Options abound for treatment of sciatica
Q: Three weeks ago I was diagnosed with sciatica. I didn’t have much pain initially, but it has been extremely painful the past few days — usually when I’m sitting. Would physical therapy be an option for treatment? I don’t like to take medications for pain. Are there other treatments I should try? Could surgery help?
A: Sciatica can cause significant discomfort. The good news is that time and treatment often successfully resolve this condition. In most cases, surgery is not necessary to treat sciatica.
Sciatica typically refers to pain from irritation of one of the spinal nerves in your low back. Although the source of the irritation is in your back, you feel the pain of sciatica along the affected nerve where it is located in your leg after it exits the spine, typically in the buttock and leg. Sciatica usually affects only one side of the body.
Sciatica pain is often a dull pain, but it also can be sharp and, at times, you may feel the pain travel or “shoot” down your leg. Symptoms of sciatica may include numbness, tingling or weakness along with the pain.
Sciatica develops due to a change in one of the cartilage pads in your spine, called discs. A small component of the disc pokes into the spinal canal, creating inflammation, or swelling. That, in turn, leads to inflammation of the nerve and triggers the symptoms of sciatica. Pressure on the nerve from the disc may contribute to sciatica as well. Other less likely causes of nerve irritation include bone spurs, cysts or other lesions in the spine that grow near a nerve.
Physical therapy can be an excellent treatment option for sciatica. It often involves learning stretches to improve your flexibility, techniques for pain control and exercises to strengthen and condition the muscles that support your back. This type of physical therapy helps reduce sciatica pain and lowers your risk for future injuries. In addition to physical therapy, staying active in whatever type of physical activity you best tolerate can help ease pain and other symptoms, too.
Though you mention that you prefer to avoid medications, newer drugs are available that can work quite well for pain caused by sciatica. They are not potentially habit-forming like narcotic drugs, or opioids, can be. Drugs like gabapentin, duloxetine, nortriptyline and pregabalin can be useful for managing severe pain or pain that makes it hard