Sciatica generally refers to an inflammation or “pinching” of the sciatic nerve by a herniated disc, misaligned vertebrae, bone spur or degenerative changes. Symptom varies in intensity and pattern but often comprises of painful leg with well-defined areas of numbness and tingling. In severe cases, it may lead to weakness and altered gait or balance. Sciatic pain may or may not be associated with low back pain.
Sciatic pain can develop virtually in any age but is more common in young to middle age adults as a result of herniated disc or in older population due to degenerative causes. Timely evaluation, including detailed history, physical examination and appropriate tests can help determine what is the precise reason for this painful condition and help prevent progressive debilitating consequences.
Most sciatica pain syndromes do resolve within 4-8 weeks with the appropriate rest and non-surgical management. Certainly a goal of treatment at Tufts Medical Center in downtown Boston, MA is patient education and an understanding of a home program to best prevent recurrence. The goal of treatment is to decrease the inflammation or nerve pressure that will then decrease pain and improve function.
Activity modification, improved body mechanics, correct lifting/bending techniques and ergonomic corrections are strongly recommended in those suffering from this condition to prevent worsening of condition. When appropriate, traction unit and inversion table may reduce sciatic symptoms. In terms of treatments, a back brace may be offered for comfort in the acute phase of the disease. Pain relief can be achieved by means of over-the-counter medications, muscle relaxants, prescribed pain medications and at times steroids. Physical therapy exercises can improve function and in many cases reduce pain, Patient’s often gain knowledge regarding ergonomic consideration, body mechanics and lifting techniques while going through the PT program.
Minimally invasive spinal procedures can be safe and effective method of controlling pain and speed up recovery. This includes image guided Epidural steroid injections and selective nerve blocks. These can be repeated periodically to achieve desired analgesia. Subsets of patient’s are good candidates for non surgical minimally invasive percutaneous disc removal to relieve leg pain.
If less invasive treatment option fails to improve symptoms , or there is surgery. Though rarely an immediate suggestion, there are infrequent circumstances when surgery needs to be done emergently.For patients whom fail to improve with conservative care or if they develop progressive neurologic and functional deficits, Surgical options including Laminectomy /Microdiscectomy and when clinically indicated instrumentation should be considered.
Programs + Services
Explore the Chronic Pain Program in the Neurology Center at Tufts Medical Center in Boston, and learn more about our treatment for neurological pain.
The Interventional Spine Care Program in Boston at Tufts Medical Center offers specialized treatments for neck pain, headaches, lower back pain and sciatica.