Sciatica is a condition where there is radiating pain in the sciatic nerve. The sciatic nerve goes from the lower back to the hips, buttocks and down the side of the leg. The condition can develop because of a herniated disk. It can also occur when a bone spur on the spine or a narrowing of the spine compresses the root of the nerve. The result is shooting pain and inflammation along the sciatic nerve pathway. There can also be numbness in the leg. Sciatica usually occurs on only one side of the body. Without treatment, it can easily get worse.
As a board certified neurosurgeon and President of Executive Spine Surgery in Hackettstown, NJ, Dr. Carl Spivak is well known for combining innovative and state-of-the-art technology with a minimally invasive approach. Sciatica pain can be severe, but when treated promptly, it usually improves over time without surgical intervention. In cases where there is chronic discomfort or recurring pain with weakness in the leg, a surgical procedure may be considered.
How Is Sciatica Treated?
Physical Exercise. Exercise can control or eliminate sciatica. In combination with anti-inflammatory agents, steroids and pain relievers, physical therapy that supports the spine and protects the back can significantly reduce discomfort and restore mobility.
Massage Therapy. Back problems are often associated with cramped back muscles, tight hamstrings and weak abdominal muscles. Gentle massage can reduce the muscle spasms and muscle stiffness caused by back injury.
Transcutaneous Electrical Nerve Stimulation (TENS). Combining stretching exercises that strengthen the back and the abdomen with massage or (TENS) can effectively reduce sciatica pain and help to restore range of motion. Pilates and weight training can also be used to supplement stretching and massage.
Steroidal, Anti-Inflammatory and Pain Relieving Medications. Pain medications can reduce discomfort and relieve inflammation so that the body can be rehabilitated. Combining medications with the nonsurgical treatments described above can postpone or even eliminate the need for surgery.
Epidural Steroid Injections. Epidural injections for sciatica can effectively reduce inflammation and relieve pain. Injections are more effective than oral medications because they are injected directly into the area where the pain is located. Epidural steroid injections are more effective for some people than others. Pain relief can last anywhere from one week to one year. A significant benefit of epidural injections for sciatica is that while the pain is relieved, a patient can begin an exercise program and take other actions that support a positive outcome and a long term solution.
Surgery. When surgery is indicated, Dr. Spivak will suggest the least invasive option followed by the treatments described above. Microdiscectomy, discectomy, laminectomy and laminotomy are all minimally invasive procedures that require no hospital stay and minimal anesthesia. There is less trauma to the tissues surrounding the compressed nerve, and recovery time is faster than it would be with traditional back surgery. A program of physical therapy and massage can be started shortly after the surgery. This approach often brings about a positive outcome.