Sciatica is a nerve condition that can be extremely painful. It can strike at any age, but mostly occurs in people over 50, and in those who are overweight. Poor posture when sitting or standing for long periods can also trigger sciatica. Symptoms range from numbness or pain beginning in the lumbar spine, spreading down from the buttocks to the lower legs. Symptoms can be mild, chronic or debilitating, and usually grow worse over time.
Though it occasionally resolves on its own, sciatic nerve pain often requires treatment. Fortunately, there is a wide range of therapies for sciatica, ranging from minimally invasive procedures such as medication and chiropracty to back surgery.
Physical and Nutritional Therapy
For mild cases of sciatica, the services of a physical therapist are often sufficient. A regimen of exercises to strengthen muscles and promote good posture can relieve symptoms in their early stages. A nutritionist can also recommend a proper diet if overweight is the cause. Both types of therapy are relatively inexpensive, covered by insurance, and do much to prevent other disorders that arise from inactivity and obesity.
Medication for Sciatic Nerve Pain Relief
Prescription drugs are the least effective sciatica treatment because they do not address the root cause of the problem, which is nerve compression. They do, however, provide relief from pain. Anti-inflammatories and muscle relaxants are slightly helpful in reducing swelling and blocking the contraction of muscles around the nerve. Narcotics and opioids may be prescribed to relieve pain, but their use over long periods of time is not recommended. Dosages tend to go up as the body builds tolerance to the medication. The risk of complications, side effects, addiction and abuse rises as the benefits of drug therapy decrease. Pharmaceuticals can be quite expensive if paid for without insurance.
Acupuncture As a Sciatica Treatment
Acupunture can sometimes provide sciatic pain relief. It is an ancient Chinese healing art based on the idea that energy has certain pathways through the body. When the pathways are blocked or weakened, illness and injury result. After an initial examination that identifies the where the flow of energy is altered, needles are inserted at very specific points to correct and stimulate that flow in order to promote healing. Though some studies have shown that acupuncture has very little effect, other studies have shown that it relieves sciatic pain and promotes healing. As with any holistic treatment, diligent research and reference checks should be undertaken before choosing a practitioner. Though this sciatica treatment is rarely covered by insurance, it is only moderately expensive.
For sciatica sufferers who are squeamish about needles, acupressure is another sciatica treatment alternative. Acupressure works on the same principles as acupuncture, without breaking the skin. If the cause of sciatic nerve compression is muscular, acupressure may bring some relief. The practitioner uses fingers, thumbs palms and elbows on pressure points to produce the same basic effect as that of a deep tissue massage. Acupressure for sciatic pain relief is not covered by insurance, but is affordable out-of-pocket.
Chiropracty is a more mechanical approach to sciatic nerve treatment. A chiropractor works to adjust the bones of the spine, neck, arms and legs to bring them into proper alignment. Before beginning therapy, a physical examination is performed and x-rays are taken to identify which structures are compressing the sciatic nerve. Then the chiropractor manipulates those structures with pressure to move them away from the nerve and into their correct alignment.
For chronic sciatica, treatments several times a week, decreasing over a period of months are needed. Exercises to strengthen muscles to support the new alignment and keep compression from recurring are often recommended with this treatment. Few insurance plans cover this sciatica treatment, but it is competitively priced.
Surgery – Invasive Therapy for Sciatica
Surgery is the most drastic and invasive therapy for sciatica. Like any surgery, it carriers a higher risk of complications and morbidity than other treatments for sciatica, and requires a greater number of diagnostic imaging procedures beforehand.
First, a complete medical history must be taken to identify whether or not the patient is a surgical candidate. Age, general health, underlying conditions and reaction to anesthetic must all be tested for or considered. Imaging technologies such as CT and closed or open magnetic resonance imaging are often used to get a clear picture of the problem. Positron emission tomography, where available, can also be used to obtain a three-dimensional image to aid the surgeon.
Possible complications that may arise from back surgery include blood clots, infection, scar tissue formation and nerve damage. Recovery must be monitored closely, and physical activity is generally very limited postoperatively. Long periods of inactivity can cause other health problems, especially for elderly patients.
Though the recovery period is about eight weeks, the sciatica surgery often brings immediate relief and is regarded as the fastest, most effective sciatica treatment when the condition has lasted for more than six months and does not respond to less invasive treatments.
Surgery is also the most expensive option. An MRI scan alone costs thousands, and the average cost of sciatica surgery is in the tens of thousands. Surgery is also the option most often paid for by insurance providers.
With so many options available, choosing one can be difficult. While insurance and finances are important considerations, it must be remembered that the method of treatment for sciatica depends upon its cause. Proper diagnosis and a thorough discussion of options with a physician are essential to a successful outcome and full recovery.