Sciatica Treatment in Fort Wayne

Sciatica travels. If your pain stays in your back, it's not sciatica. True sciatica shoots down your leg—often past your knee, sometimes to your foot. You might feel sharp, electric pain, burning, numbness, or tingling. Back pain alone, even severe back pain, is a different problem with different treatment.

Most episodes improve significantly within 6-12 weeks with conservative care. About 80-90% of patients avoid surgery. However, if you have severe weakness, progressive symptoms, or no improvement after 8-12 weeks of appropriate treatment, surgical options become more reasonable.

MRI is most useful when it would change your treatment plan. I typically order imaging if: symptoms persist beyond 6-8 weeks despite conservative care, you have progressive weakness, there are red flags like bowel/bladder changes, or we're considering injections or surgery. Early MRI for mild symptoms often creates unnecessary anxiety without changing initial treatment.

Injections reduce inflammation around the nerve, which can break the pain cycle and allow healing. They work best for disc herniations causing acute inflammation. Success rates vary—roughly 50-70% get meaningful relief. Some patients need only one injection; others need a series. Injections buy time for natural healing but don't fix structural problems like large disc fragments.

Surgery becomes reasonable when: conservative treatment fails after 8-12 weeks, you have progressive leg weakness, there's significant functional impairment affecting work or daily life, or you have cauda equina syndrome (bowel/bladder dysfunction—this is urgent). Surgery aims to remove pressure on the nerve, not cure all pain. Realistic expectations matter.

For properly selected patients with clear nerve compression on MRI matching their symptoms, microdiscectomy has 85-95% good-to-excellent outcomes for leg pain relief. Back pain is less predictable. Recovery typically takes 4-6 weeks for return to normal activity. Endoscopic techniques may allow faster recovery with similar outcomes.

Recurrence happens in about 5-10% of patients, usually within the first year. Risk factors include smoking, obesity, heavy lifting, and the size of the original herniation. We remove only the herniated portion of the disc, so there's remaining disc material that could potentially herniate again. Proper post-op activity modification reduces this risk.

Either can be appropriate depending on your situation. Pain management excels at injection-based treatments and medication optimization. Spine surgeons evaluate the structural problem and determine if surgery might help. I often work collaboratively with pain specialists—they handle injections while I provide surgical consultation if conservative care fails.

Seek urgent evaluation for: loss of bowel or bladder control, progressive leg weakness (foot drop, can't stand on toes/heels), numbness in the saddle area, fever with back pain, history of cancer, significant trauma, or pain that wakes you from sleep. These suggest more serious conditions requiring immediate assessment.

Yes, when done correctly. PT focuses on nerve gliding exercises, core stabilization, and posture correction. It won't shrink a herniated disc, but it can reduce nerve irritation and prevent recurrence. The key is finding a therapist experienced with spine conditions who understands the difference between helpful discomfort and harmful pain.

Desk work: typically 2-3 weeks. Light physical work: 4-6 weeks. Heavy lifting or labor: 8-12 weeks. Endoscopic approaches may allow faster return. The limiting factor is usually sitting tolerance and the need to avoid prolonged flexion while the surgical site heals. Most patients notice immediate leg pain improvement but need time for incision healing and strength recovery.

Rarely. Most sciatica from disc herniation is treated with simple decompression (microdiscectomy or endoscopic discectomy)—no fusion needed. Fusion becomes necessary only if there's instability, significant spondylolisthesis, or recurrent herniations requiring extensive disc removal. For straightforward disc herniations, motion-preserving decompression is the standard approach.