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Suggest treatment for management of sciatica

Jul 2013
User rating for this question
Very Good
Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I'm a pretty active mom of 4 and a RN. I started having this sudden onset upper buttock and hip pain about 5 days ago no apparent injury before the pain started. While working the night shift 4 days ago the pain started referring down along the lateral aspect and anterior Not posterior if my thigh. During my shift I used ice packs and Motrin with little relief. I went to a walk in clinic that am they said it was sciatica. Ok we'll the gave me robaxin mobic and Vicodin. Oh and a decadron shot. This has also given me little relief. I'm still having bad pain no sleep etc. I've been resting some but also trying to be active at home laundry sweeping cooking etc. I'm also having spasms in my leg. My Questions are is there anything else I can do and should I go see my primary doc since I'm not getting relief. Busy mom don't have time for this. Ugh
Posted Sat, 8 Feb 2014 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer: Initial management is by conservative methods. Detailed Answer: Hi, thanks for writing to XXXXXXX The initial management of sciatica (which is most commonly due to a prolapsed or protruded lumbar intervertebral disc causing compression over the adjacent nerve root) is always by conservative (non surgical) methods. MRI scan of the Lumbar spine is needed to establish the correct diagnosis and the severity of the condition. The initial management of your problem will be as follows - - Usually 1-2 days of bed rest will calm your leg pain & back pain. Do not stay off your feet for longer, though. - Take rest breaks throughout the day, but avoid sitting for long periods of time. - Make all your movements slow and controlled. Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. With all the above mentioned measures being followed strictly, you should get significant pain relief. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management. Hope I have addressed your query. Happy to help further Regards
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