How to treat sciatica?

Written by Ai Bing Quan
General Surgery
Updated on February 07, 2025
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Patients with sciatic nerve pain must rest in bed, especially those whose pain is caused by nerve compression. They must pay close attention to keeping warm and resting regularly, and use heat application on the waist and buttocks. For medicinal treatment, the drugs are mainly divided into Western medicine and traditional Chinese medicine. Western medicine primarily uses non-steroidal anti-inflammatory drugs and neurotrophic drugs. Traditional Chinese medicine mainly uses drugs that invigorate the blood to promote the repair of nerve edema and surrounding tissue swelling. Treatment can also include acupuncture and physical therapy, particularly ultrashort wave therapy and direct current iontophoresis during the acute phase, combined with acupuncture, which can effectively promote the alleviation of sciatic nerve pain.

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Written by Guan Jing Tao
Orthopedics
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How long does it take for sciatica to improve with rest?

Recovery of the sciatic nerve requires a long time, and also depends on the severity of the damage to broadly judge the prognosis. If it is merely a contusion, it may take one to three months for most symptoms to gradually improve, such as sensory abnormalities like numbness and soreness. If the sciatic nerve has been chronically compressed, resulting in nerve degeneration, or if it has sustained severe traumatic injury, recovery will typically require at least six months to a year, and the process will be slow. Furthermore, if a violent injury has caused a tear or rupture, surgical treatment is necessary, and the post-operative recovery remains a lengthy process, often leaving significant residual symptoms.

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Written by Cheng Bin
Orthopedics
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Is moxibustion effective for sciatica?

First of all, it must be affirmed that moxibustion can promote local blood circulation, thereby effectively improving the edema of the sciatic nerve and alleviating symptoms of sciatic nerve pain. Thus, moxibustion is effective. In addition to moxibustion for patients with sciatic nerve pain, other treatments such as acupuncture, electrical stimulation, traction, massage, and cupping can also be combined with very good effects. For those with severe pain, oral administration of non-steroidal anti-inflammatory drugs and blood-activating and stasis-removing drugs can be used. For those with severe spinal nerve compression that cannot be improved through conservative treatment, it is necessary to actively consider surgical treatment to relieve the pressure on the spinal nerves and create conditions for the recovery of sciatic nerve pain.

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Written by Na Hong Wei
Orthopedics
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What to check for sciatica

Sciatica is divided into primary sciatica and secondary sciatica. Secondary sciatica is very common and is mainly due to diseases of the spinal canal, including herniated lumbar discs, lumbar spinal stenosis, or spinal tumors compressing the spinal cord and nerve roots. Another condition is piriformis syndrome, where the sciatic nerve exits; if there is narrowing here, it can also cause sciatica. Therefore, clinically, one starts with secondary sciatica, conducting either a lumbar spine CT scan or an MRI, which can basically clarify the location causing the compression. Another type is called primary sciatica, which is caused by inflammation of the sciatic nerve, and is an internal medicine disease, not an orthopedic disease. This requires an electromyography (EMG). After completing the EMG, the diagnosis can generally be made based on the injured muscle or the muscle with abnormal electromotor conduction. Thus, the routine examinations for sciatica are X-rays, CT, MRI, and the non-routine examination is the EMG.

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Written by Lv Yao
Orthopedics
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Which department should I visit for sciatica?

Pain in the sciatic nerve first requires a visit to orthopedics or spinal surgery to look into whether the pain is caused by a herniated disc compressing the nerve root. If examinations or imaging studies find no abnormalities, we might consider the possibility of piriformis syndrome, or other reasons causing the nerve pain. You can then consult the pain management department to determine the cause and receive appropriate treatment, primarily involving orthopedics and pain management.

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Written by Lv Yao
Orthopedics
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Which department should I go to for sciatica?

For sciatic nerve pain, it is recommended to first consult an orthopedic or spinal surgery specialist. Initially, it is important to determine the cause of the pain, such as whether it is caused by a herniated disc pressing on the nerve root. If it is confirmed that the pain is not caused by a herniated disc pressing on the nerve root, and it is purely sciatic nerve pain, you can then visit a pain management clinic to check for potential issues like piriformis syndrome. In essence, start with an orthopedic consultation to rule out orthopedic conditions. If no orthopedic issues are found, then consult a pain management specialist.