FAQs on Sciatica Treatment in Houston
What is sciatica?
Sciatica isn’t a disease; rather, it is a multi-symptom condition in which a person experiences discomfort and persistent pain along the sciatic nerve, right from the lower back to the buttock and legs.
As the longest nerve in the body, the sciatic nerve controls the lower leg muscles and gives sensation to legs, thighs, and feet soles. Often sciatica affects one side of the body.
What are the symptoms?
Sciatica is a condition associated with burning pain and changes in sensation in the sciatic nerve. People may experience tingling, numbness, or a pins and needles sensation that may feel like electric shock sometimes. The pain typically affects one side of the body and may also lead to weakness of the leg or foot in addition to numbness.
If the fibers that make up the sciatic nerve are damaged due to an injury, it might be the onset of sciatica. Sciatica pain may result in pain in the thigh, leg, buttock, and hip. Depending on the severity of pain, a person may not be able to walk smoothly and may limp while walking.
What causes sciatica?
Sciatica develops due to deterioration of the structures of lower spine and irritation of nerve roots in sacral spine and lower lumbar, which may be the result of an injury, degenerative joint disease, “slipped disc”, tumor, misaligned vertebrae, herniated disc, bone spur, history of improper posture, abnormality of the nervous system, or non-spinal disorders. A person with any of these conditions is likely to have a pinched nerve, which risks causing nerve inflammation and sciatica pain.
You may experience
- unpleasant feelings and pain, starting from mid-buttock to the back of leg, traveling to the knee
- lower back pain
- pain spreading from outside of the calf to the space
- electric shock-like feelings from the calf, traveling to the inner ankle and foot sole
How is sciatica diagnosed?
The Houston pain management doctor will look into your comprehensive medical history to determine your sciatica’s cause. They may recommend MRI, X-ray, CT scan, EEG, or nerve velocity tests to determine where exactly sciatica is coming from. An MRI gives a better picture of the problem area, such as herniated disk or soft tissue abnormality compressing on nerve root, compared to an X-ray that doesn’t show soft tissue. In people with concern over muscle weakness, the doctor may recommend an EMG and a nerve conduction study to see the damage to the nerve.
Diagnostic imaging may be used to rule out a tumor or cancerous growth or other serious conditions. It can be used to determine the exact cause when patients continue to experience severe symptoms and fail to respond to conservative treatment.
What is the treatment?
Bed rest for more than 24-48 hours is no longer considered beneficial in the treatment for sciatica. Today, the focus has shifted to keeping the patient active.
Nonsurgical treatments and physical rehabilitation prove greatly effective in relieving sciatic nerve pain caused by compressed nerve roots. Such treatments include physical therapy, chiropractic, and spinal decompression therapy. Medication management treatments provided by pain doctors also include epidural steroid injections.
- Over-the-counter drugs – Prescription medications include Tylenol and anti-inflammatory drugs are given initially along with muscle relaxants to reduce swelling, which is often considered a contributing factor in sciatica pain. For short-term acute pain, pain doctors often prescribe opioids. A one-time burst of prednisone may be beneficial in providing significant pain relief. Medrol Dosepak is the most commonly used prednisone; however it should be given once in a few years. The prednisone is known to cause serious gastric problem and should thus be taken along with an H2 blocker, such as Pepcid. Care must be taken to ensure that the medication is not combined with other anti-inflammatory drugs, which can cause ulcer formation.
- Epidural Steroid Injections – An epidural injection is regarded as the gold standard for sciatica pain resulting from nerve root compression or herniated disc. It involves injecting steroids directly into the affected part around the sciatic nerve to reduce inflammation that could be the cause of acute sciatica pain. Often given as part of comprehensive treatment, the steroid injections provide anti-inflammatory effect and pain relief. The injection therapy is continued only if the patient experiences some form of relief from one injection. The objective is to provide pain relief for the body, which then begins to disintegrate the soft tissue that has been compressing the nerve root.
- Alternative treatments – For most people, conservative treatment is the best way to treat sciatica. Treatment plans often vary from one individual to another, depending on the underlying cause. Chiropractic is a drug-free, non-invasive treatment alternative that helps reduce pain and inflammation while restoring spinal movement and improving function. Other forms of alternative treatment to reduce inflammation and pain include massage therapy, acupuncture, spinal decompression and physiotherapy.
All in all, over 95% of sciatica can be treated nonoperatively effectively. This may entail combination treatment with medications and interventional procedures.