Sciatica is pain that travels along the sciatic nerve, which originates in the lower back at various levels of the spinal nerves and descends into each leg, passing through the buttocks, hips, and thighs. The pain can occur at any level of the nerve and can be very severe depending on the cause, such as muscle spasms, an abnormal disc, or other conditions, as well as the location. Typically, the pain is felt on only one side and often occurs in a certain position (such as sitting). It may last for several days or weeks, depending on the cause. It can be caused by any disorder in the lower back or spine that irritates or exposes the sciatic nerve, such as a herniated disc or pregnancy. You can manage sciatica at home with a combination of simple treatment techniques and medications. The medications to take to relieve symptoms will depend on the underlying cause, which requires the advice of a specialist.
Relieve pain at home
Let your back rest. For the first day or two after the pain begins, you should take it easy. This will help relieve some of the pain while allowing the muscles to relax and avoiding agitation of the sciatic nerve. However, this doesn't mean you should stay in bed for more than a day or two. Prolonged inactivity will weaken the muscles that help support the bones in your back, making it easier to irritate the sciatic nerve and increasing the pain you feel.
- While it's important to stay active after resting, you should be careful to spare your sciatic nerve. Avoid overly strenuous activities, such as lifting heavy objects or twisting your back.
Take anti-inflammatory medications. Sciatic nerve irritation can lead to inflammation, which will worsen and prolong the pain. There are many anti-inflammatory medications you can buy over the counter that can help reduce pain. Try ibuprofen and naproxen, for example; they are both effective. Be sure to follow the dosage instructions on the label
Treat acute pain with cold. Most patients report that cold therapy is effective in reducing pain when it is at its worst, usually between two and seven days after it begins. Apply an ice pack (or similar solution such as a plastic bag with ice cubes or a bag of frozen peas) to the pain site for up to 20 minutes, then repeat every two hours .
- Remember to wrap the ice pack in a cloth or towel. You should not apply ice directly to the skin, as this could cause frostbite.
Use heat to relieve dull pain. Many people report that pain begins to lessen three to seven days after it begins. In this case, heat may be more effective than cold in treating the pain. Apply heat to the area of your body that hurts, such as using a hot water bottle, an electric or microwaveable heat pack, or taking a bath. Apply heat for up to 20 minutes, repeating every two hours .
- Follow the manufacturer's instructions for how to use the compress.
- Although many patients prefer to use cold at the onset of pain and heat later, this is not a universal preference. If one or both of these methods are not effective, you can try alternating between cold and hot compresses every two hours.
Stretch your lower back . Gently stretching your legs , buttocks, and lower back muscles may help reduce tension, which may also reduce irritation to the sciatic nerve. It's still a good idea to consult your doctor or a physical therapist to learn effective and safe stretches. While there are many variations, the simplest and most popular method for relieving this type of pain is to pull your knee toward your torso
- Lie on your back and raise one knee until you can run your hands over the front of the knee or behind it, interlocking your fingers.
- Gently bring your knee toward your torso until you feel slight resistance in your buttocks and lower back.
- Hold for twenty seconds and inhale deeply.
- Slowly relax your leg and gently place it back on the floor.
- Repeat the stretches up to three times, then stretch the opposite leg in the same way.
Make an appointment with your doctor. Most of the time, sciatica disappears within two to three weeks. If it doesn't go away on its own or if it's very severe and your home treatments aren't enough, you should make an appointment with your doctor to discuss your treatment options. Although rare, more serious symptoms can develop, and you should see a specialist immediately. Call emergency services in the following cases: :
- numbness in both legs
- prolonged weakness in one or both legs
- a sudden loss of bladder or bowel control or an inability to urinate or have a bowel movement
Treating sciatica
Consult your doctor. Many lower back and spine disorders can cause sciatica. Your doctor will know how to find the cause of your pain. The type of tests they perform will depend on your symptoms and health, but typically, they may examine you or order imaging tests, such as an X-ray or MRI. You should describe your symptoms in detail to your doctor so they can determine the most appropriate tests for you..
- Here are some of the most common causes: a herniated or displaced disc, piriformis syndrome , a narrow lumbar spinal canal (or spinal stenosis), or spondylolisthesis
Take prescription pain medication. Typically, sciatica should clear up within two to three weeks. If your doctor doesn't think surgery is necessary, they may recommend taking pain medication while you wait for your sciatica to clear up. Here are some medications they may prescribe :
- oral steroids that have powerful anti-inflammatory effects, which help reduce inflammation and irritation in the area around the sciatic nerve
- muscle relaxants or narcotic pain medications
Receive a steroid injection in more severe cases. Steroid injections have a similar effect to oral steroids, temporarily reducing inflammation and irritation around the sciatic nerve. It's a more invasive treatment than oral steroids, but it provides better results. Your doctor may recommend steroid injections if the pain is severe
In severe cases, consider surgery. Pain can be the result of many factors and conditions, but most do not require surgery. When it is caused by a problem with discs or bones in the spine that are contacting or pinching the nerve, your doctor may recommend surgery to correct the problem. There are two most common types of surgery .
- In the case of a herniated disc (when the disc that cushions the movements of the vertebrae weakens and protrudes from its place), a surgeon may correct it with a microdiscectomy. During this procedure, the surgeon will remove the part of the disc that is rubbing and irritating the sciatic nerve.
- In the case of lumbar spinal stenosis (a narrowing of the spinal discs that causes nerve pinching), a lumbar laminectomy may be recommended. This is a more serious procedure that involves changing the shape of the disc to relieve pressure on the nerve.
Consult a physical therapist. Once your doctor has recommended medications and possible surgery to correct the problem, they may also recommend that you consult a physical therapist. A physical therapist will suggest exercises and stretches designed to strengthen your core and support your spine. The first step to permanently relieving sciatica is to increase strength and stability in your lower spine
Consult a chiropractor. Many people who suffer from sciatica find that treatment by a chiropractor provides relief. While more research is needed to prove the effectiveness of this treatment, recent studies have shown promising results in many sciatica patients.
Try alternative treatments. If traditional methods aren't providing the relief you're looking for, you may want to talk to your doctor about less conventional solutions. Here are some alternative therapies you might want to discuss with your doctor: :
- therapeutic massage to relieve tension and inflammation
- yoga classes to strengthen your core and gain better flexibility
- cognitive behavioral therapy that teaches you pain management techniques
- acupuncture and other traditional therapeutic methods
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