What to do if you have sciatica from a pinched nerve

A herniated disc sometimes pushes on a spinal nerve, causing sciatica. The sciatic nerve is actually not one nerve root but rather a compilation of multiple nerve roots including the fourth and fifth lumbar nerve route along with the first sacral nerve root which combines into one large nerve called the sciatic nerve.

This is why when the sciatic nerve is compressed, in layman’s terms called a pinched nerve, it is called sciatica. Usually, depending on which nerve root of the sciatic nerve is being compressed around the spine, that is where the patient will have the leg pain anatomically. To avoid surgery for a herniated disc, what are the treatment options available in the acute phase of having sciatica?

The best way to avoid surgery in the first place is to undergo a series of treatments at a pain control center. The first treatment that will likely be started will include narcotic medications along with muscle relaxants and the initiation of physical therapy. Also, it’s wise to start Tylenol and anti-inflammatories as well. Patients should take a gastric-protective medication, such as an H2 blocker, so that they do not develop a gastric ulcer.

Physiotherapy can help substantially along with the chiropractor’s treatment of spinal decompression therapy to decompress the sciatic nerve. Medications can make life much more tolerable, and if the patient also has back pain, a back brace can also help. Many times, narcotic medications don’t work very well for sciatica pain. If this is the situation, taking Lyrica or Neurontin may help with nerve pain and may help modulate this type of pain.

Along with medications, a treatment agenda that substantially helps acute sciatica pain would also include interventional pain treatments. This would include an epidural injection or a series of injections that involves injecting steroids under X-ray guidance around the area of ​​the pinched nerve. This will not fix the area of ​​the pinched nerve, it will simply bathe the area in a soothing steroid medication to help decrease the inflammation and therefore the pain associated with it.

Some people still think it’s a good idea to spend time in bed when you have back pain and leg pain from a pinched nerve. Studies actually show that this is a bad idea as it can actually make the situation worse. Getting out of bed and walking around while trying to do most of your daily activities is much better in the long run.

So the combination of medications along with a back brace, physical therapy, chiropractic treatment, and spinal decompression therapy, along with interventional treatments for pain, is the best combination of treatments that we have today to try to prevent the need from a surgery. Although a discectomy surgery has small risks associated with it, they are real and it is much better to avoid surgery if possible. We know that years after surgery, if the patient was able to avoid surgery, the results are equivalent.