Fortunately, most cases of sciatica caused by disc herniations will heal given sufficient conservative treatment, time and rest. Approximately 80% to 90% of patients with sciatica improve over time without surgery. Resolution of symptoms typically occurs in 4 to 6 weeks.
Initial forms of conservative treatment include the following
- Apply cold to the middle of the back
- Apply heat to soothe painful muscles
- Be as active as possible while avoid bending, lifting, or sitting in a soft, low chair. Any of these activities can actually make the pain worse.
- Over-the-counter anti-inflammatory medication such as ibuprophen or aspirin to help ease the pain.
- Lie down on your back on a firm mattress. You may want to prop your feet under a pillow to ease the tension on your back. If this position doesn’t work, try lying on your side.
- Take it easy but avoid staying in bed for longer than two days. Too much bed rest can actually be detrimental to your recovery. Also, participate in light activities only. Let pain be your guide to how much you are able to do.
- Spinal injection
- Stretching exercises, short walks and physical therapy.
Goal of non-surgical treatment: Aimed at helping you manage your pain without long-term use of medications.
- If conservative methods fail to relieve your pain within 4 to 6 weeks, consult your physician.
- X-rays and possibly a magnetic resonance imaging (MRI) exam may be obtained to determine the exact cause of the pain.
- If a disc herniation is determined to be the cause of the pain and conservative treatment has not helped the symptoms, additional treatment is available, including an epidural lumbar steroid injection and possibly surgery (laminotomy with discectomy).
If your symptoms include severe weakness in the leg(s), loss of bowel and/or bladder control, intractable pain, unexplained significant weight loss, and/or fevers, you should call the doctor immediately or go to the emergency room to be evaluated.
Who qualifies for surgery?
If a disc herniation is determined to be the cause of the pain and conservative treatment has not helped the symptoms.
Recovery
- Exercises to strengthen your back.
- Walk and move as much as possible while limiting too much bending or twisting.
- It is acceptable to perform routine activities around the house, such as cooking and cleaning.
Outcomes
- Following treatment for sciatica, you will probably be able to resume your normal lifestyle and keep your pain under control. However, it is always possible for your disk to rupture again.
