Treatment Options for Sciatica
Because of the many conditions that can compress nerve roots and cause sciatica, treatment options often differ from patient to patient. Treatment of the underlying cause of the compression is often the most effective course.
Imaging methods such as MRI neurography may help diagnosis and treatment of sciatica. MR neurography is a modified MRI technique using MRI software to provide better pictures of the spinal nerves and the effect of compression on these nerves. MR neurography may help diagnose piriformis syndrome which is another cause of sciatica that does not involve disc herniation. MR neurography is considered experimental and is not covered by insurances.
Most cases of sciatica can be effectively treated by physical therapy or massage therapy and appropriate changes in behavior and environment (for example cushioning, chair and desk height, exercise, stretching). Other conservative treatment options include anti-inflammatory medications (i.e. NSAIDs or oral steroids), pain medications, and epidural steroid injections (however the latter carries the risk of possible side effects and complications from the needle puncture and medications used).
"Alternative" and "complementary" treatments include chiropractic manipulation (although there is no scientific consensus for chiropractic's effectiveness) and somatics. Acupuncture has no effect beyond placebo in treating sciatica.