Sciatica discussed by Stephen Hochschuler at Texas Back Institute SpineHealth
Good morning, I am Stephen Hochschuler, spinesurgeon, cofounder of the Texas Back Institute, and a consultant to spinehealth . I'vebeen asked today to speak about sciatica and preliminary treatment of such. Sciatica iswhen a patient is suffering from impingement or pressure on a nerve, which causes painto go down the extremity oftentimes to the foot. This can be caused by one of severalthings. It could be caused by a herniated disc, it could be caused by spinal stenosis,which is a tightening of the spinal canal, it could be caused by a spondylolisthesis,which is a slip of one vertebrae on another, or pretty much anything that puts pressureon a nerve that causes pain down the leg.
Other things that would be included wouldbe a tumor, a growth, an infection, a cancer, etc. One treats the initial onset of sciaticaconservatively, and by that I mean simple things, such as ice for the first 24 to 48hours, heat thereafter, for the next 48 hours perhaps, the heat increasing the circulationto the area and getting away some of the metabolites, the cold helping with some of the pain. Inaddition to which we often use certain overthecounter medications, which include things like Tylenol,which include things like Advil, or Aleve. Certain amount of exercise is necessary. Wedo not believe in bed rest for more than 24, maximum 48 hours. Exercise should be nonweightbearing, such as a stationary bicycle, or
a swimming pool, something that doesn't putexcess strength or stress on the affected area. Occasionally, surgery is necessary.Prior to surgery, one must make a definitive diagnosis however, of what is going on, andthis often will require an MRI scan, a myelogram, or a myelogram followed by a CT scan. Initially,if there isn't a dangerous problem occurring, one will consider what's called an epiduralsteroid injection, or a selective nerve root block, both of which you can learn more aboutfrom other parts of spinehealth. Thank you.