“Mild symptoms can be eliminated with conservative treatments or the condition may even heal on its own,” notes Dr. Liu. “Treatments can include alternating cold and hot packs, stretching, exercise, chiropractic adjustments, physical therapy, acupuncture and over-the-counter medications to reduce inflammation.” There is even a gel administered through an injection that contains sponge-like particles that repair damaged spinal discs, which cushion the vertebrae.
According to new research published in the Annals of Internal Medicine, epidural steroids provided better relief for some patients than some anti-inflammatory drugs. While it was previously believed that mechanical problems such as degenerative discs or arthritis caused the vast majority of back pain, nerve-related pain can be a significant factor.
If pain worsens or symptoms haven’t improved after 2 to 3 months using a conservative approach, it may be time to consider sciatica surgery to remove part of the ruptured disc that is pressing on the sciatic nerve. Dr. Liu explains that today we are able to offer patients minimally invasive surgeries as treatment. Sciatica surgery is usually performed as a discectomy or foraminotomy which uses a small endoscope, a thin, flexible tube with a tiny camera on the end that allows the surgeon to decompress the affected nerve by removing the bone or other tissue that’s causing the compression. “In an endoscopic procedure the incision is tiny, less than 10 mm, and the patient’s discomfort and recovery time is much less than with traditional surgery,” Dr. Liu says. As a general rule, approximately 90% to 95% of patients will experience relief from their pain after this type of surgery.
What are the symptoms?
Sciatica symptoms can include weakness, numbness or tingling, usually on one side of the body – the radiating pain may be worsened by sitting. “If your symptoms persist for more than a week, you should see a physician,” says Dr. Liu. “Seek immediate medical care if you experience sudden, severe pain that follows an injury or traumatic event, or if you have trouble controlling your bowels or bladder.”
What causes sciatic nerve pain?
People between 30 and 50 years of age are more likely to experience sciatica. The degeneration of aging discs, combined with sudden pressure, is a common cause. Other factors include a pelvic fracture, ruptured intervertebral disc, or narrowing of the spinal canal (spinal stenosis) that puts pressure on the nerve. Some women experience sciatic nerve compression during pregnancy and there is even some evidence that a thick wallet in your back pocket can be hazardous to the lower back. However, in many cases no cause can be found.
About Dr. Liu: Kaixuan Liu, M.D., Ph.D., is a renowned endoscopic spine surgeon and founder of Atlantic Spine Center in Edison, New Jersey (http://www.atlanticspinecenter.com).Dr. Liu is certified by The American Board of Pain Medicine and The American Board of Anesthesiology, and is a member of The International Society for Advancement of Spine Surgery, The American Society of Interventional Pain Physicians (ASIPP), The American Academy of Pain Medicine (AAPM), The International Intradiscal Therapy Society (IITS), and The American Society of Anesthesiologists (ASA). He also serves as an international surgeon for The Spinal Foundations in England.
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