Neuropathy - sciatic nerve; Sciatic nerve dysfunction

Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

In some cases, no treatment is required and recovery occurs on its own.

Conservative treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation.

• Apply heat or ice to the painful area. Try ice for the first 48 - 72 hours, then use heat after that.
• Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
• While sleeping, try lying in a curled-up, fetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

If at-home measures do not help, your doctor may recommend injections to reduce inflammation around the nerve. Other medicines may be prescribed to help reduce the stabbing pains associated with sciatica.

Physical therapy exercises may also be recommended. Additional treatments depend on the condition that is causing the sciatica.

Nerve pain is very difficult to treat. If you have ongoing problems with pain, you may want to see a neurologist or a pain specialist to ensure that you have access to the widest range of treatment options.

If the cause of the sciatic nerve dysfunction can be identified and successfully treated, full recovery is possible. The extent of disability varies from no disability to partial or complete loss of movement or sensation. Nerve pain may be severe and persist for a prolonged period of time.

• Partial or complete loss of leg movement
• Partial or complete loss of sensation in the leg
• Recurrent or unnoticed injury to the leg
• Side effects of medications

Call your doctor right away if you have:

• Unexplained fever with back pain
• Back pain after a severe blow or fall
• Redness or swelling on the back or spine
• Pain traveling down your legs below the knee
• Weakness or numbness in your buttocks, thigh, leg, or pelvis
• Burning with urination or blood in your urine
• Pain that is worse when you lie down, or awakens you at night
• Severe pain and you cannot get comfortable
• Loss of control of urine or stool (incontinence)

Also call if:

1. You have been losing weight unintentionally
2. You use steroids or intravenous drugs
3. You have had back pain before but this episode is different and feels worse
4. This episode of back pain has lasted longer than 4 weeks

If any of these symptoms are present, your doctor will carefully check for any sign of infection (such as meningitis, abscess, or urinary tract infection), ruptured disk, spinal stenosis, hernia, cancer, kidney stone, twisted testicle, or other serious problem.

Images

Sciatic nerve damage

Sciatic nerve

Cauda equina

Review Date: 07/10/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)