How is sciatica treated?
For severe sciatica, the initial treatment is rest. A firm mattress or on the floor is best. Avoid sitting or lying in the bath as this will make the pain worse. Complete rest is advised for the first few days, followed by very short periods of moving around, with avoidance of any bending or lifting.

Analgesics (painkillers) are usually prescribed for sciatica. They do not cure the condition but relieve the pain. They may include aspirin (Bayer) or acetaminophen (Tylenol) or combination products (eg, acetaminophen and codeine). Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) may be prescribed to reduce pain and swelling caused by inflammation.

Topical NSAIDs in the form of gels and creams may be applied directly to the lower back. Most of these are available without prescription. Topical creams that also cause a feeling of warmth are available. These may contain analgesics such as salicylates. Some of these are available only by prescription. Muscle relaxants such as diazepam (Valium) can help relieve muscle spasm, which often aggravates the pain.

Physical therapy will not be of use until the pain has receded, which may take four to six weeks. After this time, a physical therapist can teach exercises to strengthen the back in order to prevent further episodes of sciatica. If the sciatica does not resolve with bed rest and medication after six weeks, further investigations may reveal the need for surgical treatment. This may involve removal or repair of a disc or part of a vertebra.

Self-help measures

  • Unfortunately, sciatica tends to recur. Once an episode of sciatica has happened, take care to avoid further injury to the back.
  • Practice exercises as recommended by a physical therapist on a permanent basis. Swimming and walking also help to strengthen the muscles of the back.
  • Avoid sitting for long periods, and take regular breaks on long journeys.

Further information
MedlinePlus—Sciatica: www.nlm.nih.gov/medlineplus/sciatica.html

Last Reviewed: May 2013