I have suffered from chronic sciatic pain for over 18 years. I have managed it with ultram but I still had what I call wasted days where the pain is high enough that I should not really do anything. Impossible to think clearly. Anyway, after all these years of trying every imaginable drug with only ultram working mostly my neurologist prescribed Lyrica and it worked. I have fewer wasted days and I notice my energy levels are much higher. I hope I don't sound like a shill for Lyrica. If your doc suggests it try it is all I am suggesting. My wife thinks its a miracle. Fortunately there will be generic versions next year.
things I have tried are numerous but range from fusion at l5s1 to embedded neurostimulators to hyrdocodone(yikes) back before it was fashionable. No one really knows what the problem is but I suspect its scarred nerves caused by an excessive number of situp exercise.