Sciatica & Spinal Stenosis – Non-Operative Treatment for Lower Back Pain
Lower back pain and sciatica can result from problems involving the discs, nerves or spinal canal. In selected patients, these conditions can be managed without surgery.
Dr. Vikash Singh provides assessment and non-operative interventional treatment for selected patients with sciatica, spinal stenosis and lower back pain, including image-guided transforaminal epidural injections when clinically appropriate.
What Is Sciatica?
Sciatica refers to pain caused by irritation or compression of a nerve in the lower back, typically producing pain that travels from the lower back or buttock into the leg.
Patients may experience:
Lower back pain
Buttock pain
Pain travelling down the leg
Tingling or numbness
Burning or shooting pain
Leg discomfort that worsens with standing or walking
Transforaminal Epidural Injection
For selected patients with nerve-related lower back and leg pain, a transforaminal epidural injection may be considered.
The procedure delivers medication close to the affected spinal nerve through a targeted approach.
It may be considered in patients with conditions such as:
Sciatica due to nerve irritation or compression
Selected lumbar disc-related nerve pain
Radicular pain associated with spinal stenosis
Persistent lower back and leg pain despite appropriate conservative treatment
The decision to perform an injection is made after assessment of the patient's symptoms, examination and imaging.
What Is the Aim of the Injection?
The aim is to reduce inflammation and irritation around the affected nerve and provide pain relief.
Response varies between patients. An injection does not necessarily correct the underlying structural cause of spinal stenosis or disc disease.
What Is Spinal Stenosis?
Spinal stenosis occurs when the spaces around the spinal nerves become narrowed. In the lower back, this can cause back pain, leg pain, numbness or heaviness, particularly during standing or walking.
Some patients experience relief when sitting or bending forward.
Non-Operative Treatment
Not every patient with sciatica or spinal stenosis requires surgery.
Depending on the cause and severity of symptoms, treatment may include:
Activity modification
Physiotherapy and targeted exercises
Medication when appropriate
Management of contributing factors
Interventional pain treatment in selected patients
The appropriate treatment depends on the clinical examination, symptoms and imaging findings.
When Might Surgery Be Considered?
Surgery may be considered when symptoms are severe or persistent despite appropriate non-operative treatment, or when there is significant neurological compromise.
The treatment decision depends on the individual patient's symptoms, examination and imaging.
When Should You Seek Urgent Assessment?
Seek urgent medical attention if back pain is associated with:
New or worsening weakness in the legs
Loss of bladder or bowel control
Numbness around the groin or inner thighs
Rapidly progressing neurological symptoms
These symptoms require prompt medical assessment.
No. Many patients can initially be managed with non-operative treatment. Surgery is considered when symptoms, neurological findings or the underlying spinal problem warrant it.
A transforaminal epidural injection may provide pain relief in selected patients with nerve-related pain. The response varies between individuals and it does not necessarily eliminate the underlying structural problem.
Some patients with spinal stenosis can be managed non-operatively, depending on the severity of symptoms and neurological findings.
The decision is based on the patient's symptoms, physical examination and relevant imaging. Not every patient with back pain or sciatica is a candidate for an injection.
Consult Dr. Vikash Singh
For assessment of a joint problem, fracture, sports injury, deformity or other orthopaedic condition, you can arrange a consultation in Karachi.
Read patient reviews, view clinic information, check consultation details and find directions through Google.
Dr. Vikash Singh
FCPS (Orthopaedic Surgery) | MRCS (Edinburgh) | CHPE (DUHS)
Fellowships & Advanced Training
AO-Spine Fellowship – Germany
Foot & Ankle Fellowship – Germany
Ilizarov ASAMI Fellowship – Italy
AO-Trauma Fellowship – UK
Arthroplasty Fellowship – Karachi
All pictures and videos displayed on this website represent cases treated and operated by Dr Vikash Singh.
Website content is for educational purposes only.
