Sciatica can be an extremely painful and debilitating
condition. Oftentimes sciatica sufferers make treatment
decisions out of fear and a lack of undertanding of their
condition that can wind up being very big mistakes.
The first mistake is rushing into a surgery. While most
surgeons are very responsible about not being in a hurry to
do surgery, there are some doctors who recommend surgical
intervention very early on and before any other treatment
is even attempted. Sciatica resolves in approximately 80%
of cases without surgery. Even when surgery is successful
initially, the development of scar tissue and abnormal
mechanical stresses on the spine adjacent to the surgery
often lead to future problems. Given that low back spine
surgery overall has about a 50% long-term success rate and
people treated surgically often wind up worse than they
were prior to surgery, it should be reserved as a treatment
of last resort.
The exception to the rule of considering surgery as a last
resort is in the rare case of severe neurological
compromise known as "cauda equina syndrome", which may be
indicated by a loss of bowel and/or bladder control, sudden
severe weakness in one or both legs, and/or "saddle
anaesthesia" (a loss of sensation in the lower buttocks and
inner thighs). Except in the rare instance of cauda equina
syndrome though, it is generally better to avoid surgery if
possible.
The second mistake sciatica sufferers often make is
returning to normal activities too quickly once symptoms
improve. The vast majority of true sciatica cases are due
to bulging or herniation of one or more discs in the lumbar
spine, and the inflammation that typically is associated
with such disc problems. In many cases, slight
improvements in inflammation can result in dramatic symptom
improvement. Many sciatica victims mistakenly believe they
are back to normal as soon as they feel better, but the
reality is that the bulging/herniated disc is far from
fully healed, and too much exertion too soon can easily
trigger a recurrence of symptoms - sometimes even more
severe than they were to begin with. Even professional
physical therapists sometimes make the mistake of pushing a
patient to do too much too soon, with the result being a
return or increase in sciatica symptoms.
The third mistake people, including doctors, often make
regarding sciatica is to view it as a condition that can be
"cured". Because most people continue to engage in the
activities that caused the underlying disc problems to
develop that produced sciatica in the first place, the vast
majority of sciatica sufferers will experience repeated
episodes, usually becoming more severe and more frequent
over time. This is because the disc problems that produce
sciatica will gradually worsen over time if they are
neglected. Again, people mistakenly assume that the
problem is gone if the symptoms resolve. In fact, what
happens in many cases is that the spine and discs gradually
degenerate over time, making the person more and more
susceptible to sciatica episodes. Eventually, the
degeneration can become so severe that there really is no
effective treatment, and many people are left with chronic,
debilitating pain.
The good news is that for most people, sciatica can be
effectively managed long-term with awareness and simple
home exercises. Chronic pain and disability can be
prevented, but it does take a bit of time and effort to do
the appropriate exercises on an ongoing basis and to avoid
engaging in those activities that are particularly hard on
the spinal discs, such as repeated bending, improper
lifting, and poor posture (particularly when sitting). By
making the small effort to manage your sciatica, you can
avoid big problems in the long-run.
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Dr. George Best has been treating people with sciatica and
piriformis syndrome for over 15 years. To receive a free
ebook and video information program on managing sciatica,
visit his website at http://www.sciaticaselfcare.com .
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