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Sciatica: Treatment and Recovery

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Non-Surgical Treatment
Sciatica often responds well to non-operative forms of treatment and rarely requires surgical intervention. Time, non-steroidal anti-inflammatory (NSAIDs) medication, short-term use of a narcotic for acute pain, lumbar injections, and physical therapy are beneficial.

medications

syringe, injection

two women in physical therapy, stationary bike, walking

Although short-term bed rest is recommended during the acute phase, some activity is good. In this scenario "activity" is defined as being up for periods of time that will not cause severe pain. Prescribed exercise may include light stretching, walking, and aerobic type exercise.

Surgery
Surgery is not for all patients. However, in some situations, surgery may be indicated. Patients who have followed a non-surgical course of treatment for four to six weeks without relief certainly require a re-evaluation by their physician. If a MRI scan reveals a herniated disc or spinal stenosis, surgery may provide relief of the leg pain. The type of surgical procedure is dependent in part on the patient's condition and diagnosis

Recovery
Whether treatment for sciatica is non-operative or surgical, it is always wise to follow the instructions provided by the doctor and/or physical therapist.

Work toward relieving unnecessary mechanical stress to the spine. For example, when standing, alternate resting one foot on a stool. When driving, place a small pillow or rolled towel behind the back to maintain natural spinal curvature. At bedtime, sleep on the back with a pillow under the knees or between the knees if sleeping on the side.

Strive to eat healthy, work toward your ideal body weight, and avoid smoking. These lifestyle changes all benefit the spine's health.

Updated on: 09/07/12
Richard D. Guyer, MD
Dr. Garfin very nicely described the causes of sciatica and helped explain away the myths related to sciatica. However, not all buttock and leg pain is sciatica as there are many other structures in the spine that can cause these types of pain. For example, the sacroiliac joint (the joint between the pelvis and sacrum, the lowest segment of the spine) can cause or refer pain into the buttock and so can a sprain of the facet joints which are the connecting joints in the back part of the spine. Sometimes a tear of the disc can refer pain down into one's leg. If buttock and leg are associated with any neurologic symptoms of numbness or weakness it is real sciatica and needs to be evaluated by a spine care specialist. If severe neurologic symptoms occur along with bowel or bladder control problems, this is an emergency and needs to be evaluated as soon as possible.
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