Sciatica Specialist

The Craniospinal Center of Los Angeles

Brian R. Gantwerker, MD

Neurosurgeon located in Santa Monica, CA

At some point in their life, about 40% of all men and women develop sciatica. If you have sciatica and your pain persists despite conservative treatment, surgical intervention may provide relief. Brian Gantwerker, MD, at The Craniospinal Center of Los Angeles has helped many patients return to a more active life with minimally invasive surgery to repair the problem causing their sciatica. If you have questions or would like to learn more about your treatment options, call us at (310) 694-8300 or email us at

Sciatica Q & A

What is sciatica?

Sciatica is any pain between the flank and ankle.  It may also go to your toes. The pattern of pain depends on which nerves are affected, but not all sciatica is due to the spinal nerves being compressed.  The sciatic nerve is a braided combination of spinal nerves which leave the spine and then travels down through your buttocks, legs, and feet. The nerves branch out along the way to reach different areas of your legs and feet and other areas.

What causes sciatica?

Sciatica most often occurs when the nerve is compressed by the spine. In some cases, the nerve may be pinched by a muscle spasm in the buttocks. When the problem begins in the spine, it’s the result of:

  • Herniated disc (most common cause of sciatica)
  • Arthritis
  • Bone spurs (“osteophytes”)
  • Degenerative disc disease
  • Spinal stenosis (narrowing of the spinal canal)
  • Spondylolisthesis (disc that has slipped out of place)


Your risk of developing sciatica increases as you get older due to age-related degeneration and the cumulative impact of pressure on your lower back over time.

What symptoms could I develop from sciatica?

Sciatica causes pain that starts in your lower back and radiates down your leg. Although the intensity of your pain may vary, it’s often severe and debilitating. You may develop muscle weakness, tingling, or numbness in the affected leg.

As the nerve branches, you may even experience mixed symptoms, such as pain in one part of your leg and numbness or tingling in another.

How do you treat sciatica?

The first line of treatment for sciatica is heat and gentle activity such as stretching and walking, or physical therapy to reduce inflammation and improve movement. Some patients with severe pain may receive steroid injections.

If you still have pain after several months of conservative therapy, it may be time to consider surgical intervention to repair the underlying problem.

Since most cases of sciatica are the result of a herniated disc, Dr. Gantwerker may recommend a microdiscectomy to remove the portion of the disc pressing against the nerve. If you have spinal stenosis, you may need nerve decompression surgery.  Some cases may be done on an outpatient basis.

Whenever possible, Dr. Gantwerker performs minimally invasive surgery to treat sciatica. After making a few small incisions, he uses a special microscope to view the surgical site and specialized tools that fit through the tiny incisions.

In addition to reducing bleeding and postoperative pain, minimally invasive surgery also spares muscles, which Dr. Gantwerker can gently move out of the way rather than cut them. Smaller incisions and intact muscles mean your recovery is quicker.

You don’t need to continue suffering from the pain of sciatica. To learn whether you’re a good candidate for surgery, call The Craniospinal Center of Los Angeles at (310) 694-8300 or email us at