Sciatica is the medical term used to refer to a pain that radiates along the sciatic nerve from the lower back down through the buttocks, the leg, and even as far as the feet. It is caused by irritation of the sciatic nerve. The source of such irritation can range among a variety of contenders – from herniated discs, to stenosis, to tumors and more.
Fortunately, there are a number of treatment options available for sciatica. Many of them are non-invasive treatments that have few or no side effects and, when used appropriately, can help clear up sciatica pain over only a few weeks. Other treatments, used in more severe cases, may involve surgery which, although effective, may come with greater risks.
What follows is a list of non-invasive, minimally-invasive, and surgical treatments, with a brief description and list of locations in Anchorage, Alaska where you can find caregivers who provide them.
Non-Invasive Treatments
1. Chiropractic Care
Chiropractic care for sciatica involves the manual manipulation of discs and other joints. The goal is to realign misalignments in the musculoskeletal structure thereby improving natural posture. Like physical therapy, the idea is that improving posture can reduce or eliminate what is causing the pain. When this occurs, the body can heal itself naturally.
A case report in Frontiers involving a 59-year-old woman demonstrated that spinal manipulation (specifically Cox Technic flexion distraction decompression (CTFDD) spinal manipulation) was effective at treating care sciatica.2
2. Physical Therapy
Physical therapy typically consists of a series of stretches and exercises to help build the muscles around the buttocks and lower back. If the muscles are strengthened, the individual’s posture should improve. An improved posture may be enough to reverse whatever is causing the pressure on the sciatic nerve. At the very least, it can help reduce the pain in many cases.
A case report in Taylor & Francis Online details how a 61-year-old woman was successfully treated for sciatica with physical therapy by way of exercise management1.
- Better Health Alaska – offering physical therapy, chiropractic care, and massage therapy under one roof.
- Advanced Physical Therapy – Anchorage
- Alaska Physical Therapy Specialists
- Point North Physical Therapy
3. Pain Management Medications
Medications can also be used to reduce pain and inflammation. Typical medications include over-the-counter NSAIDS (Non-steroid anti-inflammatory drugs), and muscle relaxants – although more powerful medications, even as strong as opioids, may be required in extreme cases. It should be noted, though, that unlike physical therapy and chiropractic care, meds normally do not treat the underlying cause. They help manage pain and reduce inflammation to allow other methods to heal the condition more effectively.
4. Epidural Steroid Injections
Epidural steroid injections involve injecting steroids into targeted locations around the inflamed nerve (the sciatic nerve) that is causing the pain. The injection helps inflammation around the nerve. This allows other treatment modalities to work more effectively and also serves to reduce pain by, at least for a while, reducing pressure on and irritation of the nerve.
5. Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (or CBT) is a form of psychotherapy used to alter and enhance an individual’s mood and psychological patterns. It is used to deal with the psychological side of sciatica treatment. Basically, the patient is taught techniques to ameliorate depression and mood issues that might normally result from sciatica.
A study in Spine found that CBT could be an effective means of preventing “chronification” of sciatica in patients suffering from the condition.3
- Alaska Serenity Clinic
- Trek Therapy
- Dr. Lawrence Norton
- Bailey Psychological Services LLC
6. Massage Therapy
Massage therapy is a form of medical massage that loosens and relaxes the muscles of the lower back, buttocks, and legs to alleviate pain and inflammation. It is often used in conjunction with other therapies to provide greater effect (see the Alaska Back Pain Protocol – ABPP – below).
- Northern Lights Massage
- Alaska Massage Clinic
- Better Health Alaska – offering targeted medical massage therapy
- Anchorage Massage Therapies
7. Yoga
Yoga is a form of exercise that originates from the East (specifically India). Although it originally arose intertwined with the Hindu religion, our purposes here are strictly medical. Yoga involves stretching the various muscles of the body and holding certain static positions to strengthen those same muscles and muscle groups.
- Body Renew Alaska
- Anchorage Yoga
- Open Space Yoga Studio
8. The Alaska Back Pain Protocol
The Alaska Back Pain Protocol (or ABPP) is a proprietary treatment technique developed by Chiropractor, Dr. Brent Wells of Better Health Alaska. It incorporates several other treatment modalities including chiropractic care, physical therapy, and massage therapy. When used together, these methods worked synergistically, amplifying each other’s effects so that together they exceed the “sum of the parts.”
- Better Health Alaska – The Alaska Back Pain Protocol is only available at Better Health Alaska.
Minimally-Invasive Treatments
9. Spinal Decompression Therapy
Spinal decompression therapy refers to a specific treatment modality that involves the use of a mechanical table that applies traction to the spine (the lower spine for sciatica). Basically, the spine is ‘stretched’ so as to create or enlarge the spaces between the vertebrae. This encourages slipped or bulging discs (a common cause of sciatica) to return to their normal position in the spine. Again, this will reduce or eliminate any irritation those discs are applying to the sciatic nerve.
- Better Health Alaska – one of many treatment modalities at Better Health Alaska
- Sports & Spinal Injury Clinic
- Atlas Disc & Spine Clinic
10. Percutaneous Discectomy
According to the National Spine and Pain Centers, this procedure uses a needle to remove disc material that has moved out of position and is irritating a spinal nerve (in this case, the sciatic nerve). Essentially, once the unwelcome material is removed, the nerve should heal and return to normal.
- Alaska Spine Center
- Arctic Spine
- Alaska Spine Institute: Purlver, Francine M, MD.
Surgical Treatments
11. Discectomy
In some severe cases, a large part or perhaps even the entire intervertebral disc is surgically removed. Again, once the disc is removed, the pressure on the sciatic nerve should abate. When the pressure diminishes or disappears, so should the pain.
A meta-analysis on the BMJ found that Discectomy was “superior to non-surgical treatment or epidural steroid injections in reducing leg pain and disability in people with sciatica with a surgical indication, but the benefits declined over time.”3
- Alaska Fracture & Orthopedic Clinic
- Arctic Spine
- Alaska Spine Center
12. Spinal Fusion
Spinal fusion is a surgical procedure that involves fusing two (or more) consecutive vertebrae together. This is normally done to provide stability to the spine and prevent unwanted movement between the vertebrae. This is a significant surgery and is usually only done after many other methods have been tried.
- Arctic Spine
- Alaska Spine Center
- Alaska Spine Institute: Purlver, Francine M, MD.
13. Artificial Disc Replacement
Artificial disc replacement, or Disc Athroplasty, is a procedure that replaces a patient’s natural intervertebral disc with a synthetic one. Like spinal fusion, it is done to provide stability to the patient’s spine while, at the same time, allowing for a greater degree of movement.
- Orthopedic Research Clinic of Alaska
- AA Spine & Pain Clinic
- Anchorage Neurosurgical Associates
Alternative Treatments
14. Acupuncture
Acupuncture is another medical practice that evolved in the East. It consists of the insertion of special needles into various nerve points (or acupressure points) throughout the body. It is thought to interrupt nerve signals along the nerve pathways the needles intersect. This reduces the pain that an individual normally would feel.
A systematic review on Science Direct found that acupuncture was both effective and safe in the treatment of sciatica.4
- Snowblossom Acupuncture LLC.
- Natural Health Center LLC
- Relaxupuncture
Conclusion
Although sciatica is not only a common condition and a painful one, there are many treatment methods available to deal with it. As a rule, medical professionals stress the importance of exhausting conservative, non-invasive methods (like physical therapy and chiropractic care) before trying the heavy-hitting methods like surgery and heavy-duty painkillers like opioids.
At Better Health Alaska, we offer multiple treatment modalities all under one roof. This includes not only chiropractic care for Sciatica, but physical therapy, massage therapy, and more. So, visit our website and schedule an appointment and we’ll help you tackle that persistent sciatica that’s been bothering you. And we’ll get you back to your healthy self.
Scientific Journals and Other Sources
