I have sciatica with my left toe going numb periodically. sciatica is made worse by sitting and also sporadic. what to do?

Epidural: Depending on the cause of the sciatica, you could really benefit from an epidural steroid injection.

Number of things: You should see a pain physician for proper diagnosis and imaging to see the level of disc degeneration and where the nerve impingement is. Some injections like a transforaminal injection can calm down nerves to help with this. This should be accompanied by physical therapy as well. Ask your doc also about possible piriformis syndrome causing some of these same issues.For pain, Gabapentin possibly.

Likely not sciatica: It is possible for sciatica to affect toes, but not likely what is causing the periodic numbness. The cause of the numbness could be due to a number of reasons... What toe specifically goes numb-- big toe = #1, baby toe = #5...Let me know and we can go further into possible causes / treatments.

Spine Injury: This chronic pain in the distribution as you suggested is the result of an irritated nerve or facet joints or other injury typically in the lumbar spine (low back) which are caused by herniated disks, spinal stenosis or degenerative disc disease, etc requiring further evaluation by a spine specialist.