Sciatica is common, and oftentimes self-diagnosis or treatment can cause additional problems if an incorrect technique or treatment is used. An effective approach to treat sciatica is to individualize the treatment based on the patient’s symptoms, diagnosis, and general state of health.

Typically, the treatment options often require some trial and error. Some patients may find certain treatments more effective than others. Here are a few common myths about sciatica treatments and the medical explanation for each.

Myth: Sciatica can be Self-Diagnosed and Treated

Truth: Sciatica can be caused by several lower back problems, which can be accurately diagnosed through clinical examinations and diagnostic tests conducted by a medical professional. Treatment for each cause is different.

See Diagnosing the Cause of Sciatica

Different conditions affecting the lower back, such as herniated discs, degenerated discs, or the abnormal growth of bone (bone spurs) that compress the spinal nerve roots may result in sciatica. 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/ Establishing a correct diagnosis is the first step towards sciatica relief, as the sciatica treatment options and precautions are different for each diagnosis. A medical professional can diagnose the cause and also detect any serious problems, such as tumors or infections early on and take action to prevent permanent nerve damage.

Read more about Sciatica Causes

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Myth: Everyone Can Benefit from the Same Treatment Method

Truth: The response to a specific treatment plan may vary considerably between different individuals with the same diagnosis for sciatica. 2 Lewis R, Williams N, Matar HE, et al. The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model. Southampton (UK): NIHR Journals Library; 2011 Nov. (Health Technology Assessment, No. 15.39.) 3, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99305/.

The treatment outcome of sciatica is often influenced by various factors, such as occupational ergonomics, stress, and the socioeconomic conditions of the person. 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/ Also, the patient’s general health, age, and the presence of persistent habits, such as smoking, or the use of certain drugs can also alter treatment outcomes. These factors often result in inconsistencies in the treatment outcomes between different individuals—and usually make the process of finding the right treatment one of trial and error. 2 Lewis R, Williams N, Matar HE, et al. The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model. Southampton (UK): NIHR Journals Library; 2011 Nov. (Health Technology Assessment, No. 15.39.) 3, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99305/.

A combination of different treatment options is often the most effective course, and doctors usually recommend some combination of the following treatments:

Surgery for sciatica may be considered a treatment option if there is a progression of pain and neurological symptoms.

Myth: Sciatica Always Resolves Without Recurrence

Truth: While sciatica usually resolves in 4 to 6 weeks, 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/ sometimes, the pain may recur or even progress over time despite treatments. 2 Lewis R, Williams N, Matar HE, et al. The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model. Southampton (UK): NIHR Journals Library; 2011 Nov. (Health Technology Assessment, No. 15.39.) 3, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99305/.

Sciatica pain usually decreases or completely goes away in a few weeks with or without professional medical treatment 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/ . Sometimes, depending on the type and severity of the underlying cause, sciatica pain may recur over time or the existing symptoms may worsen, even with treatment. Research indicates 3 Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y that some patients may develop persistent symptoms of sciatica up to 12 months.

It is important to seek professional help in such cases and adjust the duration, intensity, and type of treatment to address the underlying condition.

Myth: Bed Rest Helps Heal the Problem Causing Sciatica

Truth: It is important to stay active and avoid bed rest or long periods of inactivity to improve sciatica symptoms. 3 Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y , 4 Koes B. Moderate quality evidence that compared to advice to rest in bed, advice to remain active provides small improvements in pain and functional status in people with acute low back pain. Evidence-Based Medicine. 2010;15(6):171-172. doi:10.1136/ebm1132 A structured exercise routine can be more effective for pain relief 5 Fernandez M, Hartvigsen J, Ferreira ML, et al. Advice to Stay Active or Structured Exercise in the Management of Sciatica. Spine. 2015;40(18):1457-1466. doi:10.1097/brs.0000000000001036 and may also help heal the underlying problem.

While it may help to rest and use limited movement when sciatica flares up, long periods of inactivity usually makes the pain worse. With regular exercise, sciatica can be relieved in the short-term and future recurrences can be prevented. Staying active and exercising regularly helps improve muscle and bone strength and promotes healing in the inflamed and damaged tissues. Exercise also helps reduce stiffness in the muscles, joints, and the sciatic nerve.

See Sciatica Exercises for Sciatica Pain Relief

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Myth: Surgery Is Not Necessary for Sciatica

Truth: For certain sciatica causes, surgery may help provide better and more lasting pain relief compared to nonsurgical treatments. 3 Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y

Research indicates 3 Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y that for conditions such as spondylolisthesis (slipping of a vertebra over the adjacent one) and spinal stenosis (narrowing of the bony openings for spinal nerve roots) that may compress spinal nerve roots, surgery is usually more effective in providing relief from pain and other symptoms up to 2 years (or more). For disc herniation, surgery may provide immediate relief from symptoms, but long-term results are usually the same as nonsurgical treatments.

See Sciatica Surgery

It is important to note that surgery is considered only after several nonsurgical treatments are tried for many weeks and the symptoms persist or worsen. Surgery may be considered sooner for treating sciatica caused by certain medical emergencies, such as tumors, infections, or cauda equina syndrome.

See When Sciatica Pain Is a Medical Emergency

The myths about sciatica are commonly believed by people, which may prevent them from obtaining proper treatments for their condition. Gaining a clear understanding of sciatica can help patients work together with a spine specialist to understand the underlying cause and formulate the best course of treatment.

  • 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
  • 2 Lewis R, Williams N, Matar HE, et al. The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model. Southampton (UK): NIHR Journals Library; 2011 Nov. (Health Technology Assessment, No. 15.39.) 3, Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99305/.
  • 3 Fernandez M, Ferreira ML, Refshauge KM, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal. 2015;25(11):3495-3512. doi:10.1007/s00586-015-4148-y
  • 4 Koes B. Moderate quality evidence that compared to advice to rest in bed, advice to remain active provides small improvements in pain and functional status in people with acute low back pain. Evidence-Based Medicine. 2010;15(6):171-172. doi:10.1136/ebm1132
  • 5 Fernandez M, Hartvigsen J, Ferreira ML, et al. Advice to Stay Active or Structured Exercise in the Management of Sciatica. Spine. 2015;40(18):1457-1466. doi:10.1097/brs.0000000000001036

Dr. Rajesh G. Arakal is a board-certified orthopedic surgeon at the Texas Back Institute. Dr. Arakal is experienced in the evaluation and treatment of spine conditions and provides advanced, minimally invasive spine surgery.

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