A large percentage of acute sciatica cases are treated with pain medications usually taken at home. For chronic sciatica patients, treatment entails medical and self-help treatments.
Addressing Short-Term Sciatica
Painkillers – NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen and many kinds of over-the-counter painkillers are some of the best treatments for treating short-term sciatica.
NSAIDs may not be a good option if you suffer from heart disease, liver disease, high blood pressure, asthma or you have a history of digestive and abdominal conditions. In lieu then of NSAIDS, you can opt for paracetamol. You can get proper advice for your medication from your doctor or pharmacist.
A prescription medicine like a light opiate-based analgesic like codeine can be given to you by your doctor if OTC drugs fail to do the job. If you exhibit really severe symptoms, your doctor may prescribe a muscle relaxant like diazepam. This drug, however, can be habit-forming so your physician may likely only prescribe a week-long course for this drug.
Exercise – It is important for those with sciatica to be physically active whenever they can. A few hours of bed rest during the day may be good since it can give some respite for your pain. If you rest for several hours, your pain can again act up. Good exercises for sciatica sufferers can include light stretching exercises and walking.
Compression packs – A lot of sciatica patients have discovered that using either cold or hot compression packs can help minimize the pain. You can find better pain relief if you utilize one type of pack then follow it up with the other although not immediately.
Persistent sciatica treatment
Persistent sciatica is also termed chronic sciatica and its treatment entails the use of both medical treatments and self help procedures.
Painkillers – NSAIDS should not be used for long-term treatment since they can result in digestive system problems like internal bleeding, ulcers and abdominal pain. For long-term pain medication for sciatica some of the following analgesics may be utilized:
- Tricyclic antidepressant like amitriptyline – This drug’s original use was for the treatment of depression. When doctors saw that it was effective for treating nerve pain, amitriptyline then also became a drug for sciatica.
- Codeine (can be used in combination with paracetamol)
- Gabapentin – This can be taken to address neuropathic pain. This drug was primarily created to prevent seizures in patients suffering from epilepsy. But, like amitriptyline, gabapentin has shown to be effective in controlling sciatica and other types of nerve pain.
Corticosteroid injection – If the aforementioned treatments do not work your doctor may then recommend you to a specialist who can give you epidural steroid injection. An epidural steroid injection is an anti-inflammatory medicine injected straight into the inflamed part of your back specifically the region where the nerves of your spine are located. The injection takes out the pressure on the sciatic nerve thus reducing your pain.
Exercise and physiotherapy
If you have chronic sciatica, it is important for you to become active physically since this will lessen the intensity of your symptoms. Regular exercise can also strengthen your back muscles especially the ones that support your spine. It also stimulates the production of endorphins in your body that produces a pleasant and relaxing sensation in your body.
Either your doctor or a physiotherapist can recommend an effective exercise plan for you. You can learn a number of exercises that reinforce your back muscles and enhance the tractability of your spine from a physiotherapist. He can also help you improve your posture that can resolve any back strain you have.
Cognitive behavioral therapy (CBT)
Some researches have revealed that CBT can improve your ability to manage your chronic pain resulting from sciatica. This type of therapy is grounded on the belief that how we feel is due to the way we think about certain things. Researches show that individuals who condition themselves to respond in a different way to pain, by keeping a positive attitude and through the use of relaxation techniques, have shown a substantial reduction in the intensity of the pain they experience. These individuals also become more active and regularly exercise even lessening more the pain and the severity of their symptoms.
Back surgery for sciatica may be performed when:
- The symptoms become unresponsive to any type of treatments
- The symptoms keep getting worse
- The sciatica is due to a herniated or a slipped disc
Some of the surgeries that can be performed for sciatica patients include:
- Fusion surgery – This surgery places a slipped disc back in place by fusing the disc with the use of a bone graft supported by metal rods
- Discectomy – This surgery removes the herniated disc that is pressuring the nerve. Discectomy is the most commonly used form of back surgery for sciatica
- Laminectomy – This surgery is to treat spinal stenosis. It trims or takes out the arch of a vertebra to remove the pressure on the nerves
The rate of success for these types of back pain surgery is high; however, they also entail certain risks. Some of the risks can include:
- A chance albeit small that the spinal nerves will be damaged leading to muscle weakness
- Risk of a botched surgery
- Risk of infection
This ancient Chinese medical art is now a popular alternative therapy for specific types of pain. Acupuncture treatment uses small and narrow needles inserted at strategic energy points in the body. The successful placing of the needles results in the patient experiencing a sensation of relaxation and fullness in the body and tingling, numbness with a little bit of soreness on the areas where the needles are placed. A lot of people with sciatica and other back pain problems have found long-term relief from this therapy. To be sure you get the best kind of acupuncture treatment, you need to look for a reputable facility run be licensed and well-experienced acupuncturists who only utilize sterilized needles and equipments.
Dr. Jack Handlin is an experienced acupuncturist, Chinese herbalist and oriental reproductive medicine specialist at Tree of Life Acupuncture & Chinese Herbal Medicine in Bellevue, WA.