“I’ve been having a lot of pain in my lower back, and it’s traveling down my leg.” If a patient comes into DISC Sports & Spine Center with a complaint like this, it’s likely due to sciatic nerve pain, or sciatica. Assuming we are able to determine that’s where the pain is originating after a medical history and physical exam, there are a number of steps we can take to try and relieve it.
Understanding Sciatic Nerve Pain
The sciatic nerve runs a long way through the body. Starting in the lower back, it travels through the buttocks into the thigh, extending down the leg and into the foot. Certain conditions, such as a herniated disc, bone spurs, or spinal stenosis, can cause the sciatic nerve to become compressed or inflamed, resulting in pain along the path of the nerve.
The experience of sciatic nerve pain can differ from person to person. Most of the time, it’s felt in just one leg, but sometimes both legs may have pain. It may be constant or come and go. It can feel like a burning pain or a stabbing sensation. It may cause pain in the front, back, or sides of the leg. Some people may even notice numbness, tingling, or weakness in the leg or foot.
Treating Sciatic Nerve Pain at Home
Thankfully, many cases of sciatica can be resolved with conservative treatments. Over-the-counter medications, including ibuprofen and other anti-inflammatories, can decrease inflammation and improve pain. Both heat and cold therapy can help, as well; ice can be used to reduce swelling and minimize pain, and heat is useful for stimulating blood flow and relaxing stiff muscles.
Some patients want to just lie in bed when the pain is too bad, but we don’t recommend that. Taking it easy for a few days is fine, but prolonged bed rest can make the problem worse. Instead, if the sciatic pain is really interfering with the patient’s ability to move around, it’s time to make an appointment with a doctor.
Getting Medical Treatment for Sciatica
Coming to see a doctor for sciatic nerve pain doesn’t necessarily mean they’ll need surgery. Sometimes a short course of strong, prescription pain medication can get it under control. Occasionally, epidural steroid injections may be used for persistent or severe pain. These injections reduce inflammation and can provide long-lasting pain relief, sometimes even up to a year.
Once the pain is better managed, other treatment modalities may be introduced, such as physical therapy. Stretching and strengthening the core and performing specific exercises may help relieve pressure on the sciatic nerve. Lifestyle alterations to keep the pain at bay will be addressed as well.
Recognizing When Surgery May Be Needed
When sciatic nerve pain doesn’t respond to these treatments or symptoms continue to progress, surgery may be considered. The type of surgery will depend on what’s causing the pain to begin with. If it’s a herniated disc in the back, a microdiscectomy may be needed to clear out the disc material that’s pressing on the nerve root. If it’s caused by spinal stenosis, a procedure called a laminectomy can remove part of the vertebra to make more room for the sciatic nerve. Surgery is generally very successful and at DISC is performed as a minimally invasive outpatient procedure. At DISC Sports & Spine Center, we discuss the risks and benefits of any surgical procedure with patients so they can make an informed decision.
It’s important to point out that, although it’s usually perfectly OK to give sciatic pain some time to try and resolve on its own, there are a few situations in which it should be treated more urgently. Some examples include loss of bladder or bowel control and a fever occurring in conjunction with the pain. If at any point there’s a question or concern, patients are encouraged to reach out, knowing that we are always here to help. As each person is different, we encourage you schedule a time to come in to get a personalized recommendation.