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What Are the Different Types of Pain Management for Sciatica?

By Madeleine A.
Updated May 17, 2024
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Different types of pain management for sciatica include physical therapy, anti-inflammatory medications, and surgery. Sciatica is a condition that occurs when the sciatic nerve is impinged. The result can be excruciating, radiating pain in the lower back, buttock, and leg. Many people suffering from sciatica respond to home remedies and self-care treatments. These treatments include alternating hot and cold packs, taking over-the-counter anti-inflammatory medications, mild exercise, and stretching.

Although bed rest may seem appropriate when pain first begins, it can worsen symptoms of sciatica. Immobility can cause weakening of the surrounding structures, which can contribute to a decrease in range of motion and limited mobility. When pain is unresponsive to home remedies, the health care provider may recommended other treatment options, such as physical therapy. After the acute pain of sciatica resolves, the physical therapist can recommend a regimen to improve mobility and reduce the risk of future injuries.

Physical therapy can help improve flexibility and strengthen the muscles that support the back. Although results might not be immediate, over a period of about six weeks, dramatic improvement may be noticed. A physical therapy program can take place in a hospital or outpatient setting, and can be continued in the home as an ongoing treatment intervention.

Another type of pain management for sciatica is the use of anti-inflammatory medications, as these types of medications relieve pain and help reduce swelling. The health care provider may prescribe a muscle relaxant in conjunction with the anti-inflammatory medication to further relieve pain. Pain management for sciatica might also include taking prescription narcotics. Prescription narcotic medications, however, can cause significant side effects such as drowsiness, dizziness, constipation, and nausea. They should only be taken when pain is unbearable and only under the direct care of the health care provider.

An aggressive type of pain management for sciatica includes the administration of corticosteroid injections into the epidural space of the spine. Epidural injections reduce inflammation around the affected nerve, which helps relieve pain. The injections often need to be repeated over a period of time, and relief is not immediately noticed. Corticosteroid injections can cause irritation at the injection site, weight gain, a rise in blood sugar levels, and an increase in appetite.

Surgery for sciatica is generally reserved for severe cases. These patients suffer severe pain, incontinence of the bowel and bladder, profound weakness, and the inability to perform the activities of daily living. Surgery for sciatica should be discussed with the health care provider who can evaluate the risks and benefits of surgical procedures.

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