For most people, the good news is that sciatica usually will get better on its own, and the healing process usually only takes a few days or weeks. Overall, the vast majority of episodes of sciatica pain heal within a six to twelve week time span.
However, occasional flare-ups of sciatic nerve pain may be an indication of a condition that should be managed so that it does not get worse over time.
- For most, readily available pain management techniques and regular exercise will go a long way to remedying the situation.
- For others, when the pain is severe or does not get better on its own, a more structured pain management program (including specific physical therapy and exercise), and possibly surgery, may offer the best approach to finding pain relief and preventing or minimizing future flare-ups of sciatica.
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 sciatica treatments.
Heat/ice
For acute sciatica pain, heat and/or ice packs are most 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 to help with sciatica pain relief.
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 which is usually a contributing factor in sciatica.
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.
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 acupuncture, massage therapy and chiropractic manipulation.
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 and left in place for a few minutes to over half an hour. 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.
*for details click on the link “Acupuncture”.
Also see “Acupressure”.
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 details click on the link "Massage Therapy".
Spinal adjustments and manual manipulation performed by appropriately trained health professionals (e.g. 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.
Following initial pain relief, a program of physical therapy and exercise should usually be pursued in order to alleviate pain and prevent or minimize any ongoing sciatic pain.
Physical therapy and exercise
Practical point:While is seems counter-intuitive, activity and exercise typically provides more sciatica pain relief than rest.
When the sciatica pain is at its worst, patients may need to rest for a day or two, but resting for longer periods of time is usually not advisable. In fact, inactivity will usually make the sciatic pain worse. This is because regular movement and exercise is necessary to nourish the various structures in the low back and encourage the strength needed to support the low back.
Low impact aerobic exercise, such as walking or swimming (or pool therapy) is also usually a component of recovery, as aerobic activity encourages the exchange of fluids and nutrients to help create a better healing environment. Aerobic conditioning also has the added benefit of releasing endorphins, the body’s natural pain killers, which is a natural way to alleviate sciatic pain.
for details click on link "Exercises"
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