Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.
Epidural injections (ESI)
This procedure involves injecting a medication into the epidural space where the actual irritated nerve root is located.
This injection includes both a long-lasting steroid and a local anesthetic. The injection reduces the inflammation and irritation and the anesthetic works to interrupt the pain-spasm cycle and nociceptor (pain signal). The combination medicine then spreads to other areas of the spine, reducing inflammation and irritation.
This sciatica treatment usually takes less than 15 minutes. The biggest benefit to this treatment is the rapid relief patients often experience. While this relief is temporary, it can allow them to begin other treatments, such as exercise and physical therapy, that they were unable to do before.
Watch the following video to learn more about this procedure.
Trigger point injections (TPIs)
These can be an effective treatment for muscle spasms that lead to sciatica.
The procedure involves injecting a local anesthetic and steroid into a trigger point. Performing a piriformis injection can be considered a type of TPI.
Disc decompression
With this procedure, a needle is inserted through the skin into the affected disc. Disc material is suctioned out of the bulging disc and pressure is relieved within the disc.
This treatment is best combined with strengthening exercises to prevent further injury.
Spinal cord stimulation (SCS)
For this sciatica treatment, an implanted electrical device can decrease the perception of pain by interrupting pain signals being sent to your brain. Your doctor will perform a short trial procedure to see if this device will help you long-term.
In the initial trial, your pain physician places a small electrical lead through a needle in the epidural space. A tingling sensation will replace your pain signals. If this does manage your pain, you may opt to have your doctor implant a permanent SCS device.
Physical therapy
Physical therapy helps improve symptoms of sciatica by increasing flexibility, range of motion, posture, while also improving muscle strength.
This type of therapy is an excellent treatment approach when done alongside other complementary treatments. For example, you may take pain-relieving medications for short-term pain while also undergoing physical therapy to resolve the underlying cause of your sciatica.
Deep tissue massage
Sciatic massage of tender areas may help relieve muscle spasms or contractions and improve the discomfort associated with it.
Massage as a sciatica therapy can also help you relax, decreasing stress and tension.
Nutrition and exercise
Exercise can reduce the pain of sciatica by increasing flexibility and range of motion. Another benefit of regular exercise is the release of hormones called endorphins, which are your body’s natural pain relievers. Yoga and Pilates are both good introductory practices you can modify to your comfort level.
Nutrition and healthy eating are powerful treatments that combat nutritional deficits and control inflammation. In combination with one another, changes to diet and exercise can offer profound sciatic pain relief.
Biofeedback
This is a treatment that teaches you how to become aware of involuntary processes inside of the body (such as blood pressure, temperature, and heart rate control).
This method enables you to gain some conscious control of these processes, which can influence and improve your level of pain. A better awareness of one’s body teaches one to effectively relax, which can help to relieve pain.
Acupuncture
With this ancient Chinese therapy, small needles are inserted into your skin. These needles cause your body to release hormones called endorphins, which are your body’s natural pain relievers.
Acupuncture can also help you relax, decreasing stress, tension, and muscle spasms.
Transcutaneous electrical stimulation (TENs)
This pain relief technique is a passive process with no known side effects. Your doctor places patches on your skin in the affected area. These patches deliver a mild electrical current that interrupts the pain signals to the brain. A tingling sensation replaces those pain signals that typically reach your brain.
TENs unit therapy may help to:
Infusion techniques
This procedure involves inserting a small catheter through a needle into the epidural space or directly next to affected nerves.
Local anesthetic and other medicines are often given through the catheter for extended time periods. When the nerves are blocked continuously with an infusion, pain relief can be dramatic and long-lasting.
