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Sciatica Treatment Options

Most people with sciatica improve with self-care and do not require surgery. Once Dr. Girardi has diagnosed your condition through physical examination and imaging tests, he’ll start you on a treatment plan that will involve rest, ice packs, physical therapy, and over-the-counter pain medications. Anti-inflammatory corticosteroid injections may be used. Regular exercise is the key to preventing future flare-ups of sciatica. Here’s some more information on individual treatment options.

  • Heat/Ice: This is especially important in the initial phase of treatment. Ice or heat is applied for approximately 20 minutes and repeated every two hours. Ice and heat may be alternated, or one may prove more effective than the other.
  • Pain medications: Nonsteroidal anti-inflammatory pain relievers such as ibuprofen and naproxen are the first line of pain relief. Dr. Girardi prefers to avoid using prescription options unless absolutely necessary for short-term pain.
  • Epidural steroid injections: When a patient has severe acute pain, Dr. Girardi may offer steroid injections. These can be effective because they can be delivered into the painful area surrounding the sciatic nerve. For some patients, these corticosteroid injections can be very effective in relieving pain for up to a year. But in other patients they aren’t effective. The goal of these injections is to improve the pain so that the patient can participate in physical therapy.
  • Physical Therapy: Specific exercises can help alleviate pressure on the sciatic nerve and improve muscle strength and flexibility.
  • Spinal manipulation: Chiropractic care may help relieve pressure on the nerve.
  • Some patients find relief with massage, yoga or acupuncture. The following options are typically reserved for patients who have failed to find adequate pain relief from conservative treatments.
  • Radiofrequency nerve ablation: This is a minimally invasive procedure used to treat sciatica when it is associated with chronic back pain. The procedure involves the use of a radiofrequency needle that uses energy to heat up a small area of nerve tissue, effectively blocking pain signals from reaching the brain. This is an outpatient procedure performed under local anesthesia and typically takes about 30 minutes to an hour. This procedure is done under fluoroscopy, a live x-ray. Radiofrequency nerve ablation may provide long-lasting pain relief for individuals with sciatica, although results may vary. It is typically performed as a last resort after other conservative treatments have failed to provide adequate relief. Relief can last for months and up to 2 years. As the nerve regrows, the procedure will need to be repeated.
  • Endoscopic rhizotomy: This is a minimally invasive surgical procedure to treat chronic back and leg pain including sciatica. The procedure involves the use of an endoscope, a thin tube with a camera and light on the end, to visualize and access the affected nerve roots. During the procedure, the surgeon uses a small device to selectively cut or cauterize the nerve roots that cause the pain. This helps reduce pressure on the nerve and pain symptoms. It is typically an outpatient procedure performed under IV sedation and can offer a quicker recovery when compared with traditional open surgery. A nerve ablation is performed by a needle stick under the skin. With this procedure the surgeon sees the nerve and surgically severs it. Pain relief typically lasts up to five years. Speak with Dr. Girardi to determine if you are a good candidate for this procedure.
  • Surgery: In severe cases, surgery may be necessary to correct the underlying cause, such as surgery for a herniated disc or spinal stenosis.

How long does sciatica last?

The duration of sciatica can vary depending on the underlying cause and the severity of the condition. For some people, sciatica may resolve within a few days or weeks with proper treatment and self-care measures. For others, sciatica may persist for several months or even longer.

In general, the quicker the underlying cause of the sciatica is addressed, the sooner symptoms are likely to resolve. If the underlying cause is not treated, sciatica may become a chronic condition and continue to cause discomfort.

At a Glance

Dr. Federico Girardi MD

  • Triple fellowship-trained spinal surgeon
  • Performs over 400 spinal surgeries per year
  • Professor of orthopedic surgery at Cornell University
  • Learn more

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