treatment and prognosis for sciatica

Self treatment

1. Ice - In the first 48 hours, you need to use ice to help reduce the inflammation which is around the nerve. This can help to stop it from getting worse. Use the ice for 10 minutes, then off for 10 and on again for 10 minutes. Keep doing this 2 or 3 times
2. Stretching –Piriformis has the sciatic nerve running through it or along side it. By stretching this muscle you are able to ease the pain quickly.
3. Pelvis Balance –pelvis keeps everything in balance. If your pelvis is balanced, then the tension will ease off all the other areas. You can do this by lying down on the floor. Place your hand under each side of your pelvis where you would wear your belt.
4. Move – You need to keep moving, not too fast, but move. If you sit for to long at a time, your muscles will tighten much quicker.


Pain control
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, may be useful in reducing inflammation, however, if the sciatica is due to a herniated disk then studies seem to show that NSAIDs are no better than placebo (a dummy treatment). Paracetamol and other pain relievers may help to reduce back pain in the short term and help you keep active.

Epidural steroid injections
Injection of corticosteroid into affected area. Corticosteroids mimic the effects of the hormones cortisone and hydrocortisone, which are made by the outer layer (cortex) of your adrenal glands. When prescribed in doses that exceed your natural levels, corticosteroids suppress inflammation around the irritated nerve, thereby helping to relieve pain

Their usefulness in treating sciatica remains a matter of debate. Some research has found that corticosteroids can provide short-term symptom relief, but that these medications aren't a long-term solution.

Surgery
Usually for times when the compressed nerve causes significant weakness or you have pain that gets progressively worse or doesn't improve with other therapies.
Surgical options include lumbar laminectomy and microdiskectomy. In lumbar laminectomy with diskectomy, surgeons remove a portion of a herniated disk that's pressing on a nerve.
Sometimes a surgeon will perform this operation through a small incision while looking through a microscope (microdiskectomy).

Nonsurgical spinal decompression
There is a nonsurgical option available in the marketplace called nonsurgical spinal decompression. Nonsurgical decompression machines are designed and built to specifically target herniated disks and bulging disks. The machine used is the DRX9000.
The DRX9000 is actually able to enlarge the disk space and re-position the disk back into a more normal position. In doing so this removes the pressure from the sciatic nerve. Success rates are very high as demonstrated by research results from the Mayo Clinic, John Hopkins University, and Duke University. Results show decreased low back pain of 90% and satisfactory scale of 8.55/10.

Prognosis

Most people with acute low back pain are back at work within a month and fully recover within a few months. According to one study, about a third of patients with uncomplicated low back pain significantly improved after a week; two thirds recovered by 7 weeks.
However, studies now suggest that up to 75% of patients suffer at least one recurrence of back pain over the course of a year. In another study, after 4 years, less than half were symptom-free. Some doctors are approaching the problem as one that is not necessarily curable and which needs a consistent on-going approach.
• In the majority of patients with herniated disks, the condition improves (although the actual physical improvement may be slower than the reduction in pain). Researchers attempted to identify factors most likely to predict an elevated risk for recurrent pain and found that only depression was a significant factor in the majority of those who had not recovered.
• Spinal stenosis stabilizes in about 70% of cases and worsens in 15%.

For surgery
Conclusions - The rates of pain relief and of perceived recovery were faster for those assigned to early surgery. 95% were perceived to be recovered after one year


http://www.healthcentral.com/chronic-pain/back-pain-and-sciatica-000054_5-145.html
http://www.mayoclinic.com/health/sciatica/DS00516/DSECTION=treatments-and-drugs
http://www.sciaticatreatment.org/
http://www.mydr.com.au/sports-fitness/sciatica-treatment
http://content.nejm.org/cgi/content/abstract/356/22/2245
http://www.youtube.com/watch?v=EvQPZxXr3Rs