The sciatic nerve carries messages from the brain down the spinal cord to the legs. When this nerve causes pain, it is known as sciatica. Between 10% and 40% of people have this condition, making it a common health concern.
If you or a loved one has sciatica, it’s important to understand its causes and treatment options, both surgical and nonsurgical.
What Causes Sciatica?
A pinched sciatic nerve root causes sciatica. The pinch is often due to a herniated spinal disc or bone spurs (excessive overgrowth of bone on the spine.)
While anyone can suffer from this condition, a few factors may increase your risk for sciatica:
Age: The likelihood of bone spurs increases with age, meaning older people are more prone to sciatica. It’s most common in people between 30 and 50, although it can occur at any age.
Lifestyle: If your job or hobbies involve carrying heavy items, twisting your back or sitting for extended periods, you are at an increased risk of developing sciatica.
Diabetes: Diabetes can raise the risk of nerve damage, which may contribute to sciatic nerve issues.
Surgical Treatment
Advances in medicine and technology have made surgical treatment for sciatica a viable option. However, surgery is typically recommended only if multiple nonsurgical treatments have failed to provide relief.
When Should You Get Sciatica Surgery?
While lifestyle changes and other noninvasive treatments can often manage sciatica symptoms, they may not work for everyone. In some cases, surgery may be necessary to alleviate pain and improve function. Your healthcare provider will evaluate your condition and recommend surgery only after exhausting other treatment options.
You may also be a candidate for sciatica surgery if you have severe symptoms of sciatica, such as:
Sciatic pain affecting both legs.
Tumors on the spine.
Loss of bladder or bowel control.
Significant weakness, loss of reflexes or impaired movement.
A spinal fracture.
However, some patients may not be ideal candidates for sciatica surgery if they have additional health issues, such as uncontrolled high blood pressure or poorly managed diabetes. These conditions can increase the risks associated with surgery.
What Are the Types of Sciatica Surgery?
Sciatica surgery works by reducing the pressure on the nerve root, helping alleviate pain. Here are some of the most common surgical options for treating sciatica:
Discectomy: This procedure removes part of a herniated disc pressing on a nerve root. It can be performed as an open surgery or as a minimally invasive procedure using an endoscope and smaller incisions.
Foraminotomy: This surgery creates more space by removing bone or tissue to widen the opening where the nerve root leaves the spinal canal.
Laminectomy: The lamina is a part of your vertebrae that compresses nerve roots. A laminectomy removes part or all of the lamina to reduce nerve pressure and create more space in the spinal canal.
Spinal fusion: Fusions permanently join two or more vertebrae to stabilize the spine. This type of sciatica surgery is relatively rare since it can limit movement and may lead to long-term complications. It’s often a last resort if other surgical options aren’t viable.
How Does Sciatica Surgery Work?
Most sciatica surgeries follow a similar process, regardless of the specific procedure:
Preparation: Before surgery, your surgeon will provide preparation instructions, which may include stopping certain medications and avoiding food or drink the night before the operation.
Anesthesia: You will likely receive general anesthesia to ensure you are asleep and pain-free during the procedure.
Incisions: The surgeon will make an incision tailored to the type of surgery being performed.
Procedure: The surgeon will address the cause of the sciatic nerve compression by removing part of the disc, bone or tissue or by stabilizing the spine through vertebral fusion.
Recovery: After surgery, you will stay in the recovery area for monitoring. Depending on the complexity of the surgery, you may be discharged the same day or require an overnight hospital stay.
Post-Surgery Recovery
Preparing for and undergoing the surgery are only the first steps. You must also know how to take care of yourself after the surgery to increase your chances of success and lower the risk of complications.
The length of your recovery depends on what type of surgery you had. For example, a minimally invasive discectomy may have a shorter recovery period than a laminectomy, which can take up to 12 weeks to heal.
Other factors also impact how successful your recovery is, such as:
Your age.
Whether you have a chronic illness.
If there were any complications during the procedure.
Treat sciatica surgery recovery like you would healing from any operation. Get lots of rest, manage your pain as your doctor prescribes and eat a balanced diet to help your body regain strength. You may also need to see a physical therapist to help you improve your mobility. In the beginning, you may need to go for regular sessions. Once you’ve mostly recovered, your physical therapist may give you at-home exercises to continue your recovery.
Nonsurgical Treatments
Surgery isn’t the only option to treat sciatica. There are various nonsurgical treatments to manage pain and improve symptoms. The effectiveness of these treatments depends on the severity of your sciatica, the specific approach used and how consistently you follow the treatment plan.
Some sciatica treatment methods that include minimally invasive spine care are:
Pain relief medications: While pain medications cannot cure sciatica, they can help suppress pain enough for you to maintain daily activities. However, you should use these medications carefully and only as your doctor prescribes.
Water therapy: Aquatic therapy can help loosen your muscles and reduce the inflammation caused by sciatica. It allows for increased movement without adding excessive stress to your joints.
Steroid injections: Steroid injections reduce inflammation and pressure around the sciatic nerve, providing temporary pain relief. These injections may need to be repeated every few months as the effects will wear off.
Heat and cold therapy: Using temperature therapy to manage sciatic pain can be very effective, especially in less severe cases. Cold therapy can reduce swelling, which will lessen your pain. Heat therapy helps relax muscles and reduce spasms caused by the sciatic nerve.
Nerve blocks: Similar to steroid injections, nerve blocks are used to reduce pain. They block pain signal transmissions from the sciatic nerve, so while they do not cure sciatica, they assist in keeping pain levels tolerable.
Increased movement: Since prolonged periods of immobility are one of the leading causes of sciatica, regular physical activity can help reduce symptoms. Moderate movement rather than strenuous exercise can ease muscle pain and prevent sciatica.
Stretching: Like low-intensity exercises, stretching can relax muscles and increase blood flow, helping reduce sciatica symptoms. While any stretching can benefit sciatica patients, stretches for the back muscles might be the most beneficial.
Physical therapy: Physical therapy is often used after surgery to help patients recover, but it can also benefit those who haven’t had surgery. Physical therapists can teach you movements and stretches that may ease your pain. They also often have machines and equipment to massage muscles and reduce symptoms.
Why Trust Us?
At Fondren Orthopedic Group, we have more than 50 years of experience. Our qualified staff covers 10 subspecialties, equipping us to assist patients with all their orthopedic needs.
Our board-certified physicians use the latest technology and techniques, so we can give our patients the expert service they deserve. We’re also committed to orthopedic research, ensuring we’re always learning new ways to help our patients.
Contact Fondren for Your Sciatica Surgery
If you require back surgery for sciatica or simply want to learn more about your options, we’re here to help. Look at our various locations to see which office is closest to you. You can make an appointment or contact us for more details.
Notice: Dr. Joseph Allen and Dr. Marilyn Copeland will be leaving Fondren Orthopedic Group, effective February 28, 2025. For any questions or concerns, please contact us at 713-799-2300. Thanks.
