Dr. Nitish Mandal
Sciatica and slip disc
The pain shoots from your lower back into the leg. Sitting is worse. You have been told it is a disc. Tablets and rest have not settled it.
What sciatica is
Sciatica is pain that follows the sciatic nerve, usually from the lower back into the buttock and down the leg. A disc that has bulged or herniated can irritate that nerve.
People often search for slip disc, disc bulge, or PIVD. Those words describe what a scan can show. The visit is about whether that disc is the reason you cannot sit, walk, or sleep.
How it feels
- Shooting or burning pain from the back into one leg.
- Sitting, bending, or coughing can make it worse.
- The leg may feel numb, heavy, or tingly, sometimes into the toes.
MRI bulge versus the pain you feel
A scan shows structure. It does not always show which structure is causing this week's pain. Two people can have similar disc pictures and very different symptoms.
The first visit starts with conversation and a physical examination, then looks at your reports. Surgery is not the automatic next step because a disc is visible on MRI.
What you may already have tried
- Painkillers and rest, with the pain returning when you sit or travel.
- Physiotherapy that helps a little, then stalls.
- An MRI that shows a bulge, and a suggestion to wait or to plan surgery.
Care without a first jump to surgery
Alongside the procedure
- Avoid positions that sharply increase the leg pain.
- Keep moving in ways that do not provoke the nerve.
- Back-strengthening exercises after the disc has settled, as described on the ozone article.
When a targeted procedure is discussed
- Ozone discolysis (ozone nucleolysis): medical-grade ozone placed in the disc under X-ray guidance, positioned as relief of nerve pressure without surgery.
- Transforaminal epidural injections, including a small dose of steroid with local anaesthetic when sciatica is very severe.
What an ozone disc visit is like
- You lie face down. The site is cleaned and local anaesthetic is given.
- The disc is located with X-ray guidance. A thin needle is placed in the disc.
- Medical-grade ozone, made from pure oxygen just before injection, is placed. The needle is withdrawn and a bandage applied.
The procedure is described as taking around 15 to 20 minutes, with going home in about 30 minutes. Ozone is described as taking 3 to 4 weeks to shrink the disc. For very severe sciatica, a small dose of steroid with local anaesthetic may be given as the needle comes out, with pain relief described within 1 to 2 days.
Frequently asked questions
- My MRI shows a disc bulge. Do I need surgery?
- Not automatically. A bulge on a scan and the pain you feel are not always the same thing. Many people are first offered a non-surgical option such as ozone discolysis or an epidural injection, after examination.
- How soon can I go home after ozone for sciatica?
- The visit is described as going home in about 30 minutes after a 15 to 20 minute procedure. You remain awake so any shock-like feeling can be reported at once.
- How long until ozone helps?
- Ozone is described as taking 3 to 4 weeks to shrink the disc. If sciatica is very severe, a small steroid dose as the needle comes out may ease pain within 1 to 2 days. Back-strengthening exercises are still advised afterwards.
Not every disc needs an injection, and some people still need a surgeon. The first visit is to find whether this pain is coming from that disc, then choose care that fits.
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My MRI shows a disc bulge. Do I need surgery?
Not automatically. A bulge on a scan and the pain you feel are not always the same thing. Ozone discolysis and transforaminal epidural injections are listed as non-surgical options after examination.
How soon can I go home after ozone?
The procedure is described as 15 to 20 minutes, with going home in about 30 minutes. Ozone may take 3 to 4 weeks to shrink the disc.