Sciatica & Brachialgia

Unique conditions of chronic pain call for alertness during diagnosis

Sciatica is indicative of nerve irritation, inflammation or compression which could be due to many causes but is often traced to disc herniation or disc material irritating the nerve. Occurrence of nerve pain in arm and leg related to spinal symptom (neck and lower back pain) is very common and usually heals well by application of simple treatment methods like pain killers, rest and physiotherapy input in over 80% of patients. In most cases it can be attributed to a variety of reasons like road traffic accident, fall, trauma or arthritis in facet joints but sometimes there are serious causes of pain too like infection, large disc bulges compressing spinal cord, vertebral fracture or tumour.

If symptoms do not alleviate with rest and painkillers and assume disruptive proportions, you may need further assessment and surgery would emerge as a preferred option. Many patients unfortunately continue to have pain despite surgery but the good news is that this can also be helped. Advanced treatment options like spinal implants (SCS) is usually offered in NHS to deal with this chronic pain condition.

Treatment Methodology

Following are the steps which I follow with my patients as a specialist for treating sciatica and brachialgia –

  • Determining if your condition is chronic pain on basis of thorough assessment
  • Explanation of most likely cause of your pain and likely long term outcome
  • Investigations if required including MRI scan
  • Listing out possible treatment options
  • Striking a balance between minimal and advanced procedures for alleviating pain
  • Prescribing appropriate pain killers as per your chronic pain condition
  • Plan may include -

    • Physiotherapy

    • Epidural injection or root block

    • Spinal cord stimulation (SCS) implant

    • Pain management program to improve self-management of pain

  • Using state-of-the-art equipment, facility and highly skilled and passionate team
  • More complex cases require multidisciplinary team input usually on NHS