I am a 70-year-old and suffer from severe sciatica despite taking medications. Why?

Q. Does sciatica need surgery if it does not resolve by medications?

Answered by
Dr. Florilyn Joyce Chulsi Bentrez
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 12, 2023 and last reviewed on: May 23, 2023

Hello doctor,

I am a 70-year-old and suffer from severe sciatica. I had a round of steroids but did not get much relief, I can barely walk. They want to do surgery. I have not even spoken with the surgeon just his PA, my PCP (Phencyclidine or phenylcyclohexyl piperidine) is for pain management. It has been three weeks, and it usually resolves itself. Unfortunately, I live alone so for a while I did a lot of twisting and taking care of my dogs. Kindly suggest.



Welcome to icliniq.com.

I suggest it is good that you have someone help you with the chores. There are certain chores that would need twisting and forward bending and carrying. All these would not help your back. Have you got a spine MRI done already? How about calcium and vitamin D levels? Sciatica management is multimodal, pharmacological and non-pharmacological methods are effective. There are medicines for neuropathic pain but they can cause drowsiness in the daytime, causing more harm. Apart from the medications, you can undergo physical therapy weekly, yoga, and other relaxation exercises. If these are not effective, surgery will help.

Thank you.

Hello doctor,

I had an MRI and found stenosis at L4 and L5. Will this pain eventually abate? Should I rest or walk through the pain? Kindly suggest.



Welcome back to icliniq.com.

It is good that the spinal cord is not injured based on the MRI reports (attachment removed to protect the patient's identity) probably the nerve root is, and it might be causing shooting pain. You should avoid positions that trigger the pain. Avoid bending and too much weight gain. Rest is fine but too much rest makes it more difficult for you to move around. Being mobile is fine as long as safe and comfortable, pain control medications, physical therapy, meditation, and probable surgery may help. Strengthening the bones can also help. You can try Pregabalin 75 mg once a day at night. If taken in the morning might make you feel dizzy. Consult your specialist doctor, discuss with them, and take medications with their consent.

Thank you.

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