What You Need to Know about Sciatica and Back Pain
Bryan Oh, MD – Neurosurgical Spine Surgeon
Sciatica is the term used to describe painful, electric-shock-like sensations that shoot down the leg of the person experiencing it. One of the most common causes of sciatica is a pinched sciatic nerve in the lumbar spine. Similarly, a different nerve in the same region may not necessarily be pinched but can become inflamed because of constant stress or irritation. A Sciatica response can result from this occurrence as well. Finally, the sciatic nerve itself may be compressed or irritated by a muscle in the area. This too could lead to sciatica. To figure out the cause of one’s sciatica (and the best treatment for it), an individual should consult a spine specialist.
Depending on the cause, a spine health expert may recommend any one or combination of the following Sciatica treatment options:
1) Physical Therapy.
This is one of the most conservative Sciatica treatment modalities. A primary goal of this treatment is to increase one’s core strength. Once core strength is improved, a person’s posture and overall body mechanics are much better suited to decrease lumbar spinal nerve compression. A proper physical therapy treatment course typically lasts about 6 weeks and involves roughly 2-3 sessions per week.
2) Chiropractic Adjustments.
As noted above, a pinched nerve in the lumbar spine is one of the most common causes of sciatica. Treatment with chiropractic adjustment endeavors for the chiropractor to adjust or re-align the spine in order to take the compression off of the pinched nerve. Several adjustments over the course of weeks are often needed to achieve optimal results. Chiropractic adjustments are often paired with physical therapy and massage therapy to achieve optimal Sciatica treatment success.
3) Massage Therapy.
Massage therapy, or manual therapy, is designed to release knots and decrease muscle tightness and tension. When a person suffers from sciatica, he or she often tightens muscles around the source of the compression as a guarding mechanism against the pain. This increased tautness can often make the problem worse. Massage therapy is used to release knots and toxic metabolites such as lactic acid from injured or tight muscles around a compressed nerve. As with physical therapy and chiropractic adjustments, this Sciatica treatment is usually provided over the span of several weeks.
4) Spinal Decompression.
If the cause of a patient’s sciatica is a compressed nerve in the low back, one of the main goals of treatment would be to manually decompress the nerve. Non-surgical spinal decompression can be achieved by using a highly specialized, non-invasive spinal decompression table. During this Sciatica treatment, a specific spinal level is targeted. With a patient’s precise body dimensions taken into consideration, a treatment plan is developed to decompress the nerve root. This treatment is far more precise and effective than inversion tables, which cannot be designed to target a particular level in the spine. Non-surgical spinal decompression is optimally achieved with a series of treatments that spans the course of several weeks.
5) Epidural Steroid Injections.
As referenced above, a spinal nerve that is inflamed or irritated often leads to Sciatica. Steroids are designed to significantly decrease inflammation of tissues including nerves. In performing an epidural steroid injection, a specialist uses x-ray guidance to deliver the steroid medication to the space around a particularly inflamed nerve. Over the course of a few days, the inflammation diminishes, and an individual’s Sciatica symptoms decrease as a result. This is a minimally invasive, outpatient Sciatica treatment. The benefit from epidural steroid injections can last up to several months and they can be repeated up to 3-4 times per year if necessary.
6) Stem Cell Therapy Injections.
Stem cell therapy injections can be used as a cutting edge treatment for Sciatica. While the exact mechanism for how this works is still under intense investigation, stem cells are thought to act as a “super anti-inflammatory.” Stem cells are delivered to a patient in a manner very similar to an epidural steroid injection. It is an ultra minimally invasive treatment that is outpatient. Individuals who have undergone this treatment have reported relief from pain for more than a year. At BASIC, we have a proprietary stem cell product that has helped numerous patients achieve relief from Sciatica pain.
If Sciatica is caused by a damaged disc that is pinching a nerve in the lumbar spine, Microdiscectomy surgery may be the most direct treatment option. In this minimally invasive procedure, a surgeon directly removes the disc fragment that is pinching the nerve. Usually an outpatient surgical procedure, this Sciatica treatment is usually employed if all other conservative treatment options have failed to provide an individual with optimal relief from Sciatica pain and associated symptoms.