Common treatments for sciatica

Defined as pain affecting the back, hip and outer side of the leg, anyone who has experienced the discomfort associated with sciatica knows it can be distracting and debilitating. We asked Jason Voorhies, MD, PPG – Neurosurgery, to explain what causes this condition and how patients can find relief.

What causes sciatica?

The most common cause of sciatica is a pinched nerve in the lower back.  The pinched nerve can be caused by a herniated lumbar disk, arthritic bone spurs, cysts from the spine joints or instability of the spine.

Which populations are most commonly impacted by sciatica?

Sciatic affects adult men and women of any age or race. Younger people tend to have sciatica caused by herniated disks and older people tend to get sciatica from arthritic bone spurs.

What are the symptoms?

Back pain radiating through the buttocks and down either leg is the typical presentation.  Numbness, tingling and weakness of the leg can be present occasionally. Usually, the pain will radiate all the way down the leg to the foot or ankle, depending on which nerve is pinched.

How is it treated?

About 80 percent of the time the symptoms will resolve with conservative measures. These conservative measures include rest, activity modification and non-steroidal over-the-counter medications. If these initial steps do not help within a couple of days, contact your doctor.  

Steroids taken by mouth can help reduce inflammation and alleviate the pain. Physical therapy is also a mainstay of conservative treatment.

For sciatica that is severe or does not resolve within six weeks, epidural steroids and or surgery can be helpful. An MRI of the back and x-rays are needed before considering these aggressive measures. Evaluation by a neurosurgeon can help you decide on the proper course of treatment, depending on what the MRI and x-ray show.

Is there anything people can do to prevent sciatica?

There is no way to entirely prevent sciatica, but ensuring proper posture and body mechanics in everyday life, as well as strengthening the core muscles, can lower the risk of sciatica. Smoking cessation and weight control are also important in lowering the risk of back injuries (including sciatica).

 

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