How to treat sciatica?

Written by Na Hong Wei
Orthopedics
Updated on September 25, 2024
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For sciatica, conservative treatment methods should first be adopted, which include the following five points:

The first is general treatment; as soon as sciatica appears, immediately rest in bed, and the bed should be relatively hard. Second, you can apply heat to the lumbar area, use physical therapy, or acupuncture. Third, lumbar traction can be performed, which has a very clear effect in alleviating sciatica. Fourth, consider performing an intradiscal injection or sacral injection therapy, and chemical nucleolysis can also be performed.

After the above treatments, if the symptoms and pain are reduced, you can start functional exercises for the lower back muscles. Functional exercises of the lower back muscles play a significant role in enhancing the stability of the lumbar spine. If the effect of the aforementioned treatments is not significant, or if the symptoms worsen, then surgical treatment may be necessary at this time.

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Written by Na Hong Wei
Orthopedics
38sec home-news-image

Sciatica belongs to which department?

Sciatica mostly falls under the category of orthopedics. It is a common orthopedic disease, with primary and secondary causes. The secondary type is often caused by compression at the exit point of the lumbar spine and sciatic nerve, so sciatica can be treated in orthopedics or spinal surgery. Primary sciatica, generally caused by inflammation of the sciatic nerve, is managed by neurology. To address sciatica, many hospitals now have departments of pain management. Therefore, sciatica can be treated by four departments: orthopedics, spinal surgery, neurology, and pain management.

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Written by Xie Yi Song
Orthopedics
1min 13sec home-news-image

What are the symptoms of sciatica?

Sciatica refers to the pain caused by the sciatic nerve due to various reasons, such as compression from spinal diseases or simply sciatica itself, and it is inherently a symptom. What are the characteristics of this symptom? Sciatica can occur on one side or both sides simultaneously. When it occurs, the pain is usually continuous and can have episodic exacerbations. The pain is often dull, stabbing, burning, or like a knife-cutting sensation. It radiates from the buttocks along the back of the thigh and the outer back of the lower leg toward the foot. Clinically, sciatica is divided into secondary and primary types. Secondary pain is due to compression of the sciatic nerve root, commonly seen in conditions like lumbar disc herniation and other spinal disorders. It often accompanies percussion pain in the lumbar spine, and the pain may worsen with coughing, sneezing, or bending, and severe cases may experience numbness in the skin of the lower limbs. Primary sciatica refers to simple inflammation of the sciatic nerve. This type generally presents pain in the buttocks and back of the thigh and usually does not involve percussion pain in the lumbar spine.

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Written by Na Hong Wei
Orthopedics
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How to treat sciatica

Sciatica typically has two treatment methods. One is non-surgical treatment, which is currently the first and most commonly used approach. The first step is general treatment, meaning that once symptoms of sciatica occur, one should rest on a hard board bed. Second, one can combine this with some heat applications to the lumbar area, physical therapy, and acupuncture; all of these are options. The third is traction therapy, which is very effective for discogenic sciatica, as it can reduce the pressure on the intervertebral disc, thereby increasing the volume of the spinal canal and enlarging the area of the intervertebral foramen, thus reducing stimulation to the nerve. Fourth, one can consider undergoing sacral canal injections, or using papain or collagenase for chemical dissolution of the nucleus pulposus, which usually can also achieve a good effect. The fifth point is that when symptoms are reduced, one should start exercising the lumbar and back muscles to increase their strength and enhance the stability of the lumbar spine, thereby ensuring the stability of the intervertebral disc. It should be mentioned that massage and manipulation are quite effective for herniation of the disc nucleus pulposus, but if there is already obvious osteophyte formation, narrowing of the intervertebral space, or disorder of the facet joints, or even lumbar spinal stenosis, then massage and manipulation are not recommended. If the aforementioned treatments prove ineffective, the condition does not relieve or even worsens, or if there is central herniation of the lumbar disc, or if the patient shows significant cauda equina nerve stimulation symptoms, then surgical treatment is required.

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Written by Na Hong Wei
Orthopedics
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How to relieve sciatic nerve pain

How to alleviate sciatica pain. First, it is necessary to rest in bed absolutely, especially sleeping on a firm bed. While sleeping on a firm bed, you can also pad a soft pad in the lumbar area and place a soft pillow under the knee joints. The main purpose is to keep the knee and hip joints in a flexed state, allowing the muscles in the lower back to fully relax. Second, you can take some non-steroidal anti-inflammatory painkillers orally. Third, you can use traction therapy. Traction therapy is very effective for relieving sciatica pain as it can reduce the pressure inside the disc and expand the volume of the spinal canal, thus alleviating the stimulation and compression of the nerve roots. Fourth, you can consider undergoing physiotherapy, massage, and manipulation. However, aggressive massage is not recommended. Fifth, you can undergo intradiscal blockade or sacral canal injections. Sixth, you can perform nucleoplasty, which involves injecting collagenase into the intervertebral disc, or between the dura mater and the protruding nucleus pulposus. This often requires the intervention of a pain specialist. Therefore, after the aforementioned treatments, sciatica pain should generally be alleviated. If there is no relief or if symptoms worsen, then surgical treatment may be necessary.

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Written by Guan Jing Tao
Orthopedics
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Where to perform moxibustion for sciatica

Typical sciatica, in addition to soreness and numbness in the buttocks, is accompanied by sensory abnormalities in the back of the thigh, the back of the calf, the lateral muscles, and the foot. Thus, the location for moxibustion treatment spans from the buttocks to the thigh and calf, targeting corresponding traditional Chinese medicine acupoints progressively. This can alleviate, to some extent, the sensory abnormalities in the buttocks and lower limbs caused by sciatica. It is recommended to concurrently take oral medications that nourish the nerves to collectively reduce symptoms and shorten the duration of the illness. If there is no significant relief after two to four weeks of treatment, it is advised to revisit the hospital for further examination and treatment. Hospitalization for systematic treatment may be necessary.