Patients with sciatica usually respond well to conservative treatments and don’t require surgery. On average, recovery can be expected in 4-6 weeks with good rehabilitation practices. Some of the most commonly recommended therapies include:
- Lifestyle changes such as exercise and weight loss
- Physical therapy, in which special stretches may reduce pain and aid in recovery, and better motions for commonly problematic tasks may be taught to prevent exacerbation of existing problems. In addition, strengthening core muscles helps to compensate for spinal insufficiency.
- Several pharmacological treatments exist for the treatment of spinal stenosis, including the use of NSAIDs such as aspirin or ibuprofen, steroids for long term relief, and stronger narcotics for pain that does not respond to existing pain management. In the case of steroids, an injection is typically made at the level of the stenotic structure, limiting inflammation for months at a time and allowing time for recovery.
Generally, so long as patient quality of life is satisfactory, surgery is simply unnecessary. In some cases, though, surgery has the potential to significantly improve a patient’s condition. Some such indications are:
- Severe weakness of the legs
- Severe and progressive pain
- Ineffective conservative therapies
- Loss of bowel or bladder control, a condition known as cauda equina syndrome