Our last blog detailed what sciatica is and the various causes for this condition. Now, let’s venture into the treatment approach for sciatic symptoms.
So, what treatments are the most effective for this condition? Physical therapists are specifically trained to examine this type of ailment and determine the cause of the problem as well as an appropriate treatment plan. Sciatica is more of a side effect of other underlying conditions; therefore, treatment is often geared at the underlying cause while also addressing symptoms.
At the initial onset of symptoms, using ice on and off along the painful area for 2-3 days can help decrease inflammation. Keep in mind that ice should only be applied for 10 to 15 minute increments in order to be the most effective. Ibuprofen (pain reliever and anti-inflammatory) and acetaminophen (pain reliever) may also assist with decreasing pain.
Bed rest is NOT recommended. I repeat, bed rest is NOT recommended. You may need to reduce your level of activity due to pain, but eliminating activity altogether is not good for your body. Due to the fact that the back is the most common cause of sciatic symptoms, certain activities like heavy lifting or twisting should be avoided, especially within the first month following symptoms. Certain exercises and treatments can be particularly helpful depending on the cause of the problem. Disc herniations, for example, respond well to lumbar extension-based exercises while spinal stenosis responses better to forward bending-based exercises. Piriformis syndrome responds well to stretching, manual treatment, and may requires other techniques to decrease acute symptoms. One particular area that tends to be beneficial universally for sciatica is abdominal strengthening and most treatment programs will include some amount of abdominal/core exercises. A physical therapist can determine which exercises fit the condition best based on the cause of the symptoms and develop an exercise program consisting of those exercises. A PT can also determine if certain manual treatments are necessary for the condition including soft tissue techniques or joint mobilizations.
With the appropriate treatment, sciatic nerve pain can be resolved non-invasively within a relatively short period of time. Occasionally, when pain does not reduce, your doctor may choose to perform an injection to reduce nerve root inflammation. Less commonly, symptoms may stay severe enough to require surgery, but this is typically only when progressive neurologic symptoms or bowel and bladder dysfunction are present.