Sciatica & Slipped Disc Treatment in Delhi

Sciatica is pain that travels from the lower back or buttock down the leg, following the path of the sciatic nerve. It is a symptom, not a diagnosis — and in most cases the cause is a lumbar disc herniation, often called a slipped disc or PIVD, pressing on a nerve root as it leaves the spine.

The single most important thing to know is this: most slipped discs get better without surgery. The section below sets out what the research actually shows, because it is not what most clinics lead with.

The nerves that supply your leg leave the spinal canal through small openings between the vertebrae. A disc sits between each pair of vertebrae, acting as a cushion. If the tough outer ring of a disc tears, the softer inner material can push out and press against a nerve root at that opening.

The brain interprets that irritation as pain along the whole territory of the nerve — which is why a problem in your back produces pain in your calf or foot, and why the back itself sometimes barely hurts at all. Depending on which nerve root is compressed, you may also notice numbness, tingling, or weakness, such as difficulty lifting the front of the foot.

Pooled research covering more than 2,000 patients found that about 63% of lumbar disc herniations regress on their own with non-surgical treatment.

More surprisingly, the larger ones regress most often. Around 96% of the most extruded fragments shrink, compared with about 13% of mild bulges. The disc material that looks most alarming on a scan is the material your body is most likely to reabsorb.

This matters because it means a frightening MRI report is not, by itself, a reason for an operation. What matters is your symptoms, whether they are improving or worsening, and whether there is any loss of nerve function on examination. If anyone shows you a scan and tells you that you need surgery without examining you and asking how your symptoms have changed, get a second opinion.

A small number of presentations are genuinely time-critical. Go to an emergency department the same day — do not wait for an outpatient appointment — if you have:

• Difficulty passing urine, loss of bladder or bowel control, or a change in sensation when you pass urine
• Numbness in the saddle area — the inner thighs, buttocks or genital region
• Weakness in both legs, or weakness that is getting rapidly worse
• Severe leg pain with fever, or after a significant fall or accident

These can indicate cauda equina syndrome or another condition where delay causes permanent harm. Everything else on this page assumes none of the above applies.

Assessment is mostly clinical. We take a history — when it started, what makes it worse, how it has changed — and examine you for the specific pattern of sensation, reflexes and power that identifies which nerve root is involved.

An MRI is useful when symptoms have persisted, when there is a neurological deficit, or when we are planning an intervention. It is less useful at the start, because disc bulges are common in people with no pain at all. The scan tells us what a nerve is doing only when it is read alongside the examination.

If you already have imaging, please bring the films or the disc, not just the report.

For most patients the plan is:

• Staying active within limits. Prolonged bed rest makes sciatica worse, not better. Gentle continued activity is better than immobility.
• Medication to control pain enough to let you move, and to settle nerve irritation.
• Physiotherapy — guided movement, gradual strengthening, and advice on posture, lifting and work setup.
• Time, with review. Most improvement happens over weeks to a few months. We set a review date rather than leaving you to decide when things have gone on too long.

Where it is unclear which nerve is responsible, or pain is too severe to allow physiotherapy, an image-guided injection or nerve root block can help — both to clarify the diagnosis and to give a window of relief. We are straight about what injections can and cannot do on that page.

Surgery becomes a reasonable option when leg pain from a confirmed disc herniation has persisted despite proper non-surgical treatment and is limiting your life, or when there is progressive weakness. It is not a decision driven by the size of the herniation on the scan.

Where an operation is appropriate, the usual procedure is a full-endoscopic lumbar discectomy — removal of the fragment pressing on the nerve through an incision of roughly 8–10 mm, in most cases as a day-care procedure.

What surgery does well: it relieves nerve-compression leg pain faster than waiting. That is a real and well-evidenced benefit.

What it does less well: it is less reliable for back pain than for leg pain. Numbness and weakness recover more slowly than pain, and sometimes incompletely, particularly when they have been present a long time. And over several years the difference between patients who had surgery and those who did not narrows — surgery mainly buys you faster relief rather than a different final outcome.

Around 6% of patients have a recurrence within two years. We would rather you knew that in advance.

Will my sciatica go away on its own?

Usually, yes. Pooled research on more than 2,000 patients found about 63% of lumbar disc herniations shrink on their own without surgery, and most people with sciatica improve over weeks to a few months with medication, physiotherapy and staying gently active. Surgery is considered when pain persists despite that treatment and is limiting your life, or when there is weakness that is getting worse.

How long does sciatica take to get better?

Most patients improve substantially over six to twelve weeks, though it can take longer and the improvement is often uneven rather than steady. Numbness and tingling typically settle more slowly than pain. If there has been no meaningful improvement after several weeks of proper treatment, that is the point to reassess rather than simply continue.

Do I need an MRI for sciatica?

Not usually at the start. Disc bulges show up on scans in plenty of people who have no pain at all, so an MRI early on often finds something that is not the cause of your symptoms. An MRI becomes genuinely useful when symptoms have persisted, when examination shows loss of nerve function, or when we are planning an injection or an operation.

Is bed rest good for sciatica?

No. Prolonged bed rest makes sciatica worse and slows recovery. Short periods of rest when pain is severe are reasonable, but staying gently active within the limits of your pain gives better outcomes. Your physiotherapist will set out what movement is safe for you.

When is sciatica an emergency?

If you have difficulty passing urine, loss of bladder or bowel control, numbness around the saddle area, or weakness in both legs, go to an emergency department the same day. These can indicate cauda equina syndrome, where delay can cause permanent damage. Severe leg pain with fever, or following a significant fall, also needs same-day assessment.

Sciatica and slipped disc are assessed by Dr. Om Prakash Gupta, Senior Consultant Orthopaedic & Endoscopic Spine Surgeon, as part of Sama’s Minimally Invasive & Endoscopic Spine Surgery service.

Sama Hospital, 8 Siri Fort Road, Sadiq Nagar, New Delhi 110049. 24/7 emergency; specialist OPD during daytime hours. For an estimate of cost, call us.