How do you get rid of chronic sciatic nerve pain?

It is advisable to treat sciatica as early as possible in order to avoid the progression of symptoms. Sciatica treatment may include both nonsurgical and surgical methods. Typically, nonsurgical methods are tried first. Surgery may be indicated when the underlying cause is severe and/or progressive neurological deficits such as leg weakness occurs.

Nonsurgical Treatment for Sciatica

First line treatments of sciatica typically include some combination of physical therapy, medications, therapeutic injections, and alternative therapies.

Acute sciatica usually gets better with 4 to 6 weeks of nonsurgical treatment. For chronic sciatica with pain lasting over 8 weeks, treatment time may take longer and may depend on the underlying cause. Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/. , Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.

Annals of Internal Medicine: "Epidural Corticosteroid Injections in the Management of Sciatica: A Systematic Review and Meta-analysis."

Barking, Havering and Redbridge Hospitals: "Sciatica."

BMJ: "Drugs for Relief of Pain in Patients with Sciatica: Systematic Review and Meta-Analysis."

Cochrane.org: "Advice to Rest in Bed Versus Advice to Stay Active for Acute Low-Back Pain and Sciatica."

Cleveland Clinic: "Sciatica and Leg Pain," "Sciatica: Management and Treatment."

Hospital for Special Surgery: "Sciatica."

International Journal of Yoga: " Effectiveness of Iyengar Yoga in Treating Spinal (Back and Neck) Pain: A Systematic Review."

Sciatica is the type of pain that originates in your lower back and typically radiates down one or both of your legs. It results from the inflammation of the sciatic nerve in your lower back. The medical term for sciatica is lumbar radiculopathy: pinching of a nerve as it exits the spine.

Surgery is one of the treatment options for sciatica, but it's not for everyone. Below are some important questions to consider before making your decision.

1. Do you know what causes your sciatica?

   Sciatica may have a variety of causes, each of them requiring a slightly different treatment. Whether or not surgery would get rid of your sciatica will depend on why the sciatic nerve is inflamed in the first place. Possible reasons may include:

   • A herniated disc in your lower back
   • Spinal stenosis – narrowing of the space inside the spinal canal
   • Spondylolisthesis – slipped and misaligned vertebrae
   • Degeneration of the spine due to wear and tear, which may result in bone spurs (areas of extra bone growth)
   • A cyst or a tumor in the spine

   Although most of these causes can be addressed with surgery, it is rarely the first line of treatment. The type of surgery would depend on the problem.

   In addition, sciatica-like pain may result from irritation of the sciatic nerve by the piriformis muscle in the buttock. This condition is called piriformis syndrome and rarely requires surgery.

2. How is sciatica affecting your quality of life?

   Sciatica pain may extend all the way from the lower back, through the back of your thigh, to your foot. The pain can come and go, sometimes lingering for days and even weeks. This may cause anything from mild discomfort to making the simplest tasks intolerable. Sitting could be painful with sciatica — and driving even more so. Not to mention playing sports and being active.

   As you contemplate surgery for sciatica, consider how much the pain affects your quality of life. If your work, hobbies, social life or relationships suffer from your being in constant pain, it may be time to think about surgery.

   Although sciatica starts as nerve inflammation, it may eventually progress to nerve damage. If the sciatic nerve is damaged, it could result in numbness, tingling and, in more severe cases, weakness in the knees or legs. The longer it is left untreated, the longer it will take for numbness and weakness to go away, and they may become permanent.

3. Which treatments have you already tried?

   There are several ways to manage sciatica without surgery, depending on the cause. They may include pain relief medications, steroid injections, physical therapy, aquatic therapy, meditation and nerve blocks, among others. What works for one person may not be as effective for someone else.

   There are several types of doctors who treat sciatica pain. If you feel like you have exhausted your options with your primary care physician, consider making an appointment with a rehabilitation physician or a pain medicine specialist before calling a surgeon. Because every person experiences pain differently, it often takes working with the right specialist to find the combination of treatments that works for you.

4. What are your goals for this surgery?

   Making a decision about sciatica surgery when you are in a lot of pain can be tough. Be sure to discuss with your surgeon the post-surgery goals, especially those around pain and activity. Are you expecting to go back to work and the gym in a week? Are you hoping the pain will be gone entirely and for good?

   Although most people experience up to 90 percent improvement in their pain levels after a sciatica surgery, no doctor can guarantee this. Numbness may still be present after the surgery, and there is always a chance of sciatica coming back at another vertebra.

   Depending on the type of sciatica surgery, most people are walking the next day, and full recovery typically takes two to four weeks. Minimally invasive surgery usually means faster recovery, but if the surgery involves more than one vertebra or disc, your back may take longer to heal.

5. Do the benefits outweigh the risks?

   Like most surgeries that require general anesthesia, sciatica surgery comes with the risk of blood clots and heart attack. Infection is also a risk with most surgeries. And since this particular operation involves tissues around a nerve, nerve injury is a possibility.

   In addition to the general surgery risks, there may be risk factors specific to your background, lifestyle or state of health. Doctors call them comorbidities. They may increase your risk during the surgery or affect how successful the surgery is in relieving your sciatica pain. Studies have shown that factors such as smoking, high blood pressure, diabetes and duration of the sciatica pain before surgery may affect the outcome of the procedure.

   If you are seriously considering sciatica surgery, it's important to partner with a surgeon who would look beyond your physical symptoms and help assess many other factors that may influence your decision.

   How do I get my chronic sciatic nerve to stop hurting?

   Lifestyle and home remedies.

   Cold packs. Place a cold pack on the painful area for up to 20 minutes several times a day. ... .

   Hot packs. After 2 to 3 days, apply heat to the areas that hurt. ... .

   Stretching. Stretching exercises for the low back might provide some relief. ... .

   Medications..

   What do you do if your sciatic nerve won't go away?

   If home remedies are not helping, and your pain is prolonged or worsening, you should see a doctor. Specifically, consult a doctor if: Sciatica lasts longer than three months. Sciatic pain is severe and interferes with daily activity.

   Can you permanently get rid of sciatica pain?

   Many cases of sciatica will resolve on their own in a matter of weeks without treatment, but those with a deeper underlying cause will require proactive treatment to cure sciatica permanently.