What is sciatica?
Sciatica is leg pain brought on by a pinched nerve in the lower back. Although the pangs begin in nerve roots found on either side of the lower spine, they then course through the sciatic nerve, which runs the length of each leg from the butt down to the foot. The leg agony, called radiculopathy, “is frequently even worse than the back pain,” states William A. Abdu, MD, medical director of the Spine Center at Dartmouth-Hitchcock Medical Center. Typically felt in one leg, the feeling “can be unbearable,” says Birgit Ruppert, a physical therapist at the Spine Center. “Some individuals liken it to the nerve pain you experience if you have a tooth pain.”
Causes of Sciatic Nerve Pain
The most common cause is a herniated disk: When a disk develops a tear or crack and bulges into the spinal canal, it can pinch the sciatic nerve. Usually symptoms clear up within about 6 weeks, however for some people, the pain can last.
Best Treatment for Sciatic Nerve Pain
Here’s what can help you:
Sciatic Nerve Pain and Chiropractic Care
Sixty percent of individuals with sciatica who didn’t get relief from other treatments and then attempted back manipulation experienced the exact same degree of pain relief as patients who ultimately had surgery, found a 2010 research study in the Journal of Manipulative and Physiological Therapeutics. The 120 people in the research saw a chiropractic practitioner about 3 times a week for 4 weeks, and then continued weekly visits, tapering off treatment as they felt much better. In people who responded to chiropractic care, benefits lasted as much as a year. “Spinal manipulation may produce a response in the nervous system that eliminates pain and restores normal movement to the hurt area,” states research researcher Gordon McMorland, DC, of National Spine Care in Calgary, Alberta. “It likewise lowers inflammation, creating an environment that promotes the body’s natural recovery systems.”
How Acupuncture helps Sciatic Nerve Pain
“You can get relief as quickly as the first session, though it takes about 12 sessions to see enhancement,” says Jingduan Yang, MD, assistant teacher at the Jefferson Myrna Brind Center of Integrative Medicine at Thomas Jefferson University. A little research study in the Journal of Traditional Chinese Medicine found that of 30 individuals with sciatica, 17 got total relief and 10 saw symptoms improve with warming acupuncture, where the needles are heated up.
Massage for Sciatica
Don’t expect a chilled-out health club massage if you have sciatica. In this circumstances, trigger-point therapy is best, says Jeff Smoot, vice president of the American Massage Therapy Association. The sciatic nerve sits below a muscle called the piriformis, which is located below the glutes. “When the piriformis muscle gets tight, it pinches the sciatic nerve, triggering tingling and numbness down into the leg,” says Smoot. He applies pressure to inflamed and irritated areas, or trigger points, in the piriformis muscle, along with in muscles in the lower back and glutes. Generally, Smoot schedules treatments 7 to 10 days apart. If patients do not see progress by the fourth check out, “they have to attempt another kind of therapy,” he states.
St. John’s wort oil, a lotion, is “one of my favorites for nerve pain,” states Tieraona Low Dog, MD, director of the fellowship at the Arizona Center for Integrative Medicine. Use the anti-inflammatory oil two or three times a day where there’s pain. Another alternative: an OTC cayenne pepper plaster or cream; capsaicin, found in chiles, prevents the release of pain-causing compounds from nerves. For severe cases, Low Dog utilizes the prescription chile spot Qutenza, designed for shingles pain. “One application works for weeks,” says Low Dog.
Treatment with Ice or Heat for Sciatic Nerve Damage
Since the sciatic nerve is buried deep within the buttock and leg, ice or heat on the surface of the body will not reduce that inner swelling. However the timehonored treatments can work as counterirritants– that is, “they give your body other input in the painful area, which brings the pain down a notch,” states Ruppert. Apply an ice pack or a heating pad as required for 15 minutes.
Pain Relievers and Muscle Relaxants
Taking a nonsteroidal anti-inflammatory drug, either OTC (like ibuprofen) or Rx, can ease the distress. Because painful muscle spasms may likewise associated with a disk herniation, medical professionals sometimes recommend muscle relaxants or pain-reducing tricyclic antidepressants. A caveat: “These will not help with the pain brought on by pressure on the sciatic nerve,” says A. Nick Shamie, MD, a spokesperson for the American Academy of Orthopaedic Surgeons.
Epidural Steroid Injections
Individuals whose pain does not minimize within about a month and who aren’t helped by other therapies may find their pain treated by an x-ray-guided injection of steroid into the lower back near the sciatic nerve, says Raj Rao, MD, a representative for the AAOS. “The hope is to reduce inflammation within that nerve branch,” describes Rao. Since of concerns about side effects, such as loss of bone density, the epidural shots are limited to 3 a year.
Workout and Physical Therapy
Moving is typically the last thing individuals dogged by sciatica want to do, but it’s essential to be physically active. “Lying in bed makes it more likely that the pain will last longer,” states Ruppert. “Exercise enhances blood flow to the disk and the nerve, assisting to get rid of the chemicals triggering the swelling.” Take 15- to 20-minute strolls. If that harms excessive, give swimming or water aerobics a shot; there’s not as much pressure on the back when you’re in the water, states Ruppert. It may likewise be worth seeing a physical therapist, who can recommend stretching exercises to bring back versatility to the back or steps that strengthen core muscles, assisting to stabilize the spinal column and reduce the possibility of a comparable injury.
Sciatic Nerve Pain: Surgery
After 4 to 6 weeks of constant symptoms, patients might receive surgery. The Spine Patient Outcomes Research Trial found that those who had surgery for a herniated disk had higher decreases in pain and disability 3 months later than patients who did not. The benefits lasted up to 4 years.