Sciatica - Non-Surgical Treatments

Based on the diagnosis, your doctor will recommend a treatment plan. The majority of sciatica and piriformis syndrome patients respond well to non-surgical forms of treatment, and few patients need spine surgery. Below are some of the non-surgical treatments your doctor may include in your treatment plan.

Your doctor may prescribe medications. Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics help reduce swelling while relieving pain. NSAIDs include aspirin, ibuprofen, and prescription-strength drugs. You may also be prescribed muscle relaxants or other stronger pain medications. Epidural steroid injections (ESIs) place corticosteroid medicine near spinal nerve roots. Corticosteroid injections can reduce nerve inflammation and pain for months or longer, but ESIs are not effective for all patients.

If needed, your doctor will refer you to a physical therapist. Physical therapy includes passive treatments such as cold or heat, deep tissue massage, electrical stimulation, and ultrasound. These treatments help prepare you for therapeutic exercise—the active part of physical therapy. In addition, you learn how to correct your posture, incorporate ergonomic principles in daily activities, and become flexible and strong.

You may also consider going to a chiropractor. Chiropractors offer non-invasive and drug-free therapies to treat sciatica. Your treatment plan may include cold therapies, ultrasound, TENS, and spinal manipulation (adjustments).

Although not always scientifically validated, some patients experience relief from sciatica through alternative therapies. Such options include acupuncture, acupressure, yoga, and biofeedback. Acupuncture is the ancient Chinese practice based on the concept of opening the flow of Qui (energy) throughout the body. The practitioner inserts fine needles into body pathways called meridians to help relieve your symptoms and restore your health. Acupressure is similar to acupuncture—but there are no needles involved. The practitioner uses thumbs, fingers, and elbows instead.

You could try yoga, which gently stretches the sciatic nerve and helps to relieve pain. As a caution, though, yoga positions and movements that involve forward folds and twisting could make sciatica or piriformis syndrome worse. Finally, some patients benefit from biofeedback, a mind-body therapy that teaches you how to change or control a habitual reaction to stress or pain.