Physical therapy is a common first-line treatment to relieve sciatica symptoms. However, when noninvasive approaches like physical therapy fail to provide adequate relief, it may be time to consider other treatment options.
Board-certified orthopedic surgeon Thomas Jones II, MD, is part of the team at The Spine Institute of Southeast Texas, and he specializes in treating spine conditions such as degenerative disc disease and sciatica.
In most cases, sciatica responds to noninvasive therapies, such as physical therapy, and steroid injections. If you’re dealing with sciatica that seems to improve at first only to return, it’s possible that physical therapy might not be enough.
If there’s an underlying issue, such as a severely bulging disc causing recurrent sciatic nerve pain, minimally invasive surgery may be the best solution to resolve the issue.
Finding the right solution to alleviate your pain and restore function depends on the underlying cause of your sciatica and your symptoms. The sciatic nerve is the longest nerve in the body, and it’s vulnerable to compression. The nerve roots start in the lower back and travel through each buttock and down the back of each leg.
When something irritates or compresses this nerve, you may experience a characteristic pain radiating from the lower back down through one leg. Common causes of sciatica include herniated discs, spinal stenosis, and degenerative disc disease.
Prolonged sitting and being overweight or obese increase your risk of sciatica, and losing weight along with undergoing physical therapy can bring relief in some cases. However, depending on the level of nerve compression, and the exact cause, noninvasive treatments may not resolve recurrent sciatica for good.
Spinal stenosis is the narrowing of the spinal canal, which can compress the nerves and cause significant pain. Physical therapy can help manage symptoms, but it may not address the underlying structural issues causing the compression.
A herniated disc occurs when the soft inner material of the disc protrudes through its outer layer, pressing on the nerve. Physical therapy is often helpful in easing symptoms of mild herniations, but in cases where the disc is severely herniated, minimally invasive surgery might be necessary.
Patients are often referred to Dr. Jones when nonsurgical approaches haven’t provided enough relief. In these cases, surgery might be necessary to relieve the pressure on the sciatic nerve and provide lasting relief.
When appropriate, Dr. Jones may recommend surgical procedures such as a microdiscectomy, a minimally invasive surgery that involves removing part of a herniated disc that's pressing on the sciatic nerve. This procedure is often very effective in providing immediate pain relief, and it has a relatively short recovery period.
Another surgical option is a laminectomy, in which he removes part of the vertebral bone called the lamina to create more space within the spinal canal. This helps relieve pressure on the spinal cord or nerves, particularly in cases of spinal stenosis.
Other surgical techniques to relieve nerve compression include enlarging the openings through which nerve roots exit the spinal column or removing parts of the facet joints to relieve nerve impingement and improve spinal stability.
Each of these procedures aims to reduce nerve compression, relieve pain, and improve overall mobility and function. After a thorough evaluation, Dr. Jones can discuss the most appropriate treatment approach.
The Spine Institute of Southeast Texas is committed to helping you find the most appropriate treatment for your condition. If you’re struggling with recurrent sciatica, contact us today to discuss your options and determine the best course of action for your health and well-being.
