Villanueva Institute of Pain and Spine
Sciatica Treatment in Burbank, CA
Sciatica is pain that typically starts in the low back or buttock and travels down the back of the thigh, calf, or foot. It may feel sharp, electric, burning, tingling, or aching, and can also cause heaviness or weakness in the leg.
Symptoms often vary with position and activity; sitting, standing, walking, bending, or lying down can all trigger or worsen your sciatic nerve pain. Some patients notice a sudden onset, while others develop symptoms gradually.
I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). When I evaluate sciatica, I look at where the pain starts, where it travels, what it feels like, what movements trigger it, whether numbness or weakness is present, and what your imaging shows when imaging is needed.
Sciatica is a pain pattern, not the full diagnosis by itself. The next step is finding out why the nerve is irritated. A herniated disc, spinal stenosis, foraminal narrowing, degenerative disc changes, arthritis, prior surgery, or another spine problem can all cause symptoms that feel like sciatica. Once we understand the source, we can talk through the treatment options that make sense.
If you are looking for sciatica treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and see patients from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
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What Is Sciatica?
Sciatica is pain that travels along the sciatic nerve pathway. The sciatic nerve begins from nerve roots in the lower spine and runs through the buttock, down the back of the leg, and into the lower leg and foot.
Most sciatica begins when a nerve root in the lower back becomes irritated or compressed. The pain may stay mostly in the buttock and thigh, or it may travel all the way to the calf, ankle, or foot. Some patients have more leg pain than back pain. Others have both.
The medical term often used for this problem is lumbar radiculopathy. That means a nerve root in the lumbar spine is irritated, inflamed, or compressed. Sciatica is the way many patients describe the pain they feel when that nerve pathway is involved.
What Sciatica Can Feel Like
Sciatica does not feel the same for everyone. The symptoms depend on which nerve is irritated and how severe the irritation is.
Patients often describe:
- Pain starting in the low back, buttock, hip, or gluteal area
- Pain traveling down the back or side of the leg
- Burning, shooting, electric, sharp, or stabbing pain
- Numbness or tingling in the leg, calf, foot, or toes
- Leg heaviness, cramping, or fatigue
- Pain that worsens with sitting
- Pain that worsens with standing or walking
- Pain with bending, lifting, twisting, coughing, or sneezing
- Weakness in the leg, ankle, foot, or toes
- Trouble sleeping because the leg pain will not settle
- Difficulty driving, working, exercising, or walking normally
The location matters. Pain that travels into the foot may point to a different nerve level than pain that stays in the thigh. Weakness, numbness, and reflex changes also help identify which nerve may be involved.
Common Causes of Sciatica
Sciatica usually happens because something in the lower spine is irritating a nerve root. The cause can be sudden, gradual, or related to long-term spine changes.
Herniated Disc
A herniated disc is one of the most common causes of sciatica. When disc material pushes outward, it can irritate or compress a nearby nerve root. This can cause pain that travels from the low back or buttock into the leg.
Disc-related sciatica may worsen with sitting, bending, lifting, coughing, or sneezing. Some patients feel a sudden “pop” or sharp pain when the disc first becomes irritated. Others simply notice leg pain that builds over time.
Lumbar Spinal Stenosis
Lumbar spinal stenosis means the spinal canal or nerve openings in the lower back have narrowed. This can crowd the nerves and cause pain, numbness, tingling, heaviness, or weakness in the legs.
Many patients with stenosis feel worse when standing or walking and better when sitting or leaning forward. Some find themselves leaning on a shopping cart because it gives the legs relief. When this pattern is present, I look closely at whether stenosis is causing nerve compression.
Foraminal Narrowing
The foramina are small openings where nerves exit the spine. When these openings narrow, a nerve can become pinched as it leaves the spinal canal.
Foraminal narrowing can cause sciatica-like pain, numbness, tingling, or weakness. It may be related to disc height loss, arthritis, bone spurs, spondylolisthesis, or degenerative spine changes.
Degenerative Disc Disease
Degenerative disc disease can change the way the spine absorbs pressure and moves. As discs lose height or hydration, the space around nearby nerves can become tighter.
Disc degeneration does not always cause pain, but when it contributes to nerve irritation, symptoms may travel into the buttock, leg, or foot.
Spondylolisthesis
Spondylolisthesis occurs when one vertebra slips forward compared with the one below it. This can narrow the space around the nerves and lead to back pain, leg pain, numbness, tingling, or weakness.
The treatment plan depends on the degree of slippage, whether the spine is stable, how much nerve compression is present, and how symptoms affect walking and daily activity.
Pain After Spine Surgery
Sciatica can continue or return after spine surgery. The reason may involve recurrent disc herniation, scar tissue, nerve irritation, spinal stenosis, foraminal narrowing, adjacent segment changes, or another pain source.
When sciatica develops after surgery, I review the operative history, imaging, symptoms before and after surgery, and what has changed over time.
Piriformis and Other Non-Spine Causes
Not all pain down the leg comes directly from the spine. The piriformis muscle, hip problems, peripheral nerve irritation, vascular issues, and other conditions can sometimes mimic sciatica.
This is one reason the evaluation matters. The treatment should match the source of the symptoms, not just the location of the pain.
Sciatica vs. General Back Pain
Back pain and sciatica often happen together, but they are not the same thing.
General back pain may stay in the low back and feel aching, stiff, sore, sharp, or mechanical. Sciatica usually travels into the buttock and leg along a nerve pathway. It is often described as shooting, burning, electric, tingling, or radiating pain.
That difference matters because the treatment may be different. A patient with facet joint back pain may need a different plan than a patient with nerve root irritation. A patient with spinal stenosis and walking difficulty may need a different plan than someone with a new herniated disc.
When Sciatica Needs Prompt Medical Attention
Some sciatica symptoms should be evaluated urgently. Seek emergency care if you develop new loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening leg weakness, severe weakness in the foot or ankle, fever with severe back pain, or severe pain after major trauma.
You should also seek prompt medical evaluation if both legs are affected, symptoms are getting worse quickly, or weakness is interfering with walking.
For sciatica that is painful but stable, a pain management consultation can help identify the source and the right next step.
How Sciatica Is Diagnosed
Diagnosing sciatica starts with me listening to your story; I want to know where the pain begins, where it travels, how far down the leg it goes, what positions make it worse, and whether you have numbness, tingling, cramping, or weakness.
During this exam, I may check your posture, gait, low back motion, hip motion, strength, reflexes, sensation, nerve tension signs, and how symptoms change with movement. These details can help narrow down our options for which nerve root may be irritated.
Testing may include X-rays, MRI, CT scan, or EMG/NCS testing depending on your symptoms. MRI is often helpful when sciatica persists, is severe, includes neurological symptoms, or when an injection or procedure is being considered. EMG and nerve conduction studies may help when weakness, numbness, or nerve injury needs closer evaluation.
Whenever possible, I prefer to review the actual images, not only the written report. A report can be useful, but the images often show details that affect the treatment plan.
Sciatica Treatment Options
Sciatica treatment depends on what is irritating the nerve and how severe the symptoms are. A new herniated disc, chronic foraminal narrowing, lumbar spinal stenosis, post-surgical nerve pain, and piriformis-related pain all require different planning.
Physical Therapy and Rehabilitation
Physical therapy can help reduce nerve irritation, improve mobility, restore strength, and help you move without constantly protecting the painful side. Depending on the cause, therapy may include gentle mobility work, core strengthening, hip mobility, nerve glides, posture training, walking progression, or activity modification.
As a PM&R physician, I look closely at how sciatica is affecting function. The plan should help you sit, stand, walk, drive, sleep, and return to normal activity with more confidence.
Medication Management
Medication can be useful when sciatica is making it difficult to sleep, move, work, or participate in therapy. Depending on the symptoms, we may discuss options to calm nerve-related pain, reduce inflammation, ease muscle spasm, or help you get through the day with less discomfort.
I choose medication carefully based on your diagnosis, health history, current prescriptions, and how you have responded to treatment in the past. Medication is often one part of the plan while the nerve irritation settles or while another treatment begins to work.
Epidural Steroid Injections
An epidural steroid injection places anti-inflammatory medication near irritated spinal nerves. This can be helpful when sciatica is related to a herniated disc, radiculopathy, spinal stenosis, or foraminal narrowing.
The goal is to reduce inflammation around the affected nerve, so pain decreases and movement becomes more tolerable. Your response can also help clarify how much nerve inflammation is contributing to the symptoms.
Selective Nerve Root Blocks
A selective nerve root block targets a specific spinal nerve. This can be useful when the symptoms and imaging suggest one nerve root is responsible for the leg pain.
The response can provide both relief and diagnostic information. If your usual pain improves after the block, that helps confirm the nerve pathway involved.
Treatment for Lumbar Spinal Stenosis
When sciatica-like symptoms are caused by lumbar spinal stenosis, the plan may include physical therapy, medication management, epidural steroid injections, or other procedures depending on anatomy and severity.
For certain patients whose stenosis is caused in part by thickened ligament tissue, the mild® Procedure may be discussed. This is most relevant when standing and walking trigger leg heaviness, pain, numbness, tingling, or weakness, and sitting or leaning forward provides relief.
Spinal Cord Stimulation
Spinal cord stimulation may be considered for certain patients with chronic nerve-related back or leg pain, especially when symptoms have continued despite medication, therapy, injections, prior surgery, or other appropriate care.
Patients begin with a temporary trial before any permanent implant is discussed. The trial helps determine whether stimulation meaningfully improves pain and function.
Surgical Referral When Appropriate
Some cases of sciatica require a surgical opinion. This may apply when imaging shows severe nerve compression, progressive weakness, foot drop, cauda equina symptoms, severe stenosis, a large herniated disc with significant deficits, instability, or pain that has not improved with appropriate nonsurgical care.
Good Candidates for Sciatica Treatment
You may benefit from a sciatica evaluation if leg pain, numbness, tingling, or weakness is affecting how you move through the day. You do not need to know whether your pain is coming from a disc, nerve, joint, or stenosis before your visit. The consultation is where we sort that out.
Patients often come in with:
- Pain traveling from the low back or buttock into the leg
- Burning, electric, shooting, or radiating leg pain
- Numbness or tingling in the calf, foot, or toes
- Pain that worsens with sitting, bending, lifting, standing, or walking
- Leg heaviness, cramping, or weakness
- Sciatica after a herniated disc
- Sciatica from spinal stenosis or foraminal narrowing
- Symptoms that have not improved enough with rest, medication, or physical therapy
- Pain that interferes with sleep, driving, work, exercise, or daily routines
- A need for a clearer explanation before choosing the next step
How I Evaluate You Before Recommending Treatment
Before recommending treatment, I want to understand the nerve pathway involved and why it is irritated.
During your consultation, I will take plenty of time to review your history, examine your back, hips, nerves, reflexes, strength, and sensation, and study imaging when available. I may recommend updated MRI, X-rays, CT, or EMG/NCS testing when the diagnosis needs clarification.
I also ask what pain is keeping you from doing, such as sitting through a workday, driving across Los Angeles, sleeping without changing positions all night, walking through the grocery store, returning to exercise, or picking up your child or grandchild. Those details help shape the plan and measure whether treatment is working.
What Happens During Sciatica Treatment?
Your treatment depends on the cause of your symptoms.
For nerve inflammation from a herniated disc, foraminal narrowing, or radiculopathy, an epidural steroid injection or selective nerve root block may be appropriate.
For spinal stenosis, the plan may focus on improving walking tolerance and reducing nerve compression.
For long-standing nerve pain after surgery, spinal cord stimulation may be part of the discussion.
For symptoms that point away from the spine, the evaluation may lead us toward hip care, peripheral nerve testing, or another specialist.
Before any procedure, I explain what we are targeting, how the treatment works, what you may feel afterward, and how we will judge your response.
Some patients need treatment in stages. We may start by reducing the most intense nerve irritation, then build the rest of the plan around therapy, walking, strengthening, posture, activity changes, or additional care based on your response.
What Should You Expect After Sciatica Treatment?
Your response depends on the cause of sciatica, the treatment performed, and how long the nerve has been irritated.
Some injections can provide quick temporary relief because of local anesthetic. Anti-inflammatory medication may take several days to work. Nerve pain that has been present for a long time may improve gradually, especially when weakness, numbness, or significant compression has been part of the picture.
After treatment, I want you to track practical changes. Can you sit longer? Drive with less pain? Walk farther? Sleep better? Bend with less fear? Do you have less burning, tingling, or shooting pain? Are you using less rescue medication?
Those details help us decide whether to continue the current plan, adjust the target, update imaging, add rehabilitation, or discuss another option.
Sciatic Pain Treatment in Burbank, CA
VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.
This is a place where your story has time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.
We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
Burbank Sciatica FAQs
To schedule a sciatica consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right care may help you spend less time working around leg pain and more time moving with comfort, confidence, and peace of mind.
Is sciatica the same as lumbar radiculopathy?
Sciatica is a common way to describe pain traveling down the sciatic nerve pathway. Lumbar radiculopathy is the medical term for irritation or compression of a nerve root in the lower spine. Many cases of sciatica are caused by lumbar radiculopathy.
What causes sciatica?
Sciatica can be caused by a herniated disc, spinal stenosis, foraminal narrowing, degenerative disc disease, spondylolisthesis, arthritis, prior spine surgery, or other conditions that irritate a nerve in the lower back.
Can sciatica go away on its own?
Some cases improve with time, activity modification, physical therapy, and medication. If symptoms are severe, persistent, worsening, or associated with weakness or numbness, a medical evaluation is important.
Can epidural steroid injections help sciatica?
Epidural steroid injections can help when sciatica is related to irritated or inflamed spinal nerves. They are often discussed for herniated discs, radiculopathy, spinal stenosis, or foraminal narrowing.
What is a selective nerve root block?
A selective nerve root block targets a specific spinal nerve. It can help reduce pain and provide diagnostic information when symptoms and imaging suggest one nerve root is responsible for the leg pain.
How much does sciatica treatment cost in Burbank, CA?
The cost of sciatica treatment in Burbank can vary depending on the evaluation, imaging, medication plan, physical therapy, injections, nerve testing, advanced procedures, or specialist referrals involved. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.