If you are dealing with regular back pain, it may be time to seek out sciatica treatment. At our center, we work with you to find the best treatment option that will work for your overall wellbeing and quality of life, instead of just covering up your symptoms with ineffective methods. You can trust that our experienced pain management doctor will pinpoint the cause of your back pain and find the best possible treatment plan for your needs.
Sciatica is pain that radiates down the buttock and leg. It usually affects only one side of the body and is caused by compression of the root of the sciatica nerve where it leaves the spine. The compression is most commonly caused by a herniated disc or a bone spur.
Your doctor will help you to further understand sciatica and the different types of sciatica treatment that are available.
Bouts of Pain
Most people with sciatica experience bouts of pain that last for a few weeks, then it goes away only to recur again later. Others experience chronic, persistent pain. Whether the pain is recurrent, remittent, or chronic, it is often quite severe and can be very debilitating. Individuals affected by sciatica may have difficulty working and performing activities of daily living. Although it rarely causes adverse medical consequences, it can severely impair quality of life.
Causes of Sciatica
Sciatic is strongly linked to prolonged sitting, lack of exercise, and obesity. It is also associated with changes in the spine due to the aging process. It does not appear to be linked to carrying heavy loads or engaging in jobs that require repetitive twisting of the back. Poorly controlled diabetes may also contribute to the development of sciatica.
The first step in getting relief from sciatica is to be properly diagnosed. The symptoms of sciatica are quite distinctive, allowing individuals and doctors to easily diagnosis it, but it is important to identify the cause of the problem. In most cases, the cause is benign, but in a minority of cases the symptoms are caused by potentially life-threatening conditions such as tumors and infections. Spinal stenosis can also cause sciatica, and it can cause permanent nerve damage if not treated correctly. The doctor will evaluate your medical history and test the reflexes in your legs. Because many people have bone spurs and herniated discs that do not cause any symptoms, routine imaging of all patients with sciatica is not generally recommended. However, for patients with severe or progressive pain, the doctor may perform studies (radiographs, magnetic resonance imaging, computed tomography, and/or electromyography) to confirm the cause of the problem and to rule out problems such as tumors.
Individuals who experience progressive pain with limb weakness and problems with bowel or bladder control are candidates for surgery to relieve the compression. However, individuals with stable, less-severe nerve compression can almost always find relief from conservative treatment intended to relieve pain and physical therapy to help prevent future episodes.
- Initial Treatment: Initial treatment of sciatica focuses on pain relief. Individuals troubled by moderate to severe pain that is disrupting their life should consider consulting a specialist pain clinic, where experts in treating pain can advise patients about their options and tailor treatment to each individual. A variety of different medications are available. Some individuals find that anti-inflammatory agents such as ibuprofen and naproxene are able to relieve their pain, but others need stronger medications in order to function. Narcotics and muscle relaxants can be helpful for these patients. Other patients find that anti-seizure medications or tricyclic anti-depressants (both of which affect nerve function) are effective in relieving their pain. In some cases, a corticosteroid injection into the back is necessary to relieve the inflammation and pain. However, due to side effects, corticosteroid injections should be considered a last resort.
- Physical Therapy: Once a patient has achieved pain relief, the next step in treatment is physical therapy to improve posture and strengthen the core muscles. Correct posture and strong abdominal and back muscles can help prevent future episodes of sciatica.
- Surgery: Due to the high risk of complications from surgery on the spine, surgery is generally only indicated for patients with a progressive condition that is affecting nerve function to the point of causing limb weakness and difficulties in controlling the bowel or bladder. The type of surgery that is necessary depends on the cause of the problem. Bone spurs or herniated discs compressing the nerve can be removed. Spinal stenosis can be treated by removing part of the vertebrae in a procedure called a laminectomy, sometimes referred to as spinal decompression.
- Home Care: Many people mistakenly believe that back pain should be treated by resting. However, back pain does not always improve with rest and often gets worse instead. Exercise and activity will not worsen sciatica and can actually help the pain go away faster. Gentle stretching can sometimes relieve nerve compression, and applying cold or hot packs to the back is helpful for many people. Some people find that acupuncture is helpful in relieving the pain. Individuals who have to sit or stand for long periods should consider taking walking breaks every 30 minutes.
- Chiropractic Care: Some patients with non-specific low back pain feel that chiropractic manipulation is helpful, but chiropractic manipulation should be avoided by people with sciatica because it can make the nerve compression worse. It can also aggravate herniated discs. Non-specific back pain is very distinct from sciatica. It is characterized by pain in the lower back that does not radiate down the legs and is not associated with any obvious cause, such as bone spurs or herniated discs.
If you are unsure of the best approach to sciatica treatment for your situation, call our office today to schedule a consultation with one of our experienced pain management doctors. We can help you determine the best method of pain relief after a thorough diagnosis and understanding of your medical history and current overall health. We look forward to seeing you and helping you achieve a life of comfort.