Because of pain and a lack of understanding of their condition, sciatica sufferers may make some costly long-term mistakes when it comes to handling their problem.
The first mistake is rushing into a surgery. Although the vast majority of surgeons are not anxious to perform surgery on sciatica cases, there are a few who do recommend surgical treatment right from the start, and without even attempting any other type of treatment. Sciatica resolves in approximately 80% of cases without surgery. Even when surgery is successful initially, the development of scar tissue and abnormal mechanical stresses on the spine adjacent to the surgery often lead to future problems. Given that low back spine surgery overall has about a 50% long-term success rate and people treated surgically often wind up worse than they were prior to surgery, it should be reserved as a treatment of last resort.
The exception to the rule of considering surgery as a last resort is in the rare case of severe neurological compromise known as "cauda equina syndrome", which may be indicated by a loss of bowel and/or bladder control, sudden severe weakness in one or both legs, and/or "saddle anaesthesia" (a loss of sensation in the lower buttocks and inner thighs). Except in the rare instance of cauda equina syndrome though, it is generally better to avoid surgery if possible.
The second mistake sciatica sufferers often make is returning to normal activities too quickly once symptoms improve. The vast majority of true sciatica cases are due to bulging or herniation of one or more discs in the lumbar spine, and the inflammation that typically is associated with such disc problems. In many cases, slight improvements in inflammation can result in dramatic symptom improvement. Many sciatica victims mistakenly believe they are back to normal as soon as they feel better, but the reality is that the bulging/herniated disc is far from fully healed, and too much exertion too soon can easily trigger a recurrence of symptoms - sometimes even more severe than they were to begin with. Even professional physical therapists sometimes make the mistake of pushing a patient to do too much too soon, with the result being a return or increase in sciatica symptoms.
The third mistake people, including doctors, often make regarding sciatica is to view it as a condition that can be "cured". Because most people continue to engage in the activities that caused the underlying disc problems to develop that produced sciatica in the first place, the vast majority of sciatica sufferers will experience repeated episodes, usually becoming more severe and more frequent over time. This is due to the fact that the disc issues that initially produce the sciatica tend to grow worse over time if they are not managed appropriately. Once again, it is not safe to assume that a resolution of symptoms means that the problem has gone away. In fact, what happens in many cases is that the spine and discs gradually degenerate over time, making the person more and more susceptible to sciatica episodes. Eventually, the degeneration can become so severe that there really is no effective treatment, and many people are left with chronic, debilitating pain.
Fortunately, in most cases, sciatica can be managed effectively simply through an awareness of potentially damaging activities and positions and through simple exercises one can do at home. Long-term pain and disability are avoidable, if one makes the necessary effort to perform the necessary exercise regimen on a regular schedule and to avoid movements, activities, and postions that can be damaging to the discs of the spine, such as incorrect bending and lifting, and poor posture (especially sitting posture). Long-term problems can be avoided by putting forth just a small amount of effort to manage sciatica on an ongoing basis over time.
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