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Expert insight • Sciatica

Sciatica: When Should You Consider a Spinal Injection?

How to recognise nerve-related leg pain, when imaging is useful, and when specialist assessment may change what happens next.

Picture of Dr Laith Al-Obaidi

Dr Laith Al-Obaidi

Consultant Radiologist and Interventional Pain Specialist • Updated 16 September 2026

The 30-second answer

Sciatica usually means pain caused by irritation or compression of a spinal nerve, often producing pain from the back or buttock into the leg. Many episodes improve, but persistent, severe, recurrent or neurologically complicated symptoms deserve a more focused assessment.

Step 1

Your symptoms

Step 2

The right diagnosis

Step 3

The right treatment for you

Step 4

Recovery

Understanding the problem

What does sciatica actually feel like?

Sciatica is not simply any leg pain. Typical symptoms can include shooting or burning pain from the buttock into the leg, tingling, numbness or, in some cases, weakness. The exact distribution can help identify which nerve may be involved.

Start with the diagnosis, not the procedure.

When is specialist assessment useful?

Assessment becomes more useful when pain is severe, persists despite reasonable treatment, repeatedly returns, limits sleep or mobility, or is accompanied by neurological symptoms. The aim is to decide whether the problem is likely to be nerve-related and whether imaging or another treatment step is justified.

Do you need an MRI for sciatica?

Not always. In specialist care, MRI is most useful when the result is likely to change management. A scan should answer a clinical question, not simply confirm that the spine has age-related changes.

What treatments may be considered?

Most care starts with advice, activity and rehabilitation. For acute and severe sciatica, an epidural injection of local anaesthetic and steroid can be considered in selected patients. Surgery may be considered when non-surgical treatment has not improved pain or function and imaging findings match the symptoms.

The Dorset Pain Clinic difference

Everything connected in one specialist pathway.

Our model combines senior clinical assessment, specialist imaging, pain medicine, targeted intervention and rehabilitation. The aim is to reduce fragmentation, avoid unnecessary duplicated steps and give you a clearer plan.

Consultant-led assessment

Open MRI, X-ray and ultrasound

Image-guided procedures when appropriate

Physiotherapy, chiropractic and rehabilitation

Rheumatology and orthopaedic input when needed

Transparent, coordinated private care

The Dorset Pain Clinic difference

A complete team around the patient.

Dr Laith Al-Obaidi

Consultant Radiologist and Interventional Pain Specialist

Combines diagnostic imaging expertise with image-guided musculoskeletal and spinal intervention, linking symptoms, examination and imaging before deciding whether a procedure is appropriate.

Dr Khalid Alaib

Consultant in Pain Medicine and Anaesthesia

Provides senior specialist assessment of persistent and complex pain, medication review and personalised treatment planning, with extensive experience in interventional pain medicine.

Common questions

Answered simply.

Is sciatica always caused by a slipped disc?

No. Disc-related nerve irritation is common, but other causes such as narrowing around a nerve can occur.

Yes. Many episodes improve with time, activity and rehabilitation.

Urgent hospital assessment is needed for symptoms such as new bladder or bowel dysfunction, saddle numbness, or severe or worsening weakness in both legs.

Clinical sources

Guidance used for this article

This article is general information and does not replace an individual medical assessment.

Other Blogs

Start with the diagnosis, not the procedure.

If pain is affecting your sleep, work, mobility or confidence, a specialist assessment can help clarify what is happening and what the sensible next step should be.