When the cause of sciatica is due to a prolapsed or lumbar disc herniation 90% of disc prolapses will be resolved with no intervention.
Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.
Cases of sciatica are treated with different measures. Evidence of the effectiveness of these measures is limited, however. Some of these measures are:
- Anti-inflammatory medications (e.g., NSAIDs or oral steroids. However, NSAIDs are no more effective than placebos for acute sciatica)
- Paracetamol (acetaminophen): limited evidence of effectiveness
- Narcotics: often used if pain is severe
- Physical therapy / Stretching exercises
- Epidural steroid injections provide no long-term improvements in outcomes but do provide some short-term benefits
- Non-surgical spinal decompression
- Massage therapy
- Chiropractic Adjustments
- Weight loss reduces pressure on Spinal nerve roots
Surgery speeds the resolution of pain. Two years after surgery, however, surgical and non-surgical management have about the same results; so a patient's preference can be a valid reason to choose one or the other.
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