Sciatica is the result of irritation to the nerves exiting the low back and traveling into the legs. It typically manifests as pain that starts in your lower back or buttock and radiates down your leg. Patients with sciatica may also experience numbness, a “pins and needles” sensation, muscle weakness, and reflex changes. Symptoms may be worsened by bending, lifting, twisting, sitting, coughing, or sneezing.
Conservative treatment is aimed at pain reduction. Initial treatment starts with cold packs or heat, NSAIDs (non-steroidal anti-inflammatory medications), muscle relaxants, pain medications, and alternative therapies such as acupuncture. Education about proper mechanics (bending and lifting), physical therapy, and epidural steroid injections may also help patients return to full activity.
Some patients who do not respond to non-surgical care and who experience persistent, disabling sciatica may benefit from surgery.