If you’ve ever felt pain shoot from your lower back down one leg, someone has probably told you it’s sciatica. Someone else may have called it a pinched nerve. Both can be right, but the two terms don’t mean quite the same thing. Knowing the difference helps you describe your symptoms and understand your treatment options.
The short answer
A pinched nerve describes a cause: a nerve that’s being compressed or irritated by something around it. Sciatica describes a pattern of symptoms: pain that travels along the path of the sciatic nerve, from the lower back or buttock down the back of the leg.
Sciatica is usually caused by a pinched nerve in the lower back. But a pinched nerve can happen anywhere along the spine, and only one in the lower back produces sciatica.
What is a pinched nerve?
Nerves branch off the spinal cord through small openings between the vertebrae. When something crowds one of those openings, such as a bulging disc, a bone spur, or thickened ligaments, it can press on the nerve root. Doctors call this nerve root impingement or radiculopathy.
Where the nerve is pinched determines where you feel it:
- In the neck (cervical): pain, tingling, or weakness in the shoulder, arm, or hand
- In the mid-back (thoracic): pain that wraps around the ribs or chest wall
- In the lower back (lumbar): pain that travels into the buttock, hip, or leg
You can read more about each type on our nerve conditions page.
What is sciatica?
The sciatic nerve is the largest nerve in the body. It forms from several nerve roots in the lower back, runs through the buttock, and travels down the back of each leg. When one of those roots is irritated, pain can follow the nerve’s path. That pain is what we call sciatica.
Sciatica commonly feels like:
- Pain that starts in the lower back or buttock and travels down one leg
- A burning, electric, or shooting sensation rather than a dull ache
- Numbness or tingling in the leg or foot
- Weakness in the leg or foot
- Pain that gets worse when sitting, coughing, or sneezing
It usually affects one side of the body at a time.
What causes them?
Because sciatica is most often a pinched nerve in the lower back, the two share many of the same causes:
- Herniated or bulging disc. The soft center of a spinal disc pushes outward and presses on a nearby nerve root. This is one of the most common causes of sciatica.
- Spinal stenosis. The spaces in the spine narrow with age, crowding the nerves. Stenosis often causes leg pain that worsens with walking and eases when you sit or lean forward.
- Spinal arthritis and bone spurs. Wear on the joints of the spine can create bony growths that crowd nerve roots.
- Spondylolisthesis. One vertebra slips forward over the one below it, narrowing the space for the nerve.
How is it diagnosed?
A pain specialist starts with a detailed history and physical exam: where the pain travels, what makes it better or worse, and whether you have numbness or weakness. Simple strength, reflex, and sensation tests can point to which nerve root is involved.
If symptoms persist, imaging such as an MRI can show discs, joints, and nerves. Nerve testing (EMG and nerve conduction studies) can confirm whether a nerve is being affected and how much. Getting the source right matters, because the best treatment depends on what’s pinching the nerve and where.
How are sciatica and pinched nerves treated?
Many cases improve within a few weeks with conservative care: staying gently active, physical therapy, and anti-inflammatory medication. When pain lingers or keeps returning, an interventional pain specialist can offer minimally invasive options, including:
- Epidural steroid injections, which deliver anti-inflammatory medication close to the irritated nerve root, using imaging guidance for accuracy
- Nerve blocks, which can both relieve pain and help confirm which nerve is responsible
- Spinal cord stimulation for long-lasting nerve pain that hasn’t responded to other treatments, especially after back surgery
These treatments aim to calm the nerve so you can stay active and get more from physical therapy. Most people with sciatica never need surgery.
When to see a specialist
Make an appointment if your pain:
- Has lasted more than a few weeks without improving
- Keeps coming back
- Comes with numbness, tingling, or weakness
- Interferes with sleep, work, or daily activities
Get emergency care right away if back or leg pain comes with loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly worsening leg weakness.
Elevior Spine Institute’s board-certified interventional pain specialists diagnose and treat sciatica and pinched nerves at 14 clinics across Texas. Meet our providers or call us to find the clinic closest to you.
Frequently asked questions
Is sciatica the same as a pinched nerve?
Not exactly. A pinched nerve is a nerve that's being compressed or irritated, and it can happen in the neck, mid-back, or lower back. Sciatica describes pain that travels along the sciatic nerve, from the lower back or buttock down the leg. Sciatica is most often caused by a pinched nerve root in the lower back, but a pinched nerve in the neck causes arm symptoms, not sciatica.
How long does sciatica usually last?
Many people with sciatica improve within a few weeks with rest, activity changes, and physical therapy. Pain that lasts longer than six to twelve weeks, keeps coming back, or is getting worse is a good reason to see a specialist.
When is sciatica an emergency?
Seek emergency care right away if back or leg pain comes with loss of bladder or bowel control, numbness in the groin or inner thighs, or weakness in the legs that is quickly getting worse. These can be signs of serious nerve compression that needs urgent treatment.
Can sciatica be treated without surgery?
Yes. Most people never need surgery. Treatment often starts with physical therapy and medication, and an interventional pain specialist can add options like epidural steroid injections to calm the irritated nerve. For long-lasting nerve pain, spinal cord stimulation may be an option.
This article is for general education and isn't a substitute for medical advice. If you have severe or worsening symptoms, contact a healthcare provider. Call 911 for a medical emergency.