Sciatica

Staying active is one of the best things you can do for sciatica. Movement helps reduce inflammation and stiffness. While resting for a day or two might help during a pain flare-up, staying in bed too long can weaken your core muscles and make pain worse.

Try to stay as active as your pain allows. Gentle stretches, short walks and low-impact activities like swimming or using a stationary bike can help.

Other helpful at-home tips include:

• Using hot or cold packs to ease pain
• Practicing good posture when sitting or standing
• Avoiding heavy lifting or twisting movements
• Sleeping on a firm mattress with a supportive pillow

Several types of medicine can help manage discomfort while your body heals. Your doctor may suggest:

• Over-the-counter pain relievers: Medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin or naproxen, can reduce pain and inflammation.
• Nerve pain medications: Anti-seizure medicines and certain antidepressants, which are available by prescription, can lessen nerve pain.
• Corticosteroids: Spinal injections or pills may help pain that doesn’t get better with other pain relievers.

Always talk to your healthcare provider before starting any new medication, especially if you have other health conditions or take other prescriptions.

Physical therapy is an effective way to treat sciatica, especially if your symptoms last more than a few weeks or keep coming back. A physical therapist will work with you to create a personalized treatment plan that targets the source of your pain and helps you move more comfortably.

Your plan may include:

• Stretching and strengthening exercises to ease pressure on the sciatic nerve and support your lower back
• Posture training to help you sit, stand and move in ways that protect your spine
• Manual therapy and other techniques like heat, ice or electrical stimulation to reduce pain and improve mobility
• Everyday movement tips to help you safely return to your normal activities

With regular sessions and home exercises, physical therapy can help you feel better, move more comfortably and lower your risk of future flare-ups. Your primary care provider can help you get started with a referral.

Some people find relief with integrative therapy, especially when used along with other care options. These alternative therapies may include:

• Chiropractic care: Spinal adjustments may help relieve pressure on the sciatic nerve
• Acupuncture: Inserting very fine needles into specific areas of the body may help reduce nerve pain
• Massage therapy: Targeted massage can ease muscle tension and improve circulation
• Yoga or gentle movement classes: These can help improve flexibility and core strength in a low-impact way

Always talk to your doctor before trying alternative therapies to make sure they’re safe for you.

Surgery is usually considered only when other treatments haven’t worked, and your discomfort is severe, long-lasting or affecting your ability to function. If you’ve had symptoms for more than three months without relief, your doctor may recommend surgery based on the cause of your sciatica. Your doctor will talk with you about the risks and benefits of surgery based on your health and the cause of your symptoms.

Two common procedures for sciatica include:

• Discectomy: This surgery removes part or all of a herniated disc that’s pressing on a nerve. It’s often done through small incisions using minimally invasive techniques, which usually means a shorter recovery time. In some cases, a discectomy may be combined with a laminectomy.
• Laminectomy: This procedure involves removing part of the vertebral bone (called the lamina) or bone spurs to relieve pressure on spinal nerves.

Minimally invasive surgery for sciatica involves techniques that ease pressure on the sciatic nerve using smaller incisions compared to other standard open procedures. By limiting disruption to surrounding tissues, this method may lessen discomfort, shorten recovery time and help you resume daily activities sooner.