I have evaluated several patients in my career with back pain and sciatica. After the assessment, usually without an X-ray exam, I tell them that there is nothing very special to do and that over time everything will work out.

Many then look at me as if I had lost my mind. Hard to believe that this intense pain will go away on its own! Besides, what about this recommendation to avoid resting too long?

As with many other health problems, medical practices are changing. What was believed to be true a few years ago is no longer necessarily true. For example, we now know that rest extins in bed is harmful and there is no need to resort to surgery too quickly. Also, the usefulness of cold applications and anti-inflammatory drugs is questioned. The human body has a great capacity for self-healing and, in the vast majority of cases, herniated discs resolve over time.

The doctor’s role is to make a good evaluation to rule out the rare serious causes of back pain with sciatica. Thereafter, with compassion, patience, appropriate analgesia and a follow-up appointment a few weeks later are recommended.

D^r Dominic Larose, MD