CONSERVATIVE TREATMENT FOR SCIATICA

Sciatica treatments are available in various forms ranging from conservative, non-surgical techniques to Spine surgery. The treatment plan is largely dependent on a number of factors like the overall health of the patient, the location of the sciatic nerve compression, the underlying cause of the compression, and the specific symptoms being experienced. Most often, conservative treatment is the first choice for sciatica. A more aggressive approach might be advised if the symptoms do not respond to the treatment in the initial weeks.

While the treatment plan may vary from one person to another, the most commonly recommended techniques are as below :

• Bed Rest,not a prolonged one though:

Even though the pain might be severe, it is recommended that to stay active as much as possible. This will speed up the recovery process and help a person get back to the normal routine at the soonest.

• Medications:

Over the counter anti-inflammatories and analgesics help reduce the inflammation and relieve the pain. However, if these do not help, the physician maybe able to recommend a stronger dosage that will help.

• Physiotherapy:

It is recommended to commence physiotherapy shortly after the pain eases without any delay. The therapist can customize an exercise program to help the transition back to normal life. They will initially help with low intensity stretches and workouts to reduce the pain and then progress to a more vigorous routine that will help improve the flexibity and strengthen the spine. The physiotherapist can also help understand good posture, good body mechanics and be aware of activities that are to be avoided like lifting heavy objects and bending that may worsen the pain.

• Weight loss:

Extra weight especially around the abdomen tends to strain the back and hence it is recommended to stay around the ideal weight and shed the extra pounds to help manage the pain.

• Heat Therapy:
  Heat therapy application can help provide lower back pain relief through several mechanisms:

• Heat therapy dilates the blood vessels of the muscles surrounding the lumbar spine. This process increases the flow of oxygen and nutrients to the muscles, helping to heal the damaged tissue.
  • Heat stimulates the sensory receptors in the skin, which means that applying heat to the lower back will decrease transmissions of pain signals to the brain and partially relieve the discomfort.
  • Heat application facilitates stretching the soft tissues around the spine, including muscles, connective tissue, and adhesions. Consequently, with heat therapy, there will be a decrease in stiffness as well as injury, with an increase in flexibility and overall feeling of comfort. Flexibility is very important for a healthy back.

Its ease of use and effectiveness along with being inexpensive makes heat therapy an appealing option.

• Ice Therapy:
  Applying a cold pack or ice placed in a plastic bag and wrapped in a towel or any other protective barrier is one of the most effective pain relief treatments available. Applying Ice on direct skin may cause Ice burn and hence is to be avoided. Ice or a cold pack should be applied for no more than 20 minutes at a time and can be applied several times a day.
• Alternative therapies like Acupuncture, Ayurveda and Yoga are also hugely popular these days and are believed to help relieve pain effectively. Ayurvedic massages such as Podikkizhi (with Herbal powder), Ilakkaizhi (with Herbal leaves), kativasthi (Pooling medicated oil in the back), Pizhichil (Pouring medicated oils as a stream), Nhavarakkizhi (with rice boiled in medicated milk) and the Panchakarma therapies with medicated enema such as Kashaya Vasthi (enema with medicated decoctions) and Ksheeravasthi (Enema with medicated milk) are found to help even the most severe conditions where surgery is recommended. They not only relieve the symtoms but also help strengthen the core muscles in the back thereby helping in managing the condition better in the longer run. While the relief might not be immediate like allopathic medications, they provide lasting relief with no side effects and hence are more holistic.

If there is no relief post trying most of the above treatments and the pain is still debilitating, thereby affecting everyday life to a great extent, the physician might recommend surgical intervention to alleviate the nerve compression in the spine. However, surgery is generally recommended only as a last resort.