What are the types of surgeries that are used to treat sciatica?

Surgery options for sciatica include:

  • Discectomy or microdiscectomy: Both these involve the removal of all or part of the disc that is herniated and pushing of the nerve leading to symptoms. The difference between these is that microdiscectomy uses the microscopic magnification and works through a small cut or incision that uses small instruments. The recovery is quick in microdiscectomy.
Laminectomy or laminotomy: This involves lamina – a bony plate that safeguards the spinal cord and the canal. The former involves the removal of the entire lamina, while the latter removes just a part of it. This creates more space for the nerves, thus saving it from being compressed or pinched.

Is spine surgery ever necessary to treat sciatica?

Sometimes yes. But, most of the patients don’t need surgery, and in them, sciatica can be cured using simple procedures. The non-surgical methods are tried initially and depending on the pain and your ability to tolerate it, your doctor will decide about surgery.

Even after trying the other methods, if the symptoms do not get better, or your legs weaken, then the doctor may advise for a surgery. The procedure is called lumbar microdiscectomy, which is known for its positive results.

A lumbar microdiscectomy is like a traditional lumbar discectomy. Small incisions are made, thanks to technological advances, and these will cause minimum trauma to the body and will pave the way for a quicker recovery.

If someone has had sciatica, is it likely to recur?

This depends on the level of damage caused to the spinal disc. The more damage your disc that caused your sciatica for the first time, the more the chances of recurrence. However, the likeliness of recurrence is based on a lot of other factors too. Continuing to work in an environment that demands a lot of physical work can also increase the risk of recurrence.

Which healthcare specialties treat sciatica?

Depending on the various parts involved, the healthcare specialists that treat the condition can range from generalists to sub-specialists.

They may include:

  • General medicine
  • Family medicine
  • Internal medicine
  • Gynecology
  • Neurosurgery
  • Physiatry
  • Orthopedics
  • Rheumatology
  • Pain management

Alternative healthcare providers for sciatica pain may include:

  • Massage therapist
  • Physical therapist
  • Psychologists
  • Chiropractors
  • Acupuncturists

When do sciatic symptoms indicate a medical emergency?

Cauda equina syndrome, which can be caused by the dysfunction of bowel and bladder functions, continuous weakness of legs, and saddle anesthesia, is quite serious and calls for immediate medical attention. Saddle anesthesia is the numbness or paralysis in the butt. This is a warning sign of something serious. Saddle anesthesia, along with the disrupted bowel and bladder functioning, is a medical emergency.

When should I seek professional care for Sciatica?

It can be quite difficult to diagnose Sciatica on one’s own. Hence, it is imperative to seek the help of a medical professional.

Call your doctor if you experience any of the following:

  • If the pain isn’t improving  after several days
  • If the pain seems to be getting worse
  • If you are <20 years or >55 years, and experiencing sciatica for the first time
  • If you have cancer or a history of cancer
  • If you had lost a more pounds recently
  • If you have unexplained chills and fever along with back pain
  • If you are HIV positive or using IV drugs
  • If you have trouble bending forward for over a week or two
  • If you can notice weakness is getting more pronounced over the passage of time

Go to an emergency department if you experience any of the following:

  • If the pain is unbearable, in spite of trying first aid
  • If your pain has followed a violent injury
  • If the pain is in the back of your chest
  • If you are unable to move or feel your legs or feet
  • If you have lost control of your bowels or bladder or have numbness in your genitals.
  • If you have a high temperature (>101 F).

Is it possible to prevent sciatica?

Sciatica may or may not recur, and prevention is not always possible. But you can always protect your back using the following methods:

  • Special attention needs to be paid to the core muscles to keep the back strong. For proper posture and alignment, the abdominal and lower back muscles are important. You can request your doctor to suggest specific exercises.
  • It is very important to maintain proper posture while being seated. Lower back support, armrests, and a swivel base are to be looked for in a seat. You could place a cushion or a rolled towel behind you to maintain the normalcy of the curve. The knees and the hips must be on the same level.
  • To correct your bad posture or to keep up your good posture, you can use a “posture corrector brace.”
  • It is important to follow good body mechanics. After long hours of standing, rest the feet on an elevated surface. While lifting something heavy, make sure that the lower part does the work. The back must be straight, and only the knees must be bent. The load must be held close to the body. Do not lift and twist at the same time. Do not lift the weight alone if it is too heavy.

Can sciatica cause any complications?

It is a very occurrence that sciatica causes complications. But, in case it happens, it can include:

  • Irreversible damage to nerves
  • Permanent numbness and weakness in the affected leg
  • Loss of bowel function
  • Loss of bladder function

What are the risk factors of sciatica?

The risk factors are:

  • Age: The common causes of sciatica are the age-related changes that occur in the spine. Ex: herniated discs, bone spurs, etc.
  • Obesity: Obesity is another cause as it increases the stress on your spine. Thus, it can trigger sciatica.
  • Job Nature: If your job demands you to twist the back, carry heavy objects, or drive for a long duration, this may most likely lead to sciatica but there is not much proof on this.
  • Prolonged Sitting: You are more likely to develop sciatica than active people if you sit for longer hours or lead a sedentary lifestyle.
  • Diabetes: Diabetes is a condition that changes the way the body uses blood sugar. It increases the risk of nerve damage and may cause sciatica too.

What causes sciatica?

“A pinched nerve” is a better definition for Sciatica. It affects the lower spinal nerve(s). The nerves may be pinched either inside or outside of the canal as it runs through the leg.

The common causes are:

  • Slipped disc, also known as a herniated disc, which exerts pressure on the nerve root.
  • The tiny piriformis muscle is found in the butt. It becomes tight and spasms, and exerts pressure and irritates the sciatic nerve. This is known as piriformis syndrome.
  • The narrowing of the spinal canal pressurizes the nerves. This is called Spinal Stenosis.
  • The vertebra slips and is not in alignment with the one above. This narrows down an opening. It is through this opening, the sciatic nerve exits. This is spondylolisthesis.
  • Very rarely, tumors growing inside along the spinal cord, or sciatic nerve cause sciatica. This tumor, as it grows pressurizes the nerves.
  • Sacroiliitis is the burning sensation in the sacroiliac joint(s), which is the spot where the lower spine and pelvis meet. This causes pain in the butt, lower back, and extends down to one or both legs. Prolonged standing or climbing stairs can worsen the pain. It may be caused by infection, injury, arthritis, or pregnancy.

Other reasons for sciatica could be muscle injuries, such as a fracture or inflammation. Generally, any irritation or compression on the sciatic nerves causes sciatica. Sometimes, the causes are unknown.

Can sitting on the toilet cause sciatica?

If you have the habit of sitting on the toilet for a prolonged period and read a newspaper or magazine, it can lead to sciatica pain. Leading spine specialists from around the globe say that this action can put a lot of pressure on the nerve, which can cause irritation and swelling. And, sitting on the toilet can cause this, especially if the toilet seat has a hard surface.

Most of the people tend to assume a certain pose which is called leaned forward pose. This normally worsens the situation because it adds more pressure on the nerve.

While being seated, exerts a lot of pressure on the discs. A prolonged period of sitting combined with an already existing disc abnormality can worsen the condition.

Slowly, while being seated, you will experience a shooting pain, numbness, and electric shock-like pain. If one already suffers from disc abnormality and he/she experiences pain while being seated on the toilet seat, it is strongly advised to avoid sitting for long periods on the toilet seat. In case, you must spend a long time on the toilet seat, you can provide relief to your affected leg by lifting it often.

Is bed rest good for sciatica?

Bed rest is the most common solution given for sciatica. However, keep in mind that bed rest for a long period of time can worsen the pain. Hence, when the pain seems to improve, start performing gentle movements like stretching exercises. This can also help relieve the mounting pressure over the nerve.

How do you test for sciatica?

The physical and neurological examinations will be performed by a spine specialist. The doctor will note down the movement that causes pain, the range of motion, posture, and physical condition that causes pain. He will examine the spine, its curvature, and alignment, and will check for muscle spasms.

The spine specialist will test the reflexes, muscle strength, and other nerve changes.

To find the cause of sciatica, you may have to get some imaging tests done. An X-ray or a computed tomography (CT or CAT) scan may be required. If you have a herniated disc or spinal stenosis that is leading to sciatica, the doctor might advise a magnetic resonance imaging (MRI) test.

All these together will give the doctor an in-depth picture of your sciatic nerve pain. With these, he will analyze the results and will make a diagnosis of the underlying reason for your pain.

Does sciatica get worse before it gets better?

Treatments like physiotherapy can relieve sciatica pain. However, it can aggravate the pain before alleviating it. But certainly, it will improve. Doing sciatica-specific exercises will also be needed. They are painful in the beginning and with continuity and consistency, it will get better.

What does sciatica pain feel like?

It originates from lumbar to the butt and radiates down to the back of the leg. The discomfort can be felt anywhere on the nerve path, but especially from the lower back to your butt and also at the back of your calf and thigh.

It can be mild or a piercing pain, burning sensation or extreme pain. At times, it can be like an electric shock. It worsens when the affected person coughs or sneezes. Sitting for a long time can also worsen the pain. Normally, it affects one side of the body.

Numbness, weakness, or a tingling feeling will be felt in the foot when you have sciatica. And sometimes, it might cause pain in one part and make you feel numb in another.

Where is my Sciatica?

The sciatic nerve causes a back pain, which is called as sciatica. This nerve is large and runs from lower back to the back of each leg. Injury or pressure on the sciatic nerve can cause pain in the lower back that extends to hip, butt, and legs. Recovery happens without surgery in 90% of the cases.

How can I treat sciatica naturally?

Until today, scientific backup for the claim that “any alternative treatment for sciatica will help” is lacking. Gentle exercises, yoga, and hot and/or cold packs may help soothe the symptoms. Following are the alternative therapies that may fight against sciatica pain:

  1. The Chinese needle-based therapy called acupuncture can improve the sciatica-related symptoms. This was corroborated by a study conducted in 2009.
  2. For Sciatica, chiropractic care had given mixed results. But, chiropractic care may help improve the functionality of your spine, thus reducing sciatica pain.
  3. Massaging the affected areas around the lower part of the spine, pelvis, leg, and thighs can improve the symptoms based on studies conducted.
  4. Simple stretches like lifting the leg and placing the right ankle on the left knee and vice versa can help reduce and/or eliminate the swelling and inflammation of the nerve by stretching the piriformis muscle.

Is hot or cold better for sciatica pain?

Both hot and cold packs are known to help with sciatica. Cold packs reduce the swelling that is caused by the medical condition that attributes to sciatica. It will also reduce the swelling around the nerves. Ice can numb the pain in the back and legs. A chiropractor advises applying the cold pack and removing it for 20 minutes. This should be repeated many times a day.

Heat application with moisture is good at treating sciatic nerve pain. The heat will relax stiff muscles in the legs and back. The stiff muscles may compress the sciatic nerve or may prevent the nerve pain from improving.

Does Sciatica Ever Go Away?

Sciatica is a piercing pain or inflammation in the sciatic nerve. It will normally subside in a few weeks. It is not very often that it leads to ailments which exist for a few months. The sciatic nerve is a part of the nervous system and is also the largest nerve in the body.

Sciatica pain can be either acute or chronic. Acute, as the name suggests, doesn’t last long and not much of professional treatment is needed. Over-the-counter medicines, along with cold and hot packs, can treat acute sciatica, while chronic sciatica lasts longer and requires medical attention like chiropractic help and sometimes even surgery.

The pain, in the case of sciatica, will reduce by itself. It will take around 1 to 2 months. During this time, you are advised to practice a few simple stretches and exercises, use hot and cold packs, take medicines like NSAIDs, etc.

You can get relief from the following methods:

  • Painkillers
  • SI joint belts
  • Surgery
  • Acupuncture
  • Chiropractic therapy
  • Therapeutic yoga
  • Bodywork techniques
  • Osteopathic Manipulation

How to sleep with sciatica?

A few changes and tips will help you have a good night’s sleep:

  1. A good mattress can guarantee you better sleep. A mattress is not the source of sciatic problems, but a bad mattress can worsen it. A safe and excellent option is an orthopedic bed if sciatica is giving you sleepless nights. Certain mattresses like memory foam mattresses tend to lose their form quickly and do not provide support to the spine. It is advisable to avoid them.
  2. With Sciatica, it will be relieving to have your spine, hips, and pelvis aligned. Hence a body pillow can be of great help, especially if you are sleeping on your side. If not, a normal pillow between the knees can also provide relief.
  3. If it helps, you can keep your knees at an elevated level. You can use pillows below your knees and continue adding more until you come to a comfortable position.
  4. When pillows don’t work, you can use a tennis ball too. Place it on the side you don’t want to sleep on. This will prevent you from switching sides while you sleep.
  5. Always lie on your back with knees raised above. If this is not comfortable, you can sleep in the side position
  6. It is important to train your body clock. To do this, you must got to  sleep and wake up every day at the same time. This will also result in good sleeping habits.
  7. The worst sleeping position is to lie on your stomach and turn your face towards one side. This will not just spoil the natural curvature of the spine but will also strain the neck.
  8. You can avoid unwanted suffering and strain in the neck by investing in a good quality neck pillow that is supportive. This will lead to a more comfortable sleeping position.
  9. Some of the best sleeping positions are as follows. You may try one of them as they will work well for those who suffer from lower back pain:
    1. Sleeping with a pillow between the legs
    2. Sleeping in the fetal position
    3. Sleeping with a pillow under the abdomen

Does sciatica go away on its own?

In most of the cases, home remedies and rest helps improve sciatica. If you have only mild pain that doesn’t hinder your daily activities, one of the following or a combination of the following solutions can help:

  • Physiotherapy
  • Hot packs and cold packs
  • Medicines
  • Some amount of bed rest
  • SI joint braces
  • Other alternative treatments
  • Stretches

If none of them work, surgery may be required.

Is walking good for sciatic nerve pain?

One among the several benefits of walking is that it reduces the sciatic pain. Doing it gently will give your body enough amount of cardio benefits, while also not stressing it out. It could be difficult to be slow if you had been used to a lot of weight training and running. But, it is really important to slow it down and walk on flat surfaces. The speed can vary between slow and moderate.

Walking reduces inflammation while releasing pain-killing endorphins. This will help relieve the sciatic pain. However, care must be taken because wrong or poor walking may worsen the condition. It can aggravate the sciatic nerve in particular.

How long will sciatica take to heal?

This depends on the underlying cause of the pain. Sometimes temporary sciatica is caused due to various reasons, which can last between a few days and few weeks. Sprains in the back, the lumbar spine that is degenerative, disc herniation, shingles, etc. are the common causes of temporary Sciatica. But, they may also lead to chronic illness. Some of these call for surgical assistance.

If the pain has been mild for about two months, it could be acute sciatica. For such cases, medical assistance is not normally necessary. To expedite the diagnosis process, the patient’s complete medical history is required. Some exercises that will activate the sciatic nerve will be prescribed by the doctor.

Out of the above-mentioned reasons, if the Sciatica is caused by spinal stenosis, degenerative disc disease or a herniated disc that pressurizes the spine nerves, there are more chances that they turn into something chronic. Physiotherapy can cure both cases of sciatica as it will help strengthen the core and muscles around the hip, and help stretch the low back, hamstrings, and the butt to reduce the stiffness.

How do I get my sciatic nerve to stop hurting?

Normally, resting for a while provides relief to the people with sciatic pain. Once it starts aching, rest immediately, but not for too long since the absence of activity for a long time can also worsen the situation.

For temporary relief, use hot packs or cold packs. The following exercises  can help alleviate the pain:

  • Reclining pigeon pose
  • Sitting pigeon pose
  • Forward pigeon pose
  • Knee to opposite shoulder
  • Sitting spinal stretches
  • Standing hamstring stretches

Common medicines like ibuprofen or aspirin can help reduce inflammation and/or swelling and to some extent, can reduce the pain too.

To remove the discomfort and pain in the area around your hips, a SI joint belt can be used. It provides support and stability to your hip joints.

If the symptoms don’t seem to respond to self-medication or in case, the pain is only worsening, consult a doctor. Some of the commonly prescribed medicines are anti-inflammatories, antidepressants, medications to relax muscles, anti-seizure, and in rare but severe cases, narcotics.

Physiotherapy may also be suggested but only after the symptoms improve. This can prevent the pain in the future as it will strengthen your core, as well as, your back muscles.

Steroid dosage may also be suggested depending on the severity. This can calm down the nerves and inflammation. Due to side-effects, the dosages are limited.

The last resort is surgery, but only in the cases where the pain hasn’t got better. Also in case of bowel or bladder control, surgery is seen as an option.