Sciatica Treatment
For severe or ongoing flare-ups of sciatic nerve pain, the condition may need to be treated so that it does not get worse over time.
- For most, readily available nonsurgical remedies and regular exercise will go a long way to relieving their pain.
- For others, when the pain is severe or does not get better on its own, a more structured treatment approach, and possibly surgery, may offer the best approach to finding pain relief and preventing or minimizing future flare-ups of sciatica.
This page addresses nonsurgical treatment for sciatica. For more treatment options, see also Physical Therapy Exercises and Sciatica Surgery (links below).
Non-Surgical Treatment for Sciatica
Non-surgical sciatica treatments encompass a broad range of options, with the goal of relieving pain caused by compressed nerve roots. One or some combination of the treatments below are usually recommended in conjunction with a specific exercise program.
Heat/Ice
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated.
- See also Heat Therapy Cold Therapy.
Sciatica Pain Medications
Over-the-counter or prescription medications may also be helpful in relieving sciatica. Non-steroidal anti-inflammatory drugs (such as ibuprofen, naproxen, or COX-2 inhibitors), or oral steroids can be helpful in reducing the inflammation that is usually a contributing factor in causing sciatica pain.
- See also NSAIDs, Oral Steroids.
Epidural Steroid Injections for Sciatica
If the sciatica pain is severe, an epidural steroid injection can be performed to reduce the inflammation. An epidural injection is different from oral medications because it injects steroids directly to the painful area around the sciatic nerve to help decrease the inflammation that may be causing the pain. While the effects tend to be temporary (providing pain relief for as little as one week up to a year), and it does not work for everyone, an epidural steroid injection can be effective in providing relief from an acute episode of sciatic pain. Importantly, it can provide sufficient relief to allow a patient to progress with a conditioning and exercise program.
- See also Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica and Epidural Steroid Injection Video.
Alternative Sciatica Treatment
In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients. Three of the more common forms of alternative care for sciatica include chiropractic manipulation, acupuncture, and massage therapy.
- See also Chiropractic Treatments for Back Pain.
- See also Massage Therapy for Lower Back Pain.
Chiropractic/Manual Manipulation
Spinal adjustments and manual manipulation performed by appropriately trained health professionals (such as chiropractors, osteopathic physicians, physical therapists) are focused on providing better spinal column alignment, which in turn should help to address a number of underlying conditions that can cause sciatic nerve pain. Manual manipulation done to address the right indications by appropriately trained health professionals can create a better healing environment and should not be painful.
Acupuncture
The practice is centered on the philosophy of achieving or maintaining well being through the open flow of energy via specific pathways in the body. Hair-thin needles (that are usually not felt) are inserted into the skin near the area of pain. Acupuncture has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health recognized acupuncture as effective in relieving back pain, including sciatica.
Massage Therapy
Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers).
For most people, the good news is that sciatica usually will get better on its own, and the healing process for most will only take a few days or weeks. Overall, the vast majority of episodes of sciatica pain heal within a six to twelve week time span. Following initial pain relief, a program of sciatica physical therapy and exercise should usually be pursued in order to alleviate pain and prevent or minimize any ongoing sciatic pain.
There are a number of types of non-surgical spine care professionals who specialize in treating sciatica symptoms, including chiropractors, physiatrists (physical medicine and rehabilitation specialists), pain medicine specialists, and physical therapists, all of whom have specialized training to provide pain relief and to help prevent future recurrences of sciatica. It is always advisable to have a qualified medical professional oversee any type of sciatica treatment.
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