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.
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 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.
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
The treatment outcome of sciatica is often influenced by various factors, such as occupational ergonomics, stress, and the socioeconomic conditions of the person.1 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
A combination of different treatment options is often the most effective course, and doctors usually recommend some combination of the following treatments:
- Alternating heat and ice therapy to help relieve acute pain from sciatica
- Anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs
- Epidural steroid injections may help reduce inflammation around the nerve root and the associated low back pain
Surgery may be considered as a treatment option if there is a progression of pain and neurological symptoms.
See Sciatica Surgery
Myth: Sciatica Always Resolves Without Recurrence
Sciatica pain usually decreases or completely goes away in a few weeks with or without professional medical treatment1. 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 indicates3 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.3,4 A structured exercise routine can be more effective for pain relief5 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.
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
Research indicates3 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.
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.
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.