Dealing with Painful Sciatica–What are the Best Treatments?

Dealing with Painful Sciatica–What are the Best Treatments?

Owww. If you’ve ever experienced sciatica, you know it’s difficult to get comfortable either sitting or standing. Sciatica is a pain extending from the back of your pelvis down the back of your thigh, sometimes down to the foot. Leg numbness and weakness are also symptoms in more severe cases.

Why does sciatica hurt so much?
Your sciatic nerve is the primary nerve of your leg and also the largest nerve in your entire body. Usually, sciatica is caused by a herniated disk in your spine that presses on your sciatic nerve. Sometimes, the cause for sciatica cannot be identified. Its symptoms may resemble other conditions or medical problems so always consult your healthcare provider for a diagnosis.

How effective are common treatments for sciatica? Based on the evidence from evaluating relevant studies on the issue, our group of Valley family medicine physicians concluded:
• Epidural steroid injections may be offered to patients with sciatica of more than six month’s duration; Conclusion: Minimal short-term improvement in leg pain and disability scores • Surgical diskectomy can be offered to patients with severe sciatica; Conclusion: Modest, short-term improvement in leg pain and disability scores

• Nonsteroidal anti-inflammatory drugs (NSAIDs) and systemic steroids; Conclusion: Should not be used in patients with sciatica—all of these medications have adverse effects and do not appear very effective

• Traction and bed rest; Conclusion: Should not be offered to patients with sciatica because they do not improve pain or disability, and bed rest can worsen back pain

What treatments are most effective?
Sciatica usually heals on its own with some rest, time and patience. Staying active is important for those with back pain. To help relieve the pain, treatment may include:
• Heat or cold applications to the sore muscles
• Movement (keeping your body in motion minimizes inflammation)
• Surgery (to repair your herniated disk, if the condition continues)


By Adam Stephenson, DO; Gary Kelsberg, MD; and Jon O. Neher, MD, University of Washington at Valley Family Medicine Residency and Leilani St. Anna, MLIS, AHIP, University of Washington Health Sciences Library Need to find a doctor? See