Sciatica is when a patient is suffering from impingement or pressure on a nerve which causes pain to go down the extremity, oftentimes to the foot. Could be caused by herniated disc, could be caused by spinal stenosis, which is a tightening of the spinal canal, it could be caused by a spondylolisthesis, which is a slip of one vertebra on another. Or pretty much anything that puts pressure on a nerve that causes pain down the leg.
One treats the initial onset of sciatica conservatively, and by that I mean simple things such as ice for the first twenty-four to forty-eight hours, the cold helping with some of the pain, heat thereafter, for the next forty-eight hours perhaps. Increasing the circulation to the area, getting away some of the matabolites. In addition to which, we often use certain over-the-counter medications which include things like Tylenol®, Advil®, or Aleve®.
We do not believe in bed rest for more than twenty-four, maximum forty-eight hours. Certain amount of exercise is necessary.
Exercise should be non-weight bearing, such as a stationary bicycle or a swimming pool - something that doesn't put excess stress on the affected area. Occasionally surgery is necessary. Prior to surgery, one must make a definitive diagnosis, however, of what is going on - and this often will require an MRI scan, a myelogram, or a myelogram followed by a CT scan. Initially, if there isn't a dangerous problem occurring, one will consider what's called an epidural steroid injection or a selective nerve root block, both of which you can learn more about from other parts of Spine dash health.
Learn about what causes sciatica, how to diagnose it, and what treatments are available. Plus, get tips on how to prevent sciatica and when to see a doctor.Learn More
Dr. Stephen Hochschuler is an orthopedic surgeon and co-founder of the Texas Back Institute. He specializes in the lumbar spine and has been a practicing spine surgeon for more than 40 years.