At any one point in time, approximately 1% of the US population is dealing with sciatic pain from a herniated disc. This pain tends to be severe and burning and goes down one of the lower extremities as a result of a pinched nerve. Typically this is from a herniated disc and sometimes results in a need for surgery.
What are the steps involved with achieving pain relief and avoiding surgery? The first step is not to panic. It’s a very common situation and if you talk to any of your friends they probably have been dealing with a similar issue at some point in life. So the first thing to do is to understand that it’s very common.
The second thing to do is to make an appointment with the chiropractor or a pain management doctor to get some pain relief. Chiropractic treatment has been shown to work well for acute back pain as well as sciatica. Treatments may include spinal manipulation or spinal decompression therapy as well along with physical rehabilitation exercises. This may help substantially, but remember that chiropractors do not prescribe medication. So at some point with typically bad symptoms from sciatica the patient will need medication. Either your family practice doctor or pain management doctor can prescribe these which may include muscle relaxers and possibly a short term course of narcotic medication.
Of course anti-inflammatory medications along with Tylenol can be extremely beneficial as well, but typically for a rip roaring sciatica something stronger is necessary acutely. Once this is in place, it is best to try a course of nonoperative treatment which may include continued therapies with spinal decompression therapy and some adjustments, possibly a tens unit, and some physical therapy.
Depending on how bad a person’s symptoms are from the sciatica, it may be prudent to undergo an epidural injection sooner rather than later. The purpose of this is so that pain relief can be achieved and a person will be able to participate in physical therapy and other treatments more effectively. Epidural injections are typically done as a series of three injections. If the first injection provides partial relief it is a good idea to move on with the rest of the series. However, if the first injection takes care of the pain completely then it may be prudent to hold off on the rest of the series.
A person must keep in mind that the effectiveness of epidural steroids is over 75% effective for relieving the pain from sciatica, but it does not cure the problem. The hope is that it will provide enough pain relief for the body to be able to disintegrate the piece of disc that is pushing on the nerve root and causing sciatica.
Studies have shown that if the patient can avoid surgery from a herniated disc, the outcome is typically just as good at the one year time point as if the patient did go ahead with surgery. So if it can be avoided that is best. The time to think about surgery is if a couple months go by and the pain is just as bad as it was to begin with, or if muscle weakness is beginning to develop and not getting any better with treatment.