How Do Doctors Treat Severe Sciatica?

Treatment Options for Severe Sciatic Nerve Pain

Sciatica is a condition that causes pain, numbness, tingling, or weakness in the lower back, buttocks, legs, or feet. It is caused by the compression or irritation of the sciatic nerve, which is the longest and thickest nerve in the body. The sciatic nerve runs from the lower spine, through the pelvis, and down the back of each leg.

Sciatica can range from mild to severe, depending on the degree of nerve compression and inflammation. Mild sciatica may improve with home remedies, such as over-the-counter pain relievers, ice packs, heat therapy, gentle stretching, and avoiding prolonged sitting or standing. However, when sciatica is severe, the pain and other symptoms are so intense they interfere with daily activities and quality of life. Severe sciatica may also be accompanied by serious complications, such as loss of bladder or bowel control, loss of sensation or movement in the affected leg, or infection or inflammation of the nerve.

How do doctors treat severe sciatica? The answer depends on the cause and duration of the condition as well as the patient’s overall health and preference. This article explores the condition’s causes, symptoms, and various treatment options available.

Common Causes and Symptoms

Before exploring treatment options, it is essential to understand the common causes and symptoms of severe sciatica:

• Herniated disc – One of the most frequent causes of sciatica is a herniated or slipped disc in the lumbar spine. When the gel-like center of a spinal disc pushes through a tear in the outer layer, it can press on the adjacent nerve roots, leading to sciatic pain.
• Spinal stenosis – This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerve roots, leading to sciatica.
• Spondylolisthesis – When one vertebra slips forward over another, it can pinch the nerves in the lower back and cause sciatic pain.
• Piriformis syndrome – The sciatic nerve can be compressed or irritated as it passes through the piriformis muscle in the buttocks.

Medications

Doctors may prescribe different types of medications to relieve pain and inflammation, reduce muscle spasms, improve nerve function, or treat underlying infections or conditions. Some of the medications that may be used for severe sciatica are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) – These include ibuprofen, naproxen, and aspirin. They can reduce swelling and pain in the nerve and surrounding tissues.
• Corticosteroids – These drugs, such as prednisone and methylprednisolone, can suppress the immune system and reduce inflammation in the nerve. They may be given orally or by injection into the spine.
• Opioids – Codeine, hydrocodone, and oxycodone are strong painkillers that can ease severe pain that does not respond to other medications. However, they have a high risk of addiction and side effects.
• Anticonvulsants – Drugs such as gabapentin, pregabalin, and carbamazepine can stabilize the nerve impulses and reduce pain and tingling sensations in the nerve.
• Antidepressants – Medications such as amitriptyline, duloxetine, and venlafaxine can increase the levels of certain brain chemicals that regulate pain signals and mood. They can also improve sleep quality and reduce anxiety and depression.

Physical Therapy

Doctors may recommend physical therapy to improve the strength, flexibility, and posture of the spine and muscles that support it. Physical therapy can also relieve pressure on the nerve and prevent further injury. Physical therapy may include exercises, stretches, massage, heat or cold therapy, ultrasound, electrical stimulation, or traction.

Injections

Doctors may use injections to deliver medications directly into the affected area of the spine. Injections can reduce inflammation and pain in the nerve and surrounding tissues. Some of the injections that may be used for severe sciatica are:

• Epidural steroid injections (ESIs) – A corticosteroid and a local anesthetic are injected into the space around the spinal cord (epidural space). ESIs can reduce swelling and pain in the nerve for several weeks or months.
• Selective nerve root blocks (SNRBs) – A local anesthetic and a steroid are injected into a specific nerve root that is causing pain. SNRBs can help doctors diagnose and treat the source of pain in the nerve.
• Facet joint injections (FJIs) – A steroid and a local anesthetic are injected into a small joint between two vertebrae (facet joint). FJIs can reduce inflammation and pain in the joint that may be contributing to sciatica.

Surgery

Doctors may recommend surgery when patients are in the last stages of sciatica, when other treatments fail to provide relief, or when there are serious complications that threaten the function of the nerve or spinal cord. Surgery can remove or repair the cause of sciatica, such as a herniated disc, a bone spur, a tumor, an infection, or spinal stenosis. Some of the surgical procedures that may be used for severe sciatica are:

• Microdiscectomy – The surgeon makes a small incision in the back and uses a microscope and tiny instruments to remove part or all of a herniated disc that is pressing on the nerve.
• Laminectomy – The doctor removes part or all of a bony arch (lamina) from a vertebra to create more space for the nerve and spinal cord.
• Foraminotomy –The surgeon enlarges an opening (foramen) between two vertebrae where a nerve root exits to relieve pressure on it.
• Spinal fusion – The doctor joins two or more vertebrae together with bone grafts or metal rods to stabilize the spine and prevent movement that may irritate the nerve.

Severe sciatica can be a debilitating condition that affects your daily life, but with the right treatment, relief is within reach. The best treatment for each patient depends on his or her individual condition and situation. Therefore, it is important to consult a doctor before starting any treatment and follow his or her advice and instructions.

Patients who have had discectomies for herniated discs may experience sciatica if their discs become reherniated, which often occurs if there is a large hole in the outer ring of the disc after surgery. Fortunately, there is a new treatment shown to reduce the risk of reherniation by closing the hole in the disc after a discectomy. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. Barricaid was proven 95 percent effective in a study of over 500 patients, meaning 95 percent of patients did not experience a reoperation due to reherniation in the two-year study timeframe.

To learn more about the Barricaid treatment, ask your doctor or contact us at 844-705-1081.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.