There are many possible causes of sciatica. The majority of sciatica cases will resolve on their own within 6-12 weeks, although occasional flare-ups may require some management. This video highlights some immediate treatment options such as ice, heat, and oral anti-inflammatory medications, as well as more advanced treatments. Sciatica treatments can also include exercise, physical therapy, pool therapy, spinal adjustments, epidural steroid injections, and in severe chronic cases, surgery.
Video presented by Stephen Hochschuler, MD
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Sciatica is when a patient is suffering from impingement or pressure on the nerve which causes pain to go down the extremities, oftentimes to the foot. This can be caused by one of several things. It could be caused by a herniated disc. It can be caused by spinal stenosis, which is a tightening of the spinal canal. It can be caused by a spondylolisthesis, which is the slip of one vertebra on another. Or pretty much anything that puts pressure on a nerve that causes pain down the leg. Other things that may include may be a tumor, a growth, an infection, a cancer, etcetera.
One treats the initial onset of sciatica conservatively, and by that I mean simple things such as ice in the first twenty-four to forty-eight hours, heat thereafter, the next forty-eight hours perhaps. The heat increasing circulation to the area, getting away some of the matabolites. The cold helping with some of the pain. In addition to which, we often use certain over-the-counter medications which include things like Tylenol, Advil, or Aleve. Certain amount of exercise is necessary. We do not believe in bed rest for more than twenty-four, maximum forty-eight hours. Exercise should be non-weight bearing, such as stationary bicycle or swimming pool – something that does not put excess stress on the affected area. Occasionally surgery is necessary. Prior to surgery, one must make a definitive diagnosis, however – what is going on – this will often 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 block, both of which you can learn more about on other parts of Spine-health.