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Sciatica (lumbar radiculopathy) - Management
What information and advice should I provide someone with sciatica?
Provide information and advice to foster a positive attitude and realistic expectations.
Provide information and advice on:
- Understanding the problem
- Sciatica is a physical, not a psychological, problem. Although psychological issues affect how well people cope with the pain, they are not the cause of the pain.
- Sciatica is due to pressure on a nerve root.
- Sciatica settles within 6–12 weeks in most people, but in some people symptoms can persist for months.
- Understanding the treatment
- Pain control is routinely provided in the expectation that the pain will be temporary.
- Recovery is helped by getting moving again and getting back to work as soon as possible.
- If sciatic symptoms are persistent and severe, referral may be necessary for specialist assessment, magnetic resonance imaging, and treatment.
- Rarely, symptoms progress and foot drop or incontinence of the bowel or bladder can develop. If the person experiences this, advise them to seek medical help as soon as possible, as admission to hospital and surgery may be needed.
- Self care
- A positive attitude is important in coping with the problem.
- Medication can be taken to relieve the pain.
- Staying physically active is likely to be beneficial.
- Bed rest should not be prolonged any longer than is necessary.
- Normal activities should be resumed as soon as possible. Because many normal postures and movements will stimulate some pain, resuming normal activities should be paced by conducting them at a reduced level or slower rate.
- Keeping as active as possible and exercising regularly is important.
- Care should be taken when lifting and twisting.
- A cold pack or local heat may relieve pain and muscle spasm.
- A small firm cushion between the knees when sleeping on the side, or several firm pillows propping the knees up when lying on the back, may ease symptoms.
- Return to work as soon as possible
- There is no need to wait for complete freedom from pain before returning to work.
- Work adjustments can make an early return to work possible.
- Returning to work helps to relieve the pain by getting back to a normal pattern of activity and providing a distraction from the pain.
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