Sciatica Chronic Pain Treatments

Sciatica is pain and numbness traveling along the largest nerve from the lower back to the hips, buttocks, and leg(s).  Often, the pain can be severe and debilitating, and resolve itself with self care in a few weeks.  If significant leg, bowel or bladder weakness persists, the patient might be a candidate for surgery.

Symptoms

The hallmark symptom is constant, radiating pain that varies from mild aches to pins/needles, excruciating burning or electric shocks.  Some people have numbness, tingling, or muscle weakness when moving their leg or foot.  Symptoms can intensify with sudden movements like: sneezing, coughing, sitting to standing, sports, or car accidents.

Causes

The condition is the result of a herniated or degenerated disc, bone overgrowth (spur), or narrowing of the spine (spinal stenosis).  In some cases, the nerve is pinched by a tumor or damaged by a disease like diabetes.  A vertebra stress fracture, buttocks muscle irritation, or hip joint (Sacroiliac) damage can cause nerve pain similar to Sciatica.

Treatments

Physicians use a variety of medications, therapies, and procedures to treat Sciatica.

Medications

Patients can try over-the-counter (OTC) anti inflammatory like ibuprofen or naproxen, or prescription steroids (Prednisone) for inflammation, muscle relaxants (Flexeril) for spasms, antidepressants (Amitriptyline), anticonvulsants (Gabapentin) or opioids (Percocet) for nerve pain relief.

Therapy

Heat or ice packs can help reduce leg pain, and once the pain improves, physical therapy can help prevent future injuries and correct posture with core (stomach and back) strengthening exercises.

Alternative Care

Chiropractic adjustment and manipulation can address the underlying conditions causing Sciatica.  Acupuncture can open flows of energy around the nerve pain.  Cognitive behavioral therapy can help cope, take control and manage the pain. Massage therapy can alleviate pain by increasing blood circulation, muscle relaxation, and releasing endorphins (natural pain relievers).

Steroid Injections

If the pain is severe and debilitating, an injection around the nerve root can reduce the inflammation causing pain.  The pain relief can last from a week to a year, the side effects increase with frequency, and the procedure does not work for everyone.

Spinal Cord Stimulation (SCS)

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column minimizing the sensation of pain.  A minimally invasive and drug-free treatment option, SCS is a FDA approved therapy with proven results.  The treatment has been used successfully for 30 years, and includes a 3-10 day trial period to ensure success before surgically implanting in the body.

Surgery

Surgery can help a compressed nerve that causes weakness, unmanageable pain, or loss of bowel or bladder control.  Surgeons can remove bone spurs, repair a herniated disc, or release spine pressure from stenosis.

Specialists

These doctors specialize in Sciatica and can help diagnose, treat, and manage your condition.

Anesthesiologist

A doctor that administers medicine to put patients asleep during surgery, renders them numb for local procedures, or reduces chronic pain through injections.

Physiatrist

A doctor specializing in physical medicine and rehabilitation that treats both acute and chronic pain with a variety of nonsurgical treatments.

Neurosurgeon

A surgeon that diagnoses and treats pain resulting from disorders of the spine, spinal cord, nerves, brain, intracranial, and intraspinal vasculature.

Orthopedic Surgeon

A surgeon that diagnoses and treats pain resulting from spinal disorders, arthritis, sports injuries, trauma, and fractures.

To learn more about sciatica, please visit the Mayo Clinic & Spine Health.