Sciatica can cause lower back, buttock, hip, and leg pain, often with burning, tingling, numbness, or weakness. MPM provides diagnosis-first evaluation to determine whether symptoms are coming from a herniated disc, nerve irritation, spinal stenosis, SI joint dysfunction, hypermobility, or another pain generator.
Learn how Dr. Aranguren explains sciatica and herniated discs, identifies the source of nerve pain, and develops personalized treatment plans to help patients find lasting relief.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Luis Aranguren, an interventional pain management specialist here at Manhattan Pain Medicine.
One of the most common causes of back and leg pain that we treat is sciatica, often related to a herniated disc in the spine.
Sciatica refers to pain that travels along the sciatic nerve, which runs from the lower back through the hips and down the leg. When that nerve becomes irritated or compressed, people may feel sharp pain, burning, numbness, or tingling that travels down the leg. A very common reason this happens is a herniated disc.
Between the bones of the spine are discs that act like shock absorbers. Sometimes the inner portion of that disc pushes outward and presses on a nearby nerve. When that happens, it can trigger the symptoms people associate with sciatica.Patients often describe pain in the lower back that shoots into the buttock or leg, sometimes with numbness, tingling, or weakness. These symptoms may get worse with things like sitting for long periods, bending forward, or lifting.
The most important step in treating sciatica is making an accurate diagnosis. That usually involves a careful physical exam and sometimes imaging such as MRI or other studies to understand exactly where the nerve irritation is occurring. Once we know the source of the problem, we can discuss treatment options.
For many patients, treatment may include physical therapy, medications, and targeted injections such as epidural steroid injections, which can reduce inflammation around the nerve and relieve pain. The goal is to calm the irritated nerve and allow the body to recover, while also helping you return to normal movement safely.
At Manhattan Pain Medicine, we focus on identifying the specific cause of your pain and building a treatment plan that helps you reduce symptoms, restore function, and get back to your daily activities.
If you’re experiencing pain that travels from your back into your leg, it’s important to have it evaluated so we can determine the cause and discuss the best treatment options.
Sciatica is a symptom pattern, not a diagnosis by itself. It describes pain that travels from the lower back, buttock, or hip into the leg, often along the path of an irritated nerve. Some patients feel sharp, shooting pain. Others describe burning, tingling, numbness, weakness, or electric pain.
A herniated disc is one possible cause of sciatica. When disc material irritates or compresses a spinal nerve root, it can create pain that travels into the buttock, thigh, calf, or foot. However, sciatica-like symptoms may also come from spinal stenosis, spondylolisthesis, sacroiliac joint dysfunction, hip pathology, piriformis-region irritation, inflammatory spine disease, hypermobility-related instability, peripheral neuropathy, or other overlapping pain generators.
At Manhattan Pain Medicine (MPM), evaluation begins by identifying what is actually driving the pain. For patients looking for sciatica treatment in Manhattan or NYC, MPM focuses on careful diagnosis, imaging correlation, functional assessment, and individualized treatment planning.
MPM evaluates sciatica and herniated disc symptoms by reviewing the patient’s pain pattern, neurologic symptoms, prior imaging, movement limitations, prior treatment response, and functional impact.
Sciatica and herniated disc pain may overlap with spinal stenosis, spondylosis, spondylolisthesis, sacroiliac joint dysfunction, facet-mediated pain, inflammatory back pain, autoimmune-related pain, EDS, hypermobility spectrum disorder, tethered cord concerns, and complex spine pain. When appropriate, MPM coordinates care with spine specialists, neurology, orthopedics, rheumatology, rehabilitation, physical therapy, and other clinicians.
Many patients are told they have sciatica because pain travels down the leg. While a herniated disc can irritate a spinal nerve and cause radiating leg pain, not every case of leg pain comes from a disc.
Pain that feels like sciatica can also come from spinal stenosis, SI joint dysfunction, hip pain, peripheral nerve irritation, piriformis-region pain, inflammatory spine disease, pelvic pain, or chronic nerve sensitivity. Some patients also have disc findings on MRI that may not fully explain their symptoms.
MPM’s diagnosis-first approach helps determine whether the main driver is a disc, nerve root, joint, SI joint, hip, inflammation, hypermobility-related instability, or another pain source.
Sciatica and herniated disc symptoms fit within MPM’s Musculoskeletal issues Zone of Expertise, with important overlap in Hypermobility when EDS or hypermobility spectrum disorder may affect spine mechanics.
Patients with hypermobility may experience recurrent back pain, joint instability, muscle guarding, altered movement patterns, SI joint dysfunction, or increased strain on spinal structures. This does not mean every case of sciatica is caused by hypermobility, but it may make evaluation and treatment planning more complex.
MPM evaluates the full spine, SI joint, hip, nerve, and movement pattern before recommending a treatment plan.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
Sciatica describes pain that travels from the lower back, buttock, or hip into the leg along the path of an irritated nerve. It may feel sharp, shooting, burning, electric, or aching. Some patients also experience numbness, tingling, weakness, or foot symptoms. Sciatica is a symptom pattern, not a complete diagnosis, so the cause must be evaluated.
No. A herniated disc can cause sciatica when disc material irritates or compresses a spinal nerve root, but sciatica-like pain can also come from spinal stenosis, spondylolisthesis, SI joint dysfunction, hip pathology, piriformis-region irritation, peripheral nerve problems, inflammatory disease, or other pain generators.
Yes. A herniated disc can irritate a spinal nerve root and cause pain that travels into the buttock, thigh, calf, or foot. Symptoms may include burning, tingling, numbness, weakness, or electric pain. The location of symptoms often depends on which nerve root is affected.
Sciatica may feel like shooting pain from the lower back or buttock down the leg. Some patients describe burning, tingling, numbness, pins and needles, electric pain, weakness, or pain that worsens with sitting, standing, bending, lifting, coughing, or walking. Symptoms vary depending on the source and severity of nerve irritation.
Yes. Nerve irritation can cause sensory symptoms such as numbness, tingling, burning, electric pain, or sensitivity. It can also cause weakness when the affected nerve root controls certain muscles. New, worsening, or progressive weakness should be evaluated promptly.
The source is determined through history, physical examination, neurologic testing, movement assessment, imaging review, and sometimes diagnostic injections. Disc-related nerve pain, spinal stenosis, SI joint pain, hip pain, and peripheral nerve pain can overlap. MPM evaluates the full pattern before recommending treatment.
Many cases of sciatica improve with nonsurgical care, depending on the cause and severity. Treatment may include activity modification, medication management, physical rehabilitation coordination, and selected injections when appropriate. Surgery may be considered when symptoms are severe, persistent, progressive, or associated with significant nerve compression.
Epidural injections may be considered when symptoms suggest irritated or inflamed spinal nerve roots, such as radiating leg pain from a herniated disc, spinal stenosis, or lumbar radiculopathy. They are not appropriate for every type of lower back or leg pain. MPM evaluates the diagnosis, imaging, symptoms, risks, and prior treatment response before recommending an epidural injection.
Treatment depends on the severity of symptoms and the suspected pain generator. Options may include medication management, rehabilitation coordination, activity modification, epidural injections, spine injections, steroid injections, pain psychology, biofeedback, acupuncture, Feldenkrais, and referral to a spine specialist when surgery or additional evaluation may be needed.
Yes. In some patients, EDS or hypermobility spectrum disorder may contribute to recurrent spine pain, SI joint dysfunction, joint instability, muscle guarding, altered mechanics, or overlapping nerve irritation. This does not mean hypermobility is always the cause, but it may influence diagnosis, rehabilitation planning, and treatment selection.
You should consider seeing a spine pain specialist when sciatica persists, worsens, keeps returning, limits walking or daily function, causes numbness or tingling, does not improve with conservative care, or is associated with weakness, prior failed treatments, complex imaging findings, hypermobility, inflammatory symptoms, or unclear diagnosis.
Sciatica or radiating leg pain should be evaluated urgently when it is associated with new or worsening weakness, foot drop, bowel or bladder dysfunction, saddle anesthesia, fever, unexplained weight loss, history of cancer, major trauma, severe night pain, trouble walking, rapidly worsening numbness, or severe progressive neurologic symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If lower back, buttock, hip, or leg pain is affecting your movement, sleep, work, or daily life, MPM can help evaluate what may be contributing. Our diagnosis-first approach considers herniated discs, nerve irritation, spinal stenosis, SI joint dysfunction, hip-related pain, inflammatory spine pain, hypermobility, EDS, and complex spine pain patterns. Request an appointment to discuss your symptoms, imaging, and care options.
Sciatica is often described as pain that shoots from the lower back or buttock down the leg. Some patients feel pain in the hip, thigh, calf, ankle, or foot. Others describe burning, tingling, numbness, electric pain, weakness, or a feeling that the leg is unreliable.
Although many people associate sciatica with a herniated disc, sciatica is not a diagnosis by itself. It is a symptom pattern that suggests irritation somewhere along a nerve pathway. Finding the exact source matters because the right treatment depends on what is actually driving the pain.
Spinal discs sit between the bones of the spine and help absorb load and support movement. A herniated disc occurs when disc material moves out of its usual position and can irritate nearby nerves. In the lower back, this may cause lumbar radiculopathy, which can create pain, numbness, tingling, or weakness down the leg.
Not every herniated disc causes symptoms. Some disc findings are incidental. Others are clinically meaningful when the disc location matches the patient’s pain pattern, neurologic findings, and functional limitations.
When a herniated disc irritates or compresses a spinal nerve root, pain may travel along the path of that nerve. Depending on the nerve involved, symptoms may extend into the buttock, back of the thigh, outer leg, calf, foot, or toes.
Patients may notice that pain worsens with sitting, bending, lifting, coughing, sneezing, or certain movements. Some may have relief with position changes. Others may develop persistent pain that does not clearly respond to rest or physical therapy.
Sciatica is a common patient-facing term for radiating pain down the leg. Lumbar radiculopathy is a more specific clinical term that refers to irritation or dysfunction of a lumbar or sacral nerve root.
Radiculopathy may include pain, numbness, tingling, weakness, or reflex changes. MPM evaluates whether the patient’s symptoms follow a nerve root pattern and whether imaging supports that diagnosis.
Sciatica-like pain can come from more than a herniated disc. Spinal stenosis can narrow the space around spinal nerves and may cause pain, numbness, heaviness, or cramping that worsens with standing or walking. Spondylolisthesis can also contribute to nerve irritation or mechanical back pain.
The sacroiliac joint can cause lower back, buttock, hip, groin, pelvic, or leg-like pain that may mimic sciatica. Hip conditions can refer pain into the thigh or groin. Peripheral nerve entrapment, piriformis-region irritation, pelvic nerve pain, and peripheral neuropathy can also create radiating symptoms.
This is why MPM evaluates the full spine, SI joint, hip, nerve pathway, and movement pattern before assuming the diagnosis.
An MRI can provide important information, but it must be interpreted carefully. A patient may have a herniated disc that is not causing the current pain. Another patient may have symptoms that are more severe than imaging suggests. Some people have multiple findings, such as disc bulge, stenosis, facet arthritis, SI joint dysfunction, and hypermobility-related instability, making the pain pattern more complex.
MPM reviews imaging in the context of the patient’s history, examination, neurologic findings, function, and response to prior treatments. The goal is to avoid treating an image instead of treating the patient.
Patients with EDS or hypermobility spectrum disorder may experience recurrent spine pain, SI joint dysfunction, joint instability, muscle guarding, and altered movement patterns. These factors may increase the complexity of lower back and leg pain.
Hypermobility does not automatically mean sciatica is caused by instability. However, it may influence how the spine, pelvis, hips, and surrounding muscles tolerate load. MPM evaluates these factors carefully so treatment is not too aggressive, too generic, or based on assumptions.
Some back and leg symptoms may overlap with inflammatory spine pain. Seronegative spondyloarthropathy, autoimmune-related pain, arthritis-related joint pain, enthesitis, Sjogren’s, rheumatoid arthritis, and other inflammatory conditions may contribute to spine, SI joint, hip, or tendon pain.
Inflammatory back pain may behave differently from mechanical pain. It may involve morning stiffness, improvement with movement, worsening with rest, fatigue, SI joint pain, or symptoms in other joints. When this pattern is suspected, MPM coordinates with rheumatology for appropriate evaluation and treatment planning.
Treatment depends on the cause, severity, neurologic findings, imaging, prior response, and patient goals. Options may include medication management, physical rehabilitation coordination, activity modification, acupuncture, Feldenkrais, biofeedback, pain psychology, epidural injections, spine injections, steroid injections, epidural lysis of adhesions or Racz catheter procedures in selected cases, SI joint injection, regenerative medicine in carefully selected cases, PRP or prolotherapy only when appropriate for a specific musculoskeletal target, spinal cord stimulation, dorsal root ganglion stimulation, or referral to spine surgery.
These options are not interchangeable. Epidural injections may be considered when nerve root inflammation or radicular pain is suspected. SI joint injections may be considered when symptoms suggest SI joint involvement. Neuromodulation may be considered for selected chronic neuropathic pain patterns after careful evaluation. Regenerative options should not be presented as a way to repair all disc problems or replace surgery when surgery is medically indicated.
Surgery may be considered when a herniated disc, spinal stenosis, spondylolisthesis, or another structural condition causes severe or progressive neurologic symptoms, significant weakness, persistent disabling pain, or failure of appropriate nonsurgical care.
MPM can help evaluate the pain generator and coordinate referral when surgical input is appropriate. Pain medicine does not replace spine surgery when surgery is medically indicated, but it can help patients understand whether symptoms appear disc-related, nerve-related, SI joint-related, inflammatory, hypermobility-related, or mixed.
Patients should seek urgent evaluation for lower back or leg pain associated with new or worsening weakness, foot drop, bowel or bladder dysfunction, saddle anesthesia, fever, unexplained weight loss, history of cancer, major trauma, severe night pain, trouble walking, rapidly worsening numbness, or severe progressive neurologic symptoms.
These symptoms may indicate spinal cord or nerve compression, infection, fracture, malignancy, vascular disease, or another serious condition requiring immediate attention.
MPM approaches sciatica and herniated disc pain through a diagnosis-first model. The goal is to identify the true source of radiating pain, understand overlapping contributors, interpret imaging carefully, and build a treatment plan that fits the patient’s symptoms, anatomy, goals, and risk profile.
For patients looking for sciatica treatment in Manhattan or NYC, MPM provides coordinated pain medicine care for herniated discs, lumbar radiculopathy, pinched nerves, radiating leg pain, spinal stenosis, SI joint dysfunction, inflammatory spine pain, hypermobility-related spine pain, and complex chronic spine pain patterns.
