The majority of people who suffer from sciatica will usually get better with time.
They find there is no need for surgical intervention. For some however, the pain can be severe and debilitating.
After evaluation and diagnosis, the physician will use the clinical term radiculopathy. This basically means that a disc has moved from its normal place in the spinal column and put pressure on the nerve in the lower back.
It is important to note that sciatica is a symptom of other conditions and not a condition itself.
This is an important distinction to make if there is to be any significant successful sciatica pain treatment. In other words, you must treat the underlying condition in order to relieve the pain over the sciatic nerve.
Sciatica Pain Treatment Options
Most cases of sciatica resolve on their own over weeks to months.
Although medicines are frequently prescribed for the treatment of sciatica, evidence for the effectiveness of analgesics is not good. Nonsteroidal anti-inflammatory drugs (NSAIDs) do not appear to improve immediate pain and all NSAIDs appear about equivalent.
Sciatica pain treatment is usually nonsurgical and will combine several medical treatments or alternative medicine treatments.
Almost always, patients will be seen and evaluated by a physical therapists.
The physical therapist will recommend stretching and exercises for strengthening the area and holding the spinal column in place. The goal is to relieve pain and prevent any future symptoms.
Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.
On more rare occasions a surgical option will be recommended. This is to remove a portion of the disc that is irritating the nerve root. The surgery is known as a discectomy
This surgery goal is to relieve pressure and inflammation and will be warranted if pain is severe or not relieved with other manual or medical treatments.
Prior to surgical treatment doctors may evaluate the efficacy of epidural steroid injections to the affected area. The goal of this is to relieve pain.
However, the usefulness in the case of sciatica nerve problems is a matter that is debated among physicians. Some research points to short-term relief, but it is not a long-term solution.
It isn’t always possible to prevent sciatica pain from occurring.
However, there are methods of decreasing the risk as well as preventing further attacks. Individuals should exercise regularly and pay special attention to core muscles. Core muscles are those in the abdomen and lower back, and are essential for proper posture.
Using a good chair while seated that keeps your back in proper alignment will also help to decrease the risk of degenerative disc disease. Work with your feet flat on the floor in your arms on your desk.
Use good body mechanics when you stand, lift and even when you sleep. Keeping your back healthy will go a long way towards decreasing your risk of developing pressure over the nerve roots.
Sciatic Nerve Pain
The sciatic nerve pain often occurs in people between ages 30 and 50. It is a development over time and not the results of one particular event or injury.
Individuals complain that pain will radiate down the back of the leg and they may feel discomfort anywhere along that pathway from buttocks to calf.
The pain can vary from a mild ache to a sharp burning sensation and may even feel like jolts of electricity. Usually, only one lower extremity is affected.
Depending upon the severity of the underlying medical condition, individuals can also suffer from numbness or weakness. In some cases individuals report they have pain in one part of the leg but numbness in another.
Cauda Equina Syndrome
Unfortunately, there is another rare, but serious condition, loss of bladder or bowel control.
This is a sign of cauda equina syndrome, due to the nerves to the bowel and bladder being disrupted. Cauda equina syndrome is a medical emergency and requires immediate medical and possible surgical attention.
In many cases physicians are able to determine an underlying cause, such as a ruptured intervertebral disc, spinal stenosis or pelvic fracture.
However, in some cases no cause will ever be identified.
The intervertebral discs are pads of cartilage that separate the bones in the spinal column. They act as a shock absorber when you move. They keep this spine flexible and reduce shock and pain to the bones.
As we grow older these discs may dry out, become flatter or more brittle.
Eventually tiny little tears cause the jellylike substance at the center of the disc to leak out. The leak is called a herniation or a rupture. This then puts pressure on the nerve root that then causes the pain in the leg.
A herniated disc is the most common cause of sciatic nerve pain. But it can also be triggered by a lumbar spinal stenosis, spondylolisthesis (degenerative disc disease), piriformis syndrome (spasm of the piriformis muscle), spinal tumors, trauma or sciatica nerve tumor or injury.
For More Information:
Pinto, RZ; Maher, CG; Ferreira, ML; Ferreira, PH; Hancock, M; Oliveira, VC; McLachlan, AJ; Koes, B (Feb 13, 2012).
“Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis.”.
BMJ (Clinical research ed.) 344: e497.doi:10.1136/bmj.e497
Casey, E (February 2011).
“Natural history of radiculopathy.”.
Physical medicine and rehabilitation clinics of North America 22 (1): 1–5. doi:10.1016/j.pmr.2010.10.001.
Radiological Society of North America, American College of Radiology- Epidural Injections for Spinal Pain