[Aspects of conservative sciatic pain therapy]

Successful multimodal conservative treatment of sciatic pain will prevent unfavorable results of life discectomy and accelerates the natural course. In assessment of modalities of conservative treatment of sciatic pain, somatic and psychosomatic aspects have to be considered. Severe neurological deficits caused by lumbar disc herniation have to be treated surgically. Conservative treatment of sciatic pain follows the etiopathogenetic hypothesis of a centrally triggered and radicularly terminated inflammation; it reflects the biopsychosocial paradigm. Inflammatory alterations in the disc and psychosocial peculiarities of the patients prove this disease model. Conservative treatment of sciatic pain does not determine its, but works by the combined operation of different but etiopathogenetic or scientifically efficient means. Somatic therapy aims at blocking the inflammatory cascade by peridural and systemic antiphlogistic drugs, sufficiently applied analgesics and temporally limited bedrest. Physiotherapy and sports therapy for remobilization will follow. Psychosomatic therapy works through relaxation, support and interpretation. Physiotherapy, relaxation and verbal intervention work prophylactically, too. The patient-doctor relationship plays a crucial role in conservative treatment of sciatic pain.