Learn how you can manage sciatica with conservative treatments like physical therapy and corticosteroid injections.
Lower back pain is a common orthopedic complaint, and often this pain stems from a disorder called sciatica. According to one study, between 5 percent and 10 percent of people with lower back pain are diagnosed with sciatica, also known as lumbar radiculopathy.
Sciatica isn’t a distinct medical condition in and of itself; instead, it’s generally a symptom of another disorder. When the sciatic nerve in the lower back is pinched, you’ll feel severe pain in the lower spine as well as pain that radiates down from the buttocks to the leg. You may experience a tingling sensation and numbness in the leg, as well.
Most often, a herniated disc in the lower spine is causing this discomfort. Spinal stenosis — a gradual narrowing of the spinal column — can also compress the sciatic nerve. Lastly, an injury to the piriformis muscle in the buttocks may cause sciatica. Running from the lower spine to the top of femur, this muscle allows us to rotate our hips. When it’s damaged, the piriformis muscle aggravates the sciatic nerve.
Though the condition is often painful, chances are you won’t need surgery to treat your sciatica. In most cases, conservative methods are an effective way to relieve pain and increase mobility.
To diagnose the source of your sciatic nerve pain, an orthopedist will conduct a physical exam that might involve slowly lifting your leg to determine the exact source of the pain, such as a herniated disc in the lower back. Imaging tests (X-rays, MRIs, CT scans) may be ordered, as well. Your orthopedist could also perform a nerve conduction study or electromyography to monitor electrical impulses through the sciatic nerve.
Treatment depends on the precise cause of sciatica, but, in general, a conservative program of pain management and physical therapy will alleviate the discomfort and enable you to resume your daily activities pain-free.
Over-the-counter non-steroidal anti-inflammatories such as aspirin, ibuprofen, and naproxen can provide day-to-day pain relief. However, if pain is severe, a prescription pain medication may be given at the beginning of your treatment regimen.
Another option is a cortisone injection directly into the lower back or piriformis muscle. This reduces inflammation and swelling in the sciatic nerve, which, in turn, allows you to participate in a physical therapy regimen. During your physical therapy program, you’ll work on stretching tight muscles as well as strengthening the back, abdomen, and leg muscles. Aerobic exercises like walking improve flexibility and overall muscle tone.
Surgery for sciatic nerve pain is usually reserved for cases where there is extensive nerve damage. For instance, in the case of severe disc herniation, a microdiscectomy to remove the painful fragments of the disc is recommended. However, the majority of patients find relief with conservative, non-surgical methods.
Visit an Orthopedic Specialist
If you’re experiencing lower back pain, visit the orthopedic experts at New York Bone & Joint Specialists to determine if you’re suffering from sciatica. We’ll use the latest diagnostic techniques to identify the exact cause of your aching back. After pinpointing the source of your discomfort, we can recommend an effective treatment plan to get you pain-free. Contact us today to set up an appointment.