Dr. Kaliq Chang offers his recommendations on treatment choices for Sciatica
Since sciatica pain is often compared to the agony of a toothache, effective treatment options for this poorly understood back problem are welcome. Fortunately, sciatic nerve pain relief choices are also plentiful, according to Interventional Pain Management Specialist Dr. Kaliq Chang with Atlantic Spine Center.
Sciatica isn't actually a medical condition at all. Rather, it's a term used to describe symptoms stemming from the compression of the sciatic nerve in the lower back. When this happens, the pain begins in nerve roots located on either side of the lower spine and radiates down the leg, depending on the affected side. Sciatica affects up to 14% of adults at some point in their lives, according to 2017 research in the BMJ medical journal. For those affected, pain resulting from this poorly understood condition can be severe, Dr. Chang says. "Pain from sciatica can be worse than back pain alone," Dr. Chang adds. "It's often compared to the agony of a toothache and cannot simply be ignored. Luckily, there are many successful ways to treat the problem."
Symptoms of Sciatica can stem from several causes. To figure out the best sciatica pain relief, it helps to understand its potential causes. While some people are simply more prone to the problem than others (including those over 45; smokers; tall people; and those coping with acute mental stress) certain activities can also contribute to sciatica's development. These include frequent lifting, especially while twisting, and driving, especially on less smooth roads that can agitate the entire body.
Certain common back conditions also can lead to pinched nerves causing sciatica pain, including
- Bulging or herniated spinal discs
- Spinal stenosis (a narrowing of the spinal canal)
- Scar tissue
- Spinal bone spurs
Radiating pain from the lower back to the buttocks, thigh, calf and foot can also be accompanied by tingling and numbness, Dr. Chang explains. "The pain can be worse when sitting and can even affect standing or walking," he adds. "With symptoms this severe, the need for relief can feel overwhelming."
Medication to Relieve Sciatica Pain
Medication for sciatica can be a useful tool in relieving the pain associated with sciatica, and there are several options available. One of the most commonly prescribed medicines for sciatica is nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs work by reducing inflammation, which is often a key factor in causing sciatica pain. Examples of NSAIDs include ibuprofen, naproxen, and aspirin. These medications can be effective for mild to moderate sciatica relief, but they may not be strong enough for severe cases of sciatica.
For more severe sciatica pain, doctors may prescribe muscle relaxants. These medications work by reducing muscle spasms, which can contribute to nerve compression and pain. Examples of muscle relaxants include cyclobenzaprine, baclofen, and tizanidine. These drugs can cause drowsiness and should be used with caution, especially when driving or operating machinery.
In some cases, doctors may prescribe opioids for severe sciatica pain. These drugs work by blocking pain signals to the brain, but they can also be highly addictive and have the potential for abuse. Examples of opioids include morphine, oxycodone, and hydrocodone. Opioids should only be used under close supervision by a healthcare provider and should never be taken in larger doses than prescribed.
Another option for sciatica nerve pain relief is corticosteroid injections. These injections deliver a powerful anti-inflammatory medication directly to the affected area, providing fast and effective pain relief. However, corticosteroid injections can have side effects, including weight gain, mood changes, and increased blood sugar levels.
It's important to remember that medication is not always the best option for treating sciatica pain, and it should always be used in conjunction with other therapies. If you're experiencing sciatica pain, talk to your doctor about your treatment options and work together to develop a plan that will provide the most effective and safest relief for your symptoms.
Tips for pain relief
It's a good thing that many at-home remedies as well as prescribed therapies are available for sciatica. In addition to medication, there are other treatments that can help relieve sciatica pain, including physical therapy, chiropractic care, and massage therapy. Your doctor can help you determine which treatment options are best for you based on the severity of your symptoms and your overall health. Once a doctor confirms the diagnosis of sciatica (with an exam and/or and imaging scans) more conservative sciatica pain treatments will generally be recommended at first, Dr. Chang says. These include:
- Alternating ice and heat application
- Over-the-counter or prescription anti-inflammatory pain relievers or muscle relaxants
- Exercise and/or physical therapy
- Epidural spinal injections
If non-surgical options do not help after weeks or months of consistent use, only then will surgery be considered to correct the underlying condition fueling sciatica pain, Dr. Chang says. In about one-third of cases, sciatica patients will still experience persistent and disabling symptoms after one year, according to the BMJ research.
"The vast majority of sciatica patients can expect the problem to be temporary and won't need surgery," Dr. Chang says. "Easy treatments usually work, and a doctor's care can help the pain resolve even more quickly."
Needing more info? Visit our Sciatica page for educational information and a Sciatica animation.