Sciatica

Sciatica is a condition often seen in patients with disk disease of the lower back. Pressure on the sciatica nerve causes pain to radiate from the lower back or buttock down the leg.

CAUSES

It results from pressure on nerve roots coming out of the spine. This is often the result of a disc that deteriorates and pushes to one side. Often there is a history of back problems.

TREATMENT

In most cases sciatica improves greatly with conservative treatment (treatment that does not involve surgery). Most patients are completely better after 2-4 weeks of bed rest and other supportive care. Bed rest reduces the disc pressure greatly. Sitting is the worst position. When sitting pressure on the disc is over 5 times greater than it is while lying down. Avoid:

  • Bending.

  • Lifting.

  • All other activities which make the problem worse.

After the pain improves, you may continue with normal activity. Take brief periods for bed rest throughout the day until you are back to normal.

Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Muscle relaxants may help by relieving spasm and providing mild sedation. Cold or heat therapy and massage may also give significant relief. Spinal manipulation is not recommended because it can increase the degree of disc protrusion. Traction can be used in severe cases. Surgery is reserved for patients who:

  • Do not improve within the first months of conservative treatment.

  • Have signs of severe nerve root pressure.

See your doctor for follow up care as recommended. A program for back injury rehabilitation with stretching and strengthening exercises is an important part of healing.

SEEK MEDICAL CARE IF:

  • You notice increased pain.

  • You notice weakness.

  • You have numbness in your legs.

  • You have any difficulty with bladder or bowel control.