down the back of the leg
Numbness: Loss of sensation in the leg or foot along the nerve path
Tingling: A “pins and needles” sensation in the leg, foot, or toes
Muscle weakness: Difficulty moving the leg or foot, trouble walking
Worsening pain: Pain that intensifies when sitting, coughing, sneezing, or standing up
Constant pain on one side: Pain primarily affecting one buttock or leg

Some patients describe sciatica as feeling like an electric shock or a deep, aching throb. The intensity can vary from a mild ache to excruciating pain that makes it difficult to stand or walk.

Common Causes of Sciatica

Herniated Disc (Most Common)

A herniated disc in the lumbar spine is the most frequent cause of sciatica. When the soft inner material of a disc pushes through the outer wall, it can press directly on the sciatic nerve root.

Spinal Stenosis

Spinal stenosis — narrowing of the spinal canal — can compress the nerve roots that form the sciatic nerve. This condition is more common in adults over 60.

Degenerative Disc Disease

As discs break down with age, they can lose height and cause the vertebrae to shift, narrowing the openings where nerve roots exit the spine.

Spondylolisthesis

This condition occurs when one vertebra slips forward over the one below it, potentially pinching the sciatic nerve.

Piriformis Syndrome

The piriformis muscle in the buttock can spasm and irritate the sciatic nerve, which runs beneath (or sometimes through) this muscle.

Other Causes

Bone spurs (osteophytes) on the vertebrae
Spinal tumors (rare)
Spinal infections (rare)
Trauma or injury to the lumbar spine or pelvis
Pregnancy (due to weight and postural changes)

Risk Factors

Age: Age-related changes in the spine (herniated discs, bone spurs, stenosis)
Obesity: Excess weight increases stress on the spine
Occupation: Jobs requiring heavy lifting, prolonged sitting, or twisting motions
Diabetes: Increases the risk of nerve damage
Sedentary lifestyle: Prolonged sitting and lack of exercise
Smoking: Accelerates disc degeneration

How Is Sciatica Diagnosed?

Dr. Sharan performs a thorough evaluation to identify the exact cause of your sciatica:

Detailed medical history: When symptoms started, severity, what triggers pain
Physical exam: Straight-leg raise test, reflex testing, muscle strength assessment, sensory testing
MRI: The primary imaging tool to visualize disc herniations, stenosis, and nerve compression
CT scan: Detailed bone and soft tissue imaging
X-rays: To identify bone spurs, fractures, or alignment issues
EMG/Nerve conduction studies: To assess nerve function and identify the specific nerve affected

Non-Surgical Sciatica Treatments

Most sciatica cases respond well to conservative treatment. Dr. Sharan recommends a personalized plan that may include:

Physical therapy: Stretching and strengthening exercises targeting the core, back, and leg muscles. PT is the cornerstone of sciatica treatment.
Medications: NSAIDs (ibuprofen, naproxen), muscle relaxants, gabapentin or pregabalin for nerve pain, short-term oral steroids
Epidural steroid injections: A corticosteroid injected directly into the epidural space near the affected nerve root to reduce inflammation and pain
Heat and cold therapy: Ice packs for acute pain, heat therapy for muscle tension
Activity modification: Avoiding activities that worsen symptoms while staying as active as possible
Ergonomic adjustments: Proper desk setup, supportive chair, lumbar support

When Surgery Is Recommended

Surgery becomes an option when:

6-12 weeks of conservative treatment hasn’t provided adequate relief
Pain is so severe it significantly limits daily function
Progressive neurological deficits (increasing weakness, foot drop)
Bladder or bowel dysfunction (emergency — cauda equina syndrome)
Recurrent episodes that repeatedly disrupt quality of life

Minimally Invasive Surgical Options

Dr. Sharan specializes in the least invasive surgical techniques for sciatica:

Microdiscectomy

The gold standard surgical treatment for sciatica caused by a herniated disc. Through an incision less than 1 inch, Dr. Sharan removes the fragment of disc pressing on the nerve. Success rate exceeds 90%, and most patients experience immediate leg pain relief.

Laminectomy / Laminotomy

For sciatica caused by spinal stenosis, a laminectomy removes a portion of the vertebral bone (lamina) to create more space for the compressed nerves.

Awake Spine Surgery for Sciatica

Dr. Sharan’s pioneering awake spine surgery technique allows sciatica procedures to be performed with the patient awake under local anesthesia and light sedation. Advantages include:

Same-day discharge — go home hours after surgery
No general anesthesia risks (no intubation, no nausea)
Faster recovery — return to activities sooner
Real-time patient feedback during the procedure
Reduced blood loss and lower infection risk
Ideal for older patients or those with medical conditions

Recovery After Sciatica Surgery

With minimally invasive techniques:

Day of surgery: Most patients walk within hours and go home the same day
Week 1-2: Light walking encouraged; avoid bending, lifting, and twisting
Week 2-4: Gradual return to daily activities
Week 4-6: Physical therapy begins; return to desk work
Week 6-12: Progressive return to exercise and full activities

Frequently Asked Questions

How long does sciatica last?

Acute sciatica typically resolves within 4-6 weeks with conservative treatment. Chronic sciatica (lasting more than 3 months) may require more aggressive intervention, including injections or surgery.

Is walking good for sciatica?

Yes, gentle walking is one of the best things you can do for sciatica. Walking promotes blood flow to the affected area, reduces inflammation, and prevents stiffness. Avoid prolonged sitting, which can worsen symptoms.

Can sciatica come back after surgery?

Recurrence rates after microdiscectomy are approximately 5-10%. Maintaining a healthy weight, exercising regularly, and using proper body mechanics significantly reduce the risk of recurrence.

What’s the best sleeping position for sciatica?

Sleep on your back with a pillow under your knees, or on your side with a pillow between your knees. These positions help maintain spinal alignment and reduce pressure on the sciatic nerve.

Should I see a chiropractor or spine surgeon for sciatica?

Start with a spine specialist like Dr. Sharan who can properly diagnose the underlying cause. Many patients benefit from conservative care first, and surgery is only recommended when truly necessary.