Sciatica treatment – the best approach?

Many patients suffer significant sciatica pain and are looking for the most effective sciatica pain relief. But is sciatica nerve relief possible? Well there are ways to get sciatica relief and here we explain how. The best approach to sciatica treatment is usually varied and can be quite different between patients.

It should include some key components:

Firstly rule out anything more serious. We call them red flags but your physiotherapist is trained to spot them and refer you to a specialist if required. This includes cauda equina syndrome where the  pressure is not on the sciatic nerve but the spinal cord. This produces a range of symptoms that we must look out for. Usually this is not the case but it is something less well trained healthcare professionals may not do. We teach you what symptoms you must report immediately and how to respond. But remember these are rare and not related to the amount of pain you feel. If you are concerned then watch this video.

Diagnose the problem as sciatica. As discussed previously there are other possible options such as referred pain for example. This means that the sciatic nerve may bot be responsible for the pain in your leg. So identifying the source of the pain is possible through assessment and only occasionally do we to refer to a specialist for an MRI scan.

Monitor the progression or change of symptoms. If pressure on the nerve worsens then we need to know about it so we check the reflexes, power and sensation fairly regularly and ask you to report any changes you notice. Regular monitoring as well as sciatica treatment and sciatica pain relief are key to help you to understand what is happening and manage the symptoms from the sciatic nerve.

Reassurance and education are key management components for sciatica pain relief. We understand it can be worrying and distressing the nerve pain can be. Most patients have never felt pain like it (not even childbirth can come close in some cases), so having a clear understanding and plan of action helps you recover. Patients with significant sciatic nerve pain are often and understandably very anxious. It can take a long time to run its course and this guidance from the physiotherapist is a key component to a full recovery.

Pain medication for sciatica nerve relief is quickly found to be helpful but not to the degree many patients thought. It is not killing the pain from the sciatic nerve but can help create some relief from the severest symptoms. But it is not a cure! Pharmacists and GP’s are the experts here, but your physiotherapist should be able to explain the choices of medication made and help you to decide when modifications may be necessary.

Referral to a specialist for an MRI Scan or to a surgeon is required in some sciatica treatment plans. This is the rarest form of treatment as most cases are managed by the physiotherapist and GP partnership. If it is required we have great links with The Edinburgh Clinic  and can organise a scan for you or to see one of their specialists.

But what does the physiotherapist actually do to treat the sciatica!

Sciatica physiotherapy treatment can be varied depending upon each patients presentation

Key components:

• Positioning the spine to effect pain relief is important, there will be positions and postures which provoke the pain and those that relieve it to some degree. Finding these for you and explaining how to use them puts you in greater control. These positions and postures are required short term to give sciatica relief. Longer term we need to make sure you do not become too tense or posture driven. Your body should be able eventually to do everything it wants to do and that includes bending and twisting as normal!

• Mobilisation/Manipulation (small movements of the spine) performed by your physiotherapist can help reduce pain and prevent stiffness. This treatment can help some sciatica sufferers quite quickly but true sciatica takes more than one quick manipulation to sort.

• Exercise rehabilitation – some exercises will help to relieve sciatica nerve pain and promote your recovery. In terms of sciatica treatment this component is key to a full functional recovery and return to your normal sports and activities. They may be very specific or in some cases the advice might be quite general but the plan of action should be well thought out by the physiotherapist and implemented by the patient.

• Pain modulation – is our way of saying trying some of things which may help sciatica nerve pain control, but do not necessarily work with everyone. These include traction, acupuncture (dry needling), TENS machines, massage etc. They have little specific evidence of any curative benefit for these sciatica treatments, but some patients feel they help them with the pain and therefore to cope until the body gets back in control.

What’s the quick fix and is physiotherapy the answer?

Well there isn’t one quick fix. Most people will get better within 6-12 weeks, some may take a bit longer 3-6 months, a few may even take up to 12 months. Thankfully only a very small number develop a persistent pain condition and fail to recover.

A physiotherapist can help get your pain under control and get you back to normal function as quickly as possible. We see more sciatica patients than a GP, a surgeon or other healthcare professionals. So if you need help give us a call on 0131 478 4646 or book online.