I had back surgery 4 years ago and sciatic pain is back. what can i do?

See the Dr.: A good exam and some possible testing would be in order. You may do well with Physical Therapy and medications to start. Best wishes.

Pain management: Another MRI and then a consultation with a pain management specialist may be worthwhile. A cause for the pain must be identified. An epidural corticosteroid injection or an oral course of corticosteroid medication may be offered depending on the findings. Other treatment options are available. Neurosurgery is a last resort in my opinion unless the findings are compelling.

A/ w Dr. Colsantino: In addition to recommendations provided by Dr. Colsantino - talk with your doctor about acupuncture. Acupuncture can be used effectively to deal with scar tissue and can be helpful with decreasing pain & increasing range of motion due to HNP.

"...is back": To me the pivotal issue is your reference to the problem returning. If you did well with the prior surgery, had only minor residual problems, and now have had a notable exacerbation, then the strategy depends upon what has changed. Overall, from what you describe, your situation is not a chronic back pain condition, it is a recurrent back pain condition. This is very different.