Sciatica & Leg Pain Specialist · Naples & Fort Myers, FL
Sciatica. Pain down your leg. A pinched nerve in your back. There is a reason — and a solution.
Sciatica is not just back pain. It’s the electric, burning, shooting pain that takes over your leg, your sleep, and your life. Dr. Katsevman specializes in finding exactly what is compressing your sciatic nerve — and fixing it, with the least invasive approach possible.
"Sciatica is one of the most painful conditions a person can experience — and one of the most treatable. Most patients never need surgery. But when they do, the right surgery changes everything."
Dr. G. Katsevman, MD · Neurosurgeon & Spine Surgeonwithout surgery
before surgery is discussed
minimally invasive surgery
Naples & Fort Myers
Understanding sciatica
What is sciatica?
Sciatica is not a diagnosis — it is a symptom. It describes pain, numbness, tingling, or weakness that radiates from the lower back into the buttock, leg, or foot along the path of the sciatic nerve. The real question is: what is compressing the nerve?
The sciatic nerve is the largest nerve in the body — it runs from the lower spine through the buttock and down each leg to the foot. When something in the lumbar spine presses on the nerve roots that form it, the pain can be felt anywhere along its entire length. Finding and relieving that compression is what Dr. Katsevman does.
Shooting or Burning Leg Pain
Sharp, electric, or burning pain that shoots from the lower back or buttock down through the leg — often into the calf or foot. Can feel like a bolt of electricity or a deep, searing ache.
Numbness & Tingling
Pins-and-needles or a dead, numb feeling in the leg, calf, or foot. May be constant or come and go. Often localized to a specific part of the leg depending on which nerve root is compressed.
Weakness in the Leg or Foot
Difficulty lifting the foot (foot drop), weakness in the calf or thigh, or instability when walking. Motor weakness is a sign that the nerve compression is more advanced and warrants urgent evaluation.
Worse with Sitting
Sciatica classically worsens with prolonged sitting, driving, or bending forward — positions that increase disc pressure and nerve tension. Standing and walking often provide temporary relief.
One-Sided Symptoms
Sciatica typically affects one leg at a time, corresponding to which side the nerve is compressed. Bilateral (both-sided) leg symptoms are a red flag that may indicate a more serious condition.
Worsens with Coughing or Sneezing
Sudden movements that raise spinal pressure — like coughing, sneezing, or straining — can trigger or sharply worsen sciatica pain. A hallmark of nerve root compression from a herniated disc.
⚠ Seek urgent care if you experience any of these
Most sciatica is not an emergency. However, certain symptoms require immediate medical attention — do not wait for a scheduled appointment:
- Loss of bowel or bladder control — may indicate cauda equina syndrome, a surgical emergency
- Rapidly worsening weakness in both legs — progressive bilateral weakness needs urgent imaging
- Saddle area numbness — numbness in the groin or inner thighs is a cauda equina warning sign
- Sciatica after a fall, accident, or trauma — fracture must be ruled out
If you have any of these symptoms, go to the nearest emergency room or call 911.
What causes sciatica
The source of the compression
Sciatica is always caused by something pressing on the sciatic nerve roots in the lumbar spine. The treatment depends entirely on identifying which structure is responsible. Dr. Katsevman reviews your MRI to find the exact source.
Herniated Disc
The most common cause in patients under 50. The inner nucleus of the disc pushes through the outer wall (annulus) and presses directly on a nerve root. Onset is often sudden — bending, lifting, or twisting.
Most common causeSpinal Stenosis
Narrowing of the spinal canal compresses the nerve roots gradually over time. More common in patients over 60. Causes neurogenic claudication — leg pain that worsens with walking and improves with sitting.
Common over 60Degenerative Disc Disease
As discs lose height and hydration, the disc space collapses, the foramen (nerve exit hole) narrows, and the nerve is compressed. Often coexists with herniation and stenosis.
Gradual onsetSpondylolisthesis
A vertebra slips forward on the one below it, pinching the nerve roots that exit through the affected level. Causes both back pain and radiating leg symptoms depending on the severity of the slip.
Vertebral slipBone Spurs (Osteophytes)
Calcium deposits that form on the vertebrae or facet joints as part of the degenerative process. Can grow into the foramen and compress the exiting nerve root, producing sciatica even without disc herniation.
Bony growthForaminal Stenosis
Narrowing of the specific opening through which each nerve root exits the spine. Can be caused by disc bulge, bone spurs, or facet joint enlargement — a precise, often under-diagnosed cause of sciatica.
Nerve exit pinchTreatment options
From conservative care to surgery
Dr. Katsevman always starts with the least invasive option. Most patients with sciatica improve without surgery. When surgery is needed, the goal is to do the minimum necessary — and do it through the smallest possible incision.
Conservative Non-Surgical Care
The majority of sciatica episodes — approximately 80% — resolve within 6–12 weeks with structured conservative management. This includes:
Physical therapy — targeted exercises that reduce disc pressure, improve core stability, and promote nerve mobility (nerve gliding).
Anti-inflammatory medications — NSAIDs (ibuprofen, naproxen), short courses of oral steroids, and nerve pain medications (gabapentin, duloxetine) can provide significant relief while the disc heals.
Activity modification — not bed rest (which worsens outcomes) but smart activity adjustment: avoiding prolonged sitting, using ergonomic support, and maintaining gentle movement.
Dr. Katsevman will guide you through a structured conservative plan and set a clear timeline. If you are not improving within 6 weeks, the next step is considered.
Epidural Steroid Injections
When oral medications and physical therapy are not enough, an epidural steroid injection (ESI) delivers anti-inflammatory medication directly to the compressed nerve root — reducing swelling, calming the inflamed nerve, and often providing weeks to months of significant relief.
ESIs are not a cure, but they can break the pain cycle enough for physical therapy to work effectively — and for many patients, that is all that is needed. Dr. Katsevman can refer you to a pain management specialist for injection therapy and co-manage your care throughout.
If injections provide temporary relief that doesn’t last, or if symptoms are severe enough to warrant moving faster, surgery is discussed.
Minimally Invasive Surgery
Surgery is recommended when conservative treatment has failed after a reasonable trial, when symptoms are severe enough to justify moving faster, or when neurological deficits (weakness, foot drop) are present. The right surgery depends entirely on the cause of your sciatica:
Every surgical decision at Dr. Katsevman’s practice is individualized. No two patients are the same — the right approach depends on your specific MRI findings, symptoms, age, activity goals, and anatomy.
Learn more
From our blog
Patient education written by Dr. Katsevman — in plain language, without the jargon.
Common questions
What patients ask most
How do I know if my leg pain is sciatica? +
Sciatica typically causes pain that starts in the lower back or buttock and radiates down one leg — often past the knee and into the calf or foot. It frequently has an electric, burning, or shooting quality. Numbness, tingling, or weakness in the leg may accompany it. If your pain is primarily in the back without significant leg involvement, or if you have pain in both legs equally, a different diagnosis may be more likely. An MRI is the definitive way to identify the source and confirm the diagnosis.
Will my sciatica go away on its own? +
About 80% of sciatica cases caused by a herniated disc improve significantly within 6–12 weeks with conservative care. The disc material that is compressing the nerve often resorbs over time as the body’s natural immune response absorbs it. However, sciatica from spinal stenosis, spondylolisthesis, or significant disc degeneration is less likely to resolve completely without treatment. If your symptoms are not improving after 6 weeks of structured conservative care, or if you have weakness or progressive neurological changes, a surgical evaluation is appropriate.
What tests do I need for sciatica? +
An MRI of the lumbar spine is the most important diagnostic test — it shows the discs, nerve roots, and any compression in detail. X-rays are also useful to assess bone alignment, disc height, and instability. In some cases, a CT scan is added for better bony detail. EMG/nerve conduction studies may be ordered to assess the severity of nerve injury and which specific nerves are affected. Dr. Katsevman will review your existing imaging at your first consultation — bring any MRI, CT, or X-rays you have.
Is sciatica surgery dangerous? +
Minimally invasive discectomy — the most common surgery for sciatica from a herniated disc — is one of the safest and most successful procedures in spine surgery when performed by an experienced surgeon. Dr. Katsevman performs this through an incision smaller than a quarter using the METRx tube system. Patients walk the same day and go home the same day. As with any surgery, risks exist — including infection, bleeding, nerve injury, and recurrence — but these are uncommon and will be discussed in detail at your consultation.
How long does sciatica last? +
For most patients with a herniated disc, acute sciatica lasts 4–12 weeks before significantly improving. Chronic sciatica — lasting more than 12 weeks — is less likely to resolve without more active intervention. Sciatica from spinal stenosis tends to be progressive if untreated. The duration varies significantly depending on the underlying cause, the severity of compression, and how early treatment begins. Early evaluation allows Dr. Katsevman to give you a realistic prognosis specific to your MRI findings.
Can I see Dr. Katsevman for a second opinion on my sciatica? +
Absolutely. Dr. Katsevman offers in-person and telemedicine second-opinion consultations for patients across Florida and nationally. If you’ve been told you need surgery and want another perspective, or if you’ve been told surgery isn’t an option and want to know if that’s true, bring your MRI images and prior records. A second opinion is one of the most important steps you can take before any spine decision.
"Every patient who comes to me with sciatica gets the same commitment: find the exact source, start with the least invasive treatment, and only operate when it is truly the right answer."
Gennadiy (Gene) A. Katsevman, MD
Neurosurgeon & Minimally Invasive Spine Surgeon
Fellowship-trained at Barrow Neurological Institute — world-class minimally invasive spine surgery center
Neurosurgery residency, West Virginia University — Level 1 Trauma Center
30+ peer-reviewed publications in spine surgery and neurosurgery
Treats sciatica from herniated discs, stenosis, spondylolisthesis, and DDD — conservative and surgical
Naples Top Doctor in Neurosurgery — 2024, 2025, and 2026
5-star Google rating · Healthgrades Choice Provider · WebMD Preferred Provider
Offices in Naples & Fort Myers · Telemedicine available nationwide
Stop living with it
Sciatica is treatable.
Let’s find your answer.
Schedule a consultation with Dr. Katsevman in Naples or Fort Myers — or by telemedicine from anywhere in Florida. Bring your MRI and let’s build a plan.
6101 Pine Ridge Road #101
Naples, FL 34119
Fort Myers, FL 33919
Available statewide & nationwide