Sciatica treatment may take the form of professional services with one or more health care providers to self treatment methods such as home exercises. In the majority of cases, surgery is not necessary to achieve lasting relief of sciatica symptoms. But unfortunately there is not any sciatica treatment that can be done once or for a short period of time that provides a reliable long-term “cure”. Preventive exercises and other treatments are usually needed to address the underlying causes of sciatica in order to prevent pain and other symptoms from returning and getting progressively worse with future episodes.
Over the counter and/or prescription medication, is commonly the initial form of sciatica treatment that people use. Anti-inflammatories, pain relievers, and muscle relaxant drugs are among the most common types of medication used in the treatment of sciatica. But complete relief is rarely achieved with medication and some people cannot use certain medications due to side-effects.
Spinal injections, usually with cortisone or other steroids, are commonly used if medication fails to provide adequate relief. Injections are used with the intention of reducing inflammatory swelling around the nerves and thereby relieve nerve compression and irritation. Spinal injections may help considerably when swelling is a major factor in nerve irritation, but they may be totally ineffective when the nerve irritation is caused by a large disc herniation, bone spurring, and/or a spinal cyst or some other space-occupying lesion that produces direct nerve pressure. Steroid injections are usually limited in number and frequency of application by doctors because of risks of side effects from excessive use that may include immune suppression and long-term damage to bone and soft tissue structures.
Physical therapy may include a variety of sciatica treatments ranging from passive therapies like electrical stimulation to active rehabilitative exercises. Passive treatments will often provide short-term symptom relief, while rehabilitative exercise is needed to correct underlying muscle imbalances and postural distortions that tend to cause sciatica to recur. To maintain the benefits of physical therapy exercises, it is necessary to continue them on an ongoing basis for life. Because of this, it is recommended that physical therapists provide sciatica patients with exercises they can continue on their own at home without the need for access to high-tech rehab equipment.
Surgery can be considered the sciatica treatment of last resort, when all else has failed. Most people with sciatica can and do recover without surgical intervention. In cases of major disc herniation or rupture, severe degenerative spinal arthritis, or in cases where a cyst or tumor is producing pressure on one or more of the nerve roots that form the sciatic nerve, surgery may be necessary to achieve maximum long-term relief of sciatica symptoms. It was mentioned before that no treatment is really a permanent cure for sciatica, and that includes surgery. Surgical treatment can remove the majority of pressure on the involved nerves that are causing symptoms, but the surgery itself will very often produce unfavorable changes in spinal movement patterns. These changes will usually lead to abnormal stresses on spinal structures in the area, leading to accelerated spinal degeneration, and/or the development of new disc herniations at other levels of the spine. Nerve compression that results in the return of sciatica symptoms can also be produced by post-surgical scar tissue that occurs months to years after surgery.
For good long-term results, sciatica treatment must include some form of ongoing preventive care. Simple exercises and self-care methods when used on a daily basis will usually provide better long-term relief than even most professional sciatica treatments. With just a few minutes per day dedicated to prevention, years of misery from sciatica can be avoided.