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Sciatica Treatment- Neurology, Neurosurgery, Orthopedics, Physical Medicine And Rehabilitation, Spinal Surgery

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Sciatica nerve pain can radiate from your lower back down to the back of your legs. The pain usually affects only one side of your body.

Mild cases of sciatica usually resolve on their own with the help of conservative treatments such as cold/heat packs, stretching exercises, and over-the-counter pain relievers. If your pain persists after weeks of home remedies, prescribed medications, physical therapy, and spinal steroid injection are other options for sciatic pain treatment.

Lower back pain management can also be achieved by alternative therapies such as acupuncture, spinal manipulation, yoga, and biofeedback. As a last resort option, surgery may be recommended to treat sciatica.

Continue reading to learn more about sciatica pain and the different ways that can help you treat it.

What Is Sciatica?

Sciatica refers to pain in the sciatic nerve which runs from the lower back, through the hips and butt, and down each leg. It normally affects only one side of the body at a time.

Sciatica pain occurs when the sciatic nerve becomes compressed or irritated – usually because of a herniated disk in the spine. The pain generally gets better in 4-6 weeks on its own but it can last longer.

Treatments of Sciatica

Conservative treatment

Most people with sciatica get better on their own and recover fully with some time and simple  self-care sciatica treatments, such as:

  • Applying cold packs: Placing ice packs, or even a bag of frozen vegetables, on the areas that hurt can reduce pain and swelling. Apply the ice pack for 20 minutes at a time and repeat several times a day.
  • Applying hot packs: After a few days, if you’re still in pain from your sciatica, switch to a hot pack or a heating pad (on the lowest setting). If you continue experiencing pain, try to alternate between cold and hot packs to relieve your sciatica discomfort.
  • Stretching exercises: Performing gentle stretching exercises for your lower back can help relieve some of the pressure on the nerve and improve your sciatica pain.
  • Over-the-counter medication: Non-prescription pain meds such as ibuprofen (Advil, Motrin IB), and naproxen (Aleve) can reduce inflammation and relieve pain from your sciatica.

If six weeks go by and your at-home sciatica treatments haven’t provided relief, contact your healthcare provider for other sciatica treatment options.

Prescribed medications

If your pain doesn’t improve with home remedies and conservative treatments, your doctor might prescribe you a medication for your sciatica pain. Prescribed sciatica medications include:

  • Muscle relaxants: Muscle relaxants can relieve sciatica discomfort associated with muscle spasms.
  • Oral steroids: Your doctor may prescribe an oral steroid, such as prednisone, for a short period of time to reduce inflammation and treat your sciatica.
  • Narcotics: Narcotic drugs or opioids) maybe prescribed to treat moderate to severe sciatica nerve pain. These should be used with caution.
  • Antidepressants: Tricyclic antidepressants can reduce nerve pain in people with sciatica.
  • Anti-seizure medications: Prescribed anticonvulsant drugs are sometimes prescribed to manage pain caused by sciatica nerve.

The type of sciatica drug prescribed and the duration of the treatment will depend on your level of pain and discomfort.

Physical therapy

Your healthcare provider may refer you to a physical therapist who will provide you with exercise movements to reduce pressure on the nerve and decrease sciatica.

With the help of your physical therapist, you’ll learn stretching exercises and aerobic exercises (swimming, walking, water aerobics) that will improve your muscle flexibility.

Once your pain improves, you’ll also be given rehabilitation exercises to improve your posture, strengthen your back and legs, and prevent future injuries.

Steroid injections

In some sciatica cases, doctors might recommend a corticosteroid injection (an antiinflammatory medication) into the lower back. The corticosteroid medication can help reduce the inflammation of the sciatica nerve thus reducing pain.

These pain management injections are given under local anesthesia and can relieve sciatica pain for a short period of time (a few months). Depending on the level of your pain, your doctor may recommend more than one injection.

However, you can only receive a limited amount of steroid spinal injections to avoid the risk of serious side effects.

Surgery

Spinal surgery is a last-resort option for sciatica treatment and is usually not recommended unless:

  • Your sciatica symptoms have been ongoing for almost a year or more
  • You haven’t improved with any other treatment options
  • Your pain is worsening
  • You have significant weakness in your lower body (legs and lower back)
  • You have lost bowel or bladder control

Surgeries that can be done to relieve sciatica include:

  • Microdiscectomy: A minimally invasive surgical procedure that removes portions of the herniated disk that’s putting pressure on the sciatica nerve.
  • Laminectomy: A surgical procedure that removes bone spurs from the spine to reduce the compression of the sciatica nerve.

Alternative therapy

Alternative sciatica treatments are becoming increasingly popular for lower back pain management, including pain from sciatica. Alternative methods to decrease sciatic pain include:

  • Spinal manipulation: This is an effective and safe method to manage pain in the lower back. A chiropractor can adjust the spine to restore its movement, improve mobility, and reduce pain.
  • Acupuncture: This traditional Chinese treatment option may help with your back pain. Very thin needles are inserted into your skin at strategic points in your body to stimulate your nerves and muscles.
  • Yoga: Gentle yoga exercises can help reduce stress and decrease sciatica pain.
  • Biofeedback: This is a type of mind-body therapy that can improve both mental and physical health and help with pain management.

Other treatment options for sciatica

Several topical analgesic medications (numbing creams, gels, ointments) create a numbing effect and can help with sciatica pain management.

Since topical medications act locally, they may provide immediate sciatica pain relief.

Pain from sciatica can vary widely from a mild ache to sharp and excruciating pain. If your pain doesn’t improve with lifestyle changes and self-care sciatica remedies, contact a healthcare professional to provide you with alternative options to treat your sciatica.

To learn more about Sciatica Treatment, please check our blog on SCIATICA AND LEG WEAKNESS: A WORRYING COMBO.

About the Author:
Dr. Mersad is a medical doctor, author, and editor based in Germany. He's managed to publish several research papers early in his career. He is passionate about spreading medical knowledge. Thus, he spends a big portion of his time writing educational articles for everyone to learn.

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