Most cases of sciatica can be reduced spontaneously over the course of a few weeks to months if the cause is lumbar disc herniation. Conservative sciatica treatment is usually recommended for the first six to eight weeks. Some of the typical conservative measures for sciatica pain treatment include medicines, physical therapy, and steroid injections.
Medications for sciatica treatment
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These medications are available over-the-counter and will help treat sciatica pain and reduce inflammation. Some common NSAIDs are ibuprofen, aspirin, and naproxen.
- Muscle relaxants: These medications are available only with a prescription, and your doctor may suggest them to help relieve muscle spasms. Examples of muscle relaxants medications for sciatica include cyclobenzaprine (Flexeril) and methocarbamol (Robaxin).
- Narcotics: These medications for sciatica treatment also require a prescription from your doctor and are generally only used for extreme sciatica pain due to their potential for addiction. Examples are hydrocodone (Vicodin) and oxycodone (Percocet).
- Antidepressants: Some types of pain are relieved by medication that is also used to treat depression. A doctor’s prescription is required for these medications. Examples are venlafaxine (Effexor) and duloxetine (Cymbalta).
- Anti-seizure medications: Your doctor may prescribe medications used for epilepsy to help control your sciatica pain. An example is gabapentin (Neurontin).
Physical therapy for sciatica
After the most severe sciatica pain starts to improve, your doctor may recommend physical therapy or another form of rehabilitation to help prevent further injuries. Rehabilitation as part of your treatment for sciatica pain typically includes:
- Exercises – to strengthen your back and abdominal muscles, certain exercise is needed, such as those focused on your core. Sciatica exercises are critical to your recovery. Pilates, Tai Chi, and low-impact aerobics can be done.
- Stretches to improve or maintain your flexibility. Sciatica stretches can help improve or your flexibility. These stretches can include several yoga techniques such as mentioned in another article, “forward pigeon pose”, “knee to opposite shoulder”, “standing hamstring stretch” , and “sitting spinal stretch” to name a few.
- Learning ways to correct your posture – yoga may help accomplish correct posture and gait training.
In some cases of sciatica, physicians recommend injections of a corticosteroid into the area directly surrounding the affected nerve root. This form of treatment for sciatica pain includes Epidural Steroid medications to help relieve pain by reducing inflammation in the area. The benefits typically last for a few months, sometimes up to a year. However, you can only receive a limited number of these injections because the risk of severe side effects is more significant if they are given too frequently. Always remember to speak to a specialist to thoroughly weigh the pros and cons, especially if you need long-term treatment. This will also help you to make the right decision.
Surgery is usually only used if nerve compression is causing extreme weakness, loss of bowel or bladder control, or pain that is increasing and not improving despite other treatments. Resorting to sciatica surgery is usually more of the last option. There are two main types of surgery when it comes to sciatica, namely:
- Microdiscectomy or Discectomy: This procedure results in the removal of all or specific herniated discs that are pinching the sciatic nerve. As a result, microdiscectomy is minimum invasive, and recovery time is swifter.
- Laminectomy: Laminectomy, also known as Laminotomy, is the removal of part of the lamina responsible for protecting the spinal cord and canal. Laminectomy (removal of the entire lamina). Again, talking with your doctor about the benefits and risks involved is very important, and your specialist will be able to answer all questions that you may have related to it.