Sciatica Pain Management: Find the Root Cause and Weigh Your Treatment Options

PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. The specific surgery will depend on the cause of the nerve compression. For a herniated disk, a surgeon may perform a microdiscectomy, in which the piece of the disk coming in contact with the nerve is shaved off. You don’t have to be an Olympic athlete, but incorporating some safe exercise, sports, or outdoor activities into your daily routine can make a big difference. Applying a cold compress or ice pack to the painful area for 15 to 20 minutes can relieve pain quickly by reducing inflammation.

Occasionally, short courses (seven to 10 days) of oral corticosteroids are used for their anti-inflammatory benefits. A magnetic resonance imaging (MRI) test may be done, but generally only if pain persists for six to eight weeks after starting treatment or there is weakness or a change in reflexes that indicate a more seriousissue. If you have what you think is sciatica, see a doctor to get a proper diagnosis.

• Chiropractors are trained to manipulate the body in such a way that promotes healthy nerve pathways without the use of drugs or surgery.
• Considerable uncertainty exists about the clinical efficacy and safety of muscle relaxants.
• The surgeon may remove a portion of the herniated disc to relieve the pressure on the sciatic nerve.
• Medication is commonly prescribed; therapy and/or exercise also options short of surgery.

The epidural space, where the injections are directed, is the outermost part of the spinal canal. Specially trained physicians perform this procedure using x‑ray guidance to ensure safety and accuracy. To sort out the underlying problem, your physician will ask questions about your symptoms, conduct a physical examination, and obtain X-rays. The specific location and character of symptoms can indicate where in the spine the nerve is pinched. For example, compression of the nerve at L4 usually causes symptoms in the lower and inner leg.

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Hyperpyretic crisis seizures, and deaths have occurred in patients receiving cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitor drugs. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more. The study quality was assessed independently in duplicate, with substantial interrater agreement (κ, 0.79). If someone has taken an overdose of this medicine and has serious symptoms such as trouble breathing, seek medical advice immediately. Sciatica pain originates in your lower spine and travels down your sciatic nerve into your thigh and leg.

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Our review updates the evidence for use of muscle relaxants in adults with low back pain. All analyses were done using Stata 6.0 (Stata Corp, College Station, Tex). Analysis of the continuous outcome involved comparing standardized differences in means between control and treatment groups. Mean outcome scores for the 5 continuous outcomes (local pain, muscle spasm, tenderness to palpation, range of motion, and activities of daily living) were standardized by dividing the means for the placebo and treatment groups in each study by their SD. The differences between these standardized outcome scores, also known as effect sizes, were calculated for each study and analyzed. This approach is especially appropriate when studies measure the same concept but use various continuous scales.

Because cyclobenzaprine is closely related to the tricyclic antidepressants, some of which are known to be excreted in human milk, caution should be exercised when FLEXERIL is administered to a nursing woman. Because of its atropine-like action, FLEXERIL should be used with caution in patients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in patients taking anticholinergic medication. Tricyclic antidepressants have been reported to produce arrhythmias, sinus tachycardia, prolongation of the conduction time leading to myocardial infarction and stroke. Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss…from exercises to build a stronger core to advice on treating cataracts.

Video: What Is Your Sciatic Nerve and Why Does It Hurt So Much?

This information is not intended to endorse any particular medication. While these reviews may be helpful, they are not a substitute for the expertise, knowledge, and judgement of healthcare professionals. As a last resort, your provider may recommend surgery to release the muscle and relieve pressure on the nerve. If physical therapy doesn’t work, your doctor will likely put you on a course of medication. Studies indicate that the use of dry needling with ultrasound guidance can ease pressure and pain felt by people with piriformis syndrome.

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The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. “Flexeril makes me so drowsy that flexeril during pregnancy I fall asleep before I can feel actual relief of pain and then I miss out on everything. The only good thing is that it relaxes me so that I’m not tense.”

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Based on the findings, FLEXERIL should be used with caution in subjects with mild hepatic impairment starting with the 5 mg dose and titrating slowly upward. Due to the lack of data in subjects with more severe hepatic insufficiency, the use of FLEXERIL in subjects with moderate to severe impairment is not recommended. These injections, if effective, may reduce pain enough to help patients progress more quickly to physical therapy, which is the most crucial aspect of the treatment program. “My sciatica is acting up.” This commonly uttered statement refers to pain that starts in the lower back and radiates down the leg. It’s mostly annoying, but it can be debilitating, making effective sciatica pain management an important pursuit. A sensitivity analysis was also performed to assess the effects of study quality, year of publication, duration of treatment, type of back pain, and whether Merck, Sharpe and Dohme sponsored the study.

Medication is commonly prescribed; therapy and/or exercise also options short of surgery. Abstracted data included setting, country of origin, treatment characteristics (dose, duration, and follow-up), demo graphics, number of participants enrolled, follow-up losses, adverse effects, and outcomes. Outcomes were extracted as either dichotomous or continuous variables (or both), depending on how they were reported in the studies.