Causes of Sciatica

Herniated Disc (90% of cases)

The main cause of sciatica. L4-L5 herniation compresses the L5 root: pain along the lateral thigh, calf, dorsum of the foot, numbness of the big toe. L5-S1 herniation compresses the S1 root: pain along the posterior thigh, calf, lateral foot margin, weakness of plantar flexion. Central herniation may compress both roots.

→ Disc Herniation Treatment Using the MIBRAR Method

Spinal Stenosis

Narrowing of the spinal canal or foraminal openings. Characteristic: pain and numbness in both legs when walking, relief with forward flexion and sitting (neurogenic claudication). Unlike herniation — bilateral involvement and association with walking distance.

→ Stenosis Treatment

Spondylolisthesis

Forward slippage of a vertebra. Degenerative (L4-L5 in the elderly) or isthmic (L5-S1 in young athletes). Compression of neural structures at the site of slippage. Pain worsens with extension and prolonged standing.

→ Spondylolisthesis Treatment

Piriformis Syndrome

Spasm of the piriformis muscle compresses the sciatic nerve in the infrapiriform space. Pain in the buttock with radiation along the posterior thigh. Worsens with prolonged sitting. Spinal MRI shows no pathology — this is "pseudo-sciatica." Diagnosis: tenderness on palpation of the piriformis muscle, Freiberg test, FAIR test.

Facet Joint Syndrome with Root Compression

Hypertrophied facet joints and osteophytes narrow the foraminal opening. Pain on lumbar extension, radiation to the leg. Distinction from discogenic sciatica: pain worsens with extension (not flexion).

→ Facet Joint Syndrome Treatment

Pain Characteristics by Level of Involvement

L4 Root (L3-L4 Herniation)

Pain: anterior thigh, medial calf. Numbness: anteromedial calf. Weakness: knee extension (quadriceps). Reflex: reduced knee reflex. Frequency: 5% of sciaticas.

L5 Root (L4-L5 Herniation)

Pain: buttock, lateral thigh and calf, dorsum of foot. Numbness: lateral calf, first-second interspace. Weakness: big toe extension, foot dorsiflexion. Reflex: unchanged. Frequency: 45%.

S1 Root (L5-S1 Herniation)

Pain: buttock, posterior thigh, calf, lateral foot margin. Numbness: heel, lateral foot, little toe. Weakness: plantar flexion (inability to rise on toes). Reflex: reduced Achilles reflex. Frequency: 50%.

Red Flags

Cauda Equina Syndrome

Bilateral sciatica + perineal numbness + urinary/defecatory dysfunction. Emergency decompression within 24-48 hours. Delay leads to irreversible damage.

Progressive Foot Drop

Worsening "foot drop" — inability to lift the foot and toes. Sign of progressive L5 root compression.

Sciatica + Fever

Back pain with radiation + fever — epidural abscess or spondylodiscitis possible. Emergency MRI with contrast.

Treatment of Sciatica using the MIBRAR method

MIBRAR eliminates the cause of sciatic nerve compression and restores damaged nerve tissue.

1. Elimination of Compression

Intradiscal injection of CGF + Lipogems® initiates regeneration of the damaged disc. As the annulus fibrosus recovers, the herniated protrusion decreases, reducing pressure on the nerve root.

2. Relief of Nerve Root Inflammation

Periradicular injection of CGF directly to the inflamed nerve root. Growth factors suppress the inflammatory cascade (IL-1, TNF-alpha, PGE2) and edema. Effect faster than blockade, without cortisone side effects.

3. Neuroregeneration

Neurotrophic factors from CGF (NGF, BDNF) and paracrine secretion of stem cells stimulate remyelination and axonal recovery. Numbness and weakness decrease within 2-6 weeks.

93% Effectiveness for Sciatica

2-4 wk. Onset of Improvement

30-60 min Procedure

5-20 years Duration of Effect

Don't tolerate pain — it indicates nerve damage

Prolonged nerve compression leads to irreversible atrophy. Send MRI for free evaluation.

Send MRI Images

Questions about Sciatica

How to distinguish sciatica from regular leg pain?

Sciatica is shooting, burning pain from the lower back along the posterior thigh to the foot. Worsens with coughing, sneezing, bending. Regular muscle pain is dull, local, without radiation below the knee.

Can sciatica be cured without surgery?

Yes, in 85-90% of cases. MIBRAR eliminates the cause: disc regeneration reduces herniation, CGF relieves root inflammation, stem cells restore the nerve. 93% effectiveness.

How long does sciatica last?

Acute episode 4-8 weeks. In 30% it becomes chronic. With MIBRAR: improvement in 2-4 weeks, full effect 3-6 months.

Can you exercise with sciatica?

Acute phase — rest 2-3 days, then gentle activation. Walking, swimming — beneficial. Running, jumping, pulling — contraindicated until resolved. After MIBRAR — sports after 4-6 weeks.

What tests are needed?

Lumbar MRI — mandatory. EMG — for numbness and weakness in the leg (determines level and degree of damage). X-ray — if spondylolisthesis suspected.