Spine Pain Options. This pain in the distribution as you suggested is the result of an irritated nerve or facet joints or other injury typically in the lumbar spine (low back) which are caused by herniated disks, spinal stenosis or degenerative disc disease, etc requiring further evaluation by a spine specialist and may be candidate for facet injections/radiofrequency ablation and epidural steroid injections.
Traction/injections. Mechanical lumbar traction, or lumbar epidural steroid injections, are the best treatment options.
Sciatic Pain. The first step is to determine the cause of the pain. Sciatic pain will generally extend below the knee and the most common cause are disc herniations at l4-5 or l5-s1. If an MRI does not reveal a source, there are times that the sciatic nerve can be entraped as it exits the pelvis, piriformis syndrome. The history of onset and examination are key to making the right diagnosis and treatment plan.
Ok. First get evaluated to ensure you have the correct diagnosis. There are lots of things thought to be sciatica, that really are not. Without the correct diagnosis, treatments will have a lower chance of being effective. Regarding treatments, your physician will guide you through treatment. It will include nsaids, pt, home exercises, and possibly neuro-diagnostic or neuro-therapeutic injections.
Spine Pain Options. This sciatica pain as you suggested is the result of an irritated nerve or facet joints or other injury typically in the lumbar spine (low back) which are caused by herniated disks, spinal stenosis or degenerative disc disease, etc requiring further evaluation by a pain/spine specialist and may be candidate for facet injections/radiofrequency ablation and epidural steroid injections.
Options. If the pain is significant then I usually recommend an epidural cortisone injection. If that does not improve the pain and there is clear pressure on the nerve (MRI) then surgery is usually indicated.
Conservative care. Unless the disc is so large on MRI scan that nothing short of surgery will help, patients should be started on non steroidal anti-inflammatory meds, muscle relaxants, pain medications, steroids if necessary. Try pt for some time. If symptoms persist, then I agree that epidural injections and surgery should be considered.
Core Exercises. Typically core strengthening exercises are the best to help relieve pressure and forces in the spine. I would try and google some or look them up on youtube to see descriptions. If you can do them yourself, wonderful otherwise ask your doctor to get a referral to a good physical therapist for further assistance.
If epidural steroid blocks have not elevated my sciatic nerve pain, what treatments are recommended?
What's the cause? Further treatment of your sciatic nerve pain would depend on the cause. You may need further imaging studies or other tests to determine the source of the pain. It could be a slipped disc (common) or there are other less common causes. Once your doctor has figured out the cause, other treatment recommendations may be made, such as physical therapy or even surgery.
Progression. Usually the treatment for sciatica is a series of conservative modalities. Start with medications (ant-inflammatories), physical therapy, epidural injections. If these do not help and pain is still substantial you need to see a surgeon to discuss if surgery would be the appropriate next step to treat your problem.
Sciatica Tx. There are many treatments for sciatica like heat pads, accupuncture, chiropractic therapy, exercise, massage, medications, injections. .. Please see a pain management doctor for evaluation. You might benefit from a comprehensive evaluation and treatment.
Facet Joints? Maybe the pain is coming from your facet joints and you may be candidate for facet injections and/or radiofrequency ablation for longer lasting relief. Speak with your doctor regarding your options. In some situations spinal cord stimulation is an option, however surgery should also be considered at that time as well.
Be gentle. Sciatic nerve pain in a lot of cases in due to the piriformis muscle. Http://www. Thestretchinghandbook. Com/archives/piriformis-syndrome. Php I love acupuncture because it will find and release the muscle spasm all at once!
Recommend. Avoid flexing his hip and raising leg up into air. Those movements will aggravate sciatica symptoms. Otherwise its hit or miss what might actually be an issue for the patient. Muscles can be tight and hurt if nerve is irritated, not sure that would be a problem but if it hurts patient suggest avoiding those areas with deep pressure.
Which feels better. Which feels better? WE use ice for acute injury. Then heat after 36 hours. But for chronic pain either can work.