Nerve Pain Treatment | Austin, TX

Radiculopathy & Sciatica

Precision-guided interventional treatment for nerve pain radiating into the arms, legs, or feet.

Overview

Radiculopathy occurs when a spinal nerve root is compressed, irritated, or inflamed as it exits the spine — producing pain, numbness, tingling, or weakness that travels along the path of that nerve. Lumbar radiculopathy affecting the sciatic nerve — commonly called sciatica — produces symptoms down the buttock, leg, and sometimes into the foot. Cervical radiculopathy produces similar symptoms in the arm and hand. Dr. Migdale is specifically trained to identify the precise level and side of nerve involvement and deliver targeted interventional treatment directly to the source.

What Causes Radiculopathy?

The most common causes of radiculopathy are: disc herniation pressing directly on a nerve root; foraminal stenosis (narrowing of the opening through which the nerve exits); bone spurs irritating the nerve; and, less commonly, tumors, cysts, or other compressive lesions. The L4-L5 and L5-S1 levels are most commonly affected in lumbar radiculopathy; the C5-C6 and C6-C7 levels are most common in cervical radiculopathy.

Sciatica: A Specific Form of Lumbar Radiculopathy

Sciatica refers specifically to radiculopathy affecting the sciatic nerve — the longest nerve in the body, formed by nerve roots from L4 through S3. Sciatic pain typically starts in the lower back or buttock and radiates down the back of the thigh and leg, sometimes reaching the foot. True sciatica is caused by nerve root compression in the spine, though piriformis syndrome (compression of the sciatic nerve by the piriformis muscle in the buttock) can produce similar symptoms.

Treatment

Transforaminal epidural steroid injections — where corticosteroid is delivered precisely at the affected nerve root using fluoroscopic guidance — are the most effective interventional treatment for radiculopathy and sciatica. Dr. Migdale's training and experience allows her to target the exact level and side of involvement with high precision. For patients whose symptoms persist after injections, spinal cord stimulation can provide sustained relief for the neuropathic component.

Common Questions

Frequently Asked Questions

How do I know if I have sciatica or something else?
True sciatica produces pain that follows the specific path of the sciatic nerve — from the lower back or buttock, down the back of the thigh and leg, sometimes into the foot. It is usually accompanied by numbness or tingling and may include weakness. Pain that is more diffuse, bilateral, or primarily in the back without radiation is less likely to be true sciatica. A thorough examination and imaging review by Dr. Migdale can clarify the diagnosis.
How quickly do epidural steroid injections work for sciatica?
Most patients notice improvement within 2–7 days after a transforaminal epidural steroid injection. Some experience dramatic relief within hours. The injection reduces inflammation around the nerve root, allowing it to recover. Physical therapy alongside injections tends to produce better long-term outcomes than injections alone.
Can radiculopathy be cured?
Many patients with radiculopathy achieve complete or near-complete resolution of symptoms, particularly when treated early. The prognosis depends on the underlying cause — most disc herniations causing radiculopathy improve over 6–12 weeks with appropriate treatment. Chronic or severe cases may require ongoing management, but the goal is always to restore maximum function.

Medical Disclaimer: The information on this page is intended for general educational purposes only and does not constitute medical advice. It is not a substitute for professional medical evaluation, diagnosis, or treatment. Please consult Dr. Migdale or another qualified healthcare provider regarding your specific condition.

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