The Conservative Treatment of Sciatica

In the absence of absolute indications for surgery (cauda equina syndrome or marked progressive muscle weakness) it seems reasonable to permit up to 3 months of conservative therapy before recommending surgery.

Abstract

The mainstay of rational treatment of acute sciatica involves bed rest and antiinflammatory drugs. The authors recommended 2 weeks of complete bed rest with progressive gradual mobilization over the next 7-10 days. Buffered aspirin in a dosage of 10-15 grains every 4 hours is prescribed both for its analgesic effect as well as for its antiinflammatory properties. Through the low-back school, the patient is instructed in low-back hygiene. Physically capable patients are encouraged to begin an aerobic exercise program. In the absence of absolute indications for surgery (cauda equina syndrome or marked progressive muscle weakness) it seems reasonable to permit up to 3 months of conservative therapy before recommending surgery.