What are the discharge instructions for a patient diagnosed with sciatica?

Discharge Instructions for Sciatica

For patients diagnosed with sciatica, conservative management is recommended as first-line treatment, with most pain and related disability improving within 2-4 weeks with or without treatment. 1

Understanding Your Condition

• Sciatica is a symptom characterized by pain radiating from your lower back down your leg, typically below the knee and into the foot and toes
• It is most commonly caused by a herniated disc pressing on a nerve root
• Most cases improve within 2-4 weeks with proper self-care

Pain Management

• Take over-the-counter NSAIDs (such as ibuprofen) as first-line treatment 2

  • Typical dose: 400-600mg every 6-8 hours as needed for pain
  • Take with food to minimize stomach irritation
  • Do not exceed maximum daily dose (3200mg for ibuprofen)

• If you cannot take NSAIDs, acetaminophen is an alternative 2

  • Typical dose: 500-1000mg every 6 hours as needed
  • Do not exceed 3000mg in 24 hours

• For nighttime pain or muscle spasms, your doctor may prescribe:

  • Muscle relaxants (such as cyclobenzaprine 5-10mg at bedtime) 2
  • For nerve pain: medications such as gabapentin or pregabalin may be prescribed 2

Activity Recommendations

• Stay active within your pain limits - complete bed rest is not recommended 3
• Avoid activities that worsen your pain (heavy lifting, prolonged sitting/standing)
• Gradually increase your activity level as pain improves
• Apply ice for 15-20 minutes every 2-3 hours for the first 48-72 hours to reduce inflammation
• After 48-72 hours, you may apply heat to relieve muscle tension

Exercise Program

• Begin with gentle stretching exercises for your lower back
• Progress to strengthening exercises for your core and back muscles as pain allows
• Walking is an excellent low-impact exercise to maintain mobility
• Consider physical therapy if your symptoms don't improve within 1-2 weeks

When to Seek Immediate Medical Attention

Return to the emergency department or call 911 if you experience:

• New or worsening weakness in your legs
• Loss of bladder or bowel control
• Numbness in the "saddle" area (around genitals, buttocks)
• Severe, uncontrollable pain

Follow-up Care

• Schedule a follow-up appointment with your primary care provider within 1-2 weeks
• If your symptoms don't improve after 6-8 weeks of conservative treatment, imaging (preferably MRI) may be warranted 1
• Consider referral to a specialist if:
  • Pain persists beyond 6-8 weeks despite treatment
  • You have progressive neurological symptoms
  • Your pain significantly limits daily activities

Additional Recommendations

• Use proper body mechanics when lifting (bend at knees, not waist)
• Maintain good posture while sitting and standing
• Consider using a lumbar support pillow when sitting
• Sleep on a firm mattress, preferably on your side with a pillow between your knees

Remember that most cases of sciatica improve with time and conservative management. Follow these instructions and contact your healthcare provider if your symptoms worsen or don't improve within 2-4 weeks.