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Sciatica Treatment: Understanding Your Options

Sciatica treatment varies based on the severity of the patient’s condition. Pain relievers and physical therapy are the most common treatments.

For severe sciatica or continuous flare-ups, treatment is necessary to prevent worsening over time.

Most people will find that non-surgical remedies and regular exercise greatly alleviate the pain. For others, when the pain is severe or does not improve on its own, a more structured treatment approach, or possibly surgery, may offer the best chances for pain relief or prevention and significant reduction of future sciatica flare-ups. This page details non-surgical treatments for sciatica. For more treatment options, see also Physiotherapeutic exercises and surgery for sciatica (see links below).

Irritation of the sciatic nerve causes pain called sciatica. Anything that irritates this nerve can cause pain, which varies in intensity from mild to severe. The compression of a nerve in the lower spine usually causes sciatica.

Non-Surgical Treatments for Sciatica

A wide range of non-surgical sciatica treatment options aim to relieve pain caused by the compression of nerve roots.

Generally, doctors recommend one of the treatments below, a combination of them, or a specific exercise program.

Heat and Ice

For acute sciatic pain, heat or ice packs are readily available and can help relieve leg pain, especially in the initial phase.

Generally, one applies ice or heat for about 20 minutes and repeats it every two hours. Most people first use ice, but some find more relief with heat. You can alternate the two.

Sciatica Treatment Options
Medications for Sciatic Pain

Prescription or over-the-counter medications can also help relieve sciatica.

Nonsteroidal anti-inflammatory drugs (such as ibuprofen, naproxen, or COX-2 inhibitors) or oral corticosteroids can be useful for reducing inflammation, which is usually a contributing factor to sciatic pain.

Epidural Corticosteroid Injections for Sciatica

If the sciatic pain is severe, one can apply an epidural corticosteroid injection to reduce inflammation. Unlike oral medications, an epidural injection delivers corticosteroids directly to the painful area around the sciatic nerve to help reduce inflammation that may be causing pain.

Although its effects are usually temporary (providing pain relief lasting as little as a week or up to a year), and it does not work for everyone, an epidural corticosteroid injection can be effective for acute sciatic pain relief.

It has the advantage of potentially providing enough relief to allow the patient to improve with a conditioning and exercise program.

Microdiscectomy (Microdecompression)

In this surgery, the part of the herniated disc that is pinching the nerve is removed. This surgery is generally considered after 4 to 6 weeks if severe pain is not relieved by non-surgical methods.

Microdiscectomy is performed in a hospital or an outpatient surgical center. Spinal anesthesia (to numb the spine area) or general anesthesia (asleep and pain-free) will be applied.

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