Mayo Clinic: Three weeks ago I was diagnosed with sciatica. I
didnít have much pain initially, but it has been extremely
painful the past few days ó usually when Iím sitting.
Would physical therapy be an option for treatment? I donít
like to take medications for pain. Are there other treatments
I should try? Could surgery help?
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
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.
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.
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.
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.
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 to sleep.
are another treatment option. These potent anti-inflammatory
drugs are delivered via an injection that places the
medication just where it is needed. You have an imaging exam,
such as a CT scan or an MRI, before a corticosteroid
injection, so your health care provider can see where the
medication should go. Imaging also is used to guide the
injection as itís being delivered to ensure safety and
90 to 95 percent of sciatica cases, the problem is
successfully resolved with time and conservative, non-surgical
treatments. If sciatica persists despite these treatments,
though, surgery may be considered.
uncommon, surgery may be recommended as a first step in
treatment if weakness associated with sciatica is moderate to
severe, if weakness gets worse over time, if symptoms affect
both legs or if you are experiencing incontinence due to
sciatica. Very rarely, sciatica can lead to extensive numbness
in the buttocks and pelvic floor. When that happens, prompt
surgical intervention is often required.
sciatica is the result of a disc problem ó as it is in most
typical cases ó and surgery is required, it can be quite
effective. The procedure involves removing the portion of the
disc thatís affecting the nerve. This surgery usually takes
about 75 minutes and requires only one day in the hospital.