Treatment
When the cause of sciatica is due to a prolapsed or lumbar disc herniation, 90% of disc prolapses resolve with no intervention. Treatment of the underlying cause of the compression is needed in cases of epidural abscess, epidural tumors, and cauda equina syndrome.
Although medications are commonly prescribed for the treatment of sciatica, evidence from clinical trials to guide the use of analgesics to relieve pain and disability is lacking. Research has shown no significant difference between placebos, NSAIDs, analgesics, and muscle relaxants. Evidence is also lacking in use of opioids and compound drugs.
Research has failed to show a significant difference in outcomes between advice to stay active and recommendations of bed rest. Similarly, physical therapy (exercises) has not been found better than bed rest.
Elective surgery is the main option for unilateral sciatica and focuses on removal of the underlying cause by removing disk herniation and eventually part of the disc. In a controlled study, surgical intervention was found to have better results after one year but after four and ten year follow ups no significant differences were found.
Moderate quality evidence suggests that spinal manipulation is effective for the treatment of acute sciatica; however, only low level evidence was found to support spinal manipulation for the treatment of chronic sciatica. Spinal manipulation has been found safe for the treatment of disc-related pain in some circumstances. According to the WHO, in their guidelines on chiropractic practice, spinal manipulation is contraindicated for disc herniations when there are progressive neurological deficits.
Read more about this topic: Sciatica
Famous quotes containing the word treatment:
“[17th-century] Puritans were the first modern parents. Like many of us, they looked on their treatment of children as a test of their own self-control. Their goal was not to simply to ensure the child’s duty to the family, but to help him or her make personal, individual commitments. They were the first authors to state that children must obey God rather than parents, in case of a clear conflict.”
—C. John Sommerville (20th century)
“If the study of all these sciences, which we have enumerated, should ever bring us to their mutual association and relationship, and teach us the nature of the ties which bind them together, I believe that the diligent treatment of them will forward the objects which we have in view, and that the labor, which otherwise would be fruitless, will be well bestowed.”
—Plato (c. 427–347 B.C.)
“Judge Ginsburg’s selection should be a model—chosen on merit and not ideology, despite some naysaying, with little advance publicity. Her treatment could begin to overturn a terrible precedent: that is, that the most terrifying sentence among the accomplished in America has become, “Honey—the White House is on the phone.””
—Anna Quindlen (b. 1952)