Sciatica Treatment Options
What is Sciatica?
Sciatica refers to pain that originates in your lower back and travels down along the sciatic nerve through your buttocks, hips, and leg. The medical term for this condition is lumbar radiculopathy. Sciatica typically occurs on one side of the body.
The most common cause of sciatic pain is a herniated disk in the lumbar spinal column pressing on part of the nerve, which can lead to inflammation, numbness and pain radiating through the buttocks, hips, and leg. Spinal stenosis (a narrowing of the spaces within your spine) or bone spurs may be other causes of sciatic pain. Since sciatica is a broad term encompassing nerve pain in the leg, it is important to ascertain the root cause of the pain so you can decide upon the best treatment option.
Sciatica Treatment Options
Mild sciatica often resolves in a few weeks with self-care measures and rest, especially if the cause is a herniated disc. Up to 90% of patients can recover without surgical intervention. While the outlook is bright for most people with sciatica, complications such as permanent nerve damage may occur if the underlying cause is not treated.
Lifestyle and Home Remedies
A short period of rest can be helpful but staying sedentary for a long period of time could aggravate sciatica. Consider gentle stretches initially and gradually advance to activities such as daily walks, swimming and biking, which are less likely to injure your lower back.
A few simple home remedies can relieve your sciatic pain over time. These self-care measures include:
- Ice: Placing a cold pack on your lower back can help reduce inflammation and lessen swelling. You can use a cold pack for up to 20 minutes, several times a day.
- Heat: After a few days, apply heat to the affected area for 20 minutes at a time. If the pain continues, try alternating cold packs and heating pads (on the lowest setting).
- Stretching: Stretching exercises may help provide relief from nerve compression. Limit excessive bending and twisting, and hold each stretch for 30 seconds, if possible.
You may also wish to explore complementary and alternative approaches to medicine such as meditation, acupuncture, or chiropractic care.
Over-the-counter medications such as nonsteroidal anti-inflammatory drugs, including ibuprofen, aspirin, and naproxen can help to reduce sciatic pain while you heal. If the anti-inflammatory medications are not providing enough relief, your doctor may prescribe a muscle relaxer such as cyclobenzaprine to treat pain, stiffness, and discomfort. Other classes of medications that your healthcare provider might prescribe to relieve sciatic pain include narcotics for severe pain and nerve pain modulating medications.
Self-care measures and medications are often used in conjunction with physical therapy to treat sciatica. A physical therapist will design a personalized exercise regimen for you, with the goal of decreasing sciatica and preventing future injuries. Stretching exercises to reduce low back pain help by reducing pressure on the nerve roots, while exercises to strengthen the muscles supporting your back will lessen the chance of further injury. Maintaining good posture and using good body mechanics are essential to a healthy back.
Epidural steroid injections can provide months of relief by reducing inflammation around the affected nerve. Since sciatica is frequently a temporary problem, epidural injections may be all the intervention needed to successfully treat the pain. In keeping with our conservative approach, Dallas Neurosurgical & Spine Associates provides in-house pain management care.
If lifestyle changes and other treatment options have not provided relief, or if you develop neurological problems such as numbness, weakness, or bowel/bladder problems, it may be time to ask your doctor if you are a candidate for surgery. The two most common surgeries to relieve sciatic pain are microdiscectomy and laminectomy. Microdiscectomy is used to remove fragments of a herniated disk. Laminectomy or laminotomy is another common procedure where part of the lamina (part of the vertebral arch) is removed to relieve pressure on the nerve roots.
Depending on the type of surgery you have, recovery time can take up to four weeks.
Sciatica surgery can be very successful, with most people experiencing 90% improvement in their pain levels. Risks include those related to general anesthesia, as well as possible nerve injury. Minimally invasive microdiscectomy and laminectomy can be safer and require less recovery time than open spine surgery and the surgeons at Dallas Neurosurgical & Spine offer the latest in minimally invasive surgery options.
Outlook and Prognosis
Given adequate time and rest, the prognosis for this condition is good and most people recover within six weeks with nonsurgical treatments. If you have severe pain and home remedies are not providing relief, discuss alternate treatment options with your doctor. Come to your visit with your Dallas Neurosurgical & Spine expert prepared with information such as when your symptoms began, medication that you are currently taking, and any accidents or injuries that might have led to your sciatic pain.