Sciatic nerve pain can sometimes be so excruciating and debilitating to the extent that it keeps you on your couch for the rest of the day. The condition can be caused by a number of reasons. A ruptured disk, injury, and the narrowing of the spinal canal are however some of the most common causes of sciatic nerve pain.
Many certified physical therapists agree though that while causes for sciatic nerve pain vary from patient to patient, the key to treatment is an early diagnosis. Knowing where the pain is originating from is vital in dealing with it. Some homemade solutions like stretching and trying to rotate the hip can offer some immediate relief too. However, you will still need to seek additional medical help just to be sure.
Sciatica may have many symptoms that will often vary from one patient to another. Some patients may experience a mild ache while in some cases the pain can be too much to bear. Sciatic pain often runs from your lower back down your hips until it reaches the legs. This leads to significant impairment of normal mobility.
Some of the other effects include numbness in the affected area and tingling sensations. Other patients may also experience some level of muscle weakness across their thighs right down to the calf and foot. The pain gets worse if you have a cold. Coughing and sneezing with sciatica is not always the best thing to do.
In most cases, the pain resulting from sciatica will be experienced on one side of the body. Although it’s important to seek medical advice, the pain can easily be relived through simple physical therapy, massage treatment, or basic chiropractic treatment. It’s also important to work on improving your body strength and flexibility, especially around your core muscles in order to reduce the risk of sciatica in the future. Applying some ice packs and heat on the affected areas may also offer some relief.
Different Types of Sciatic Nerve Pain?
Most sciatica pain comes from the lower back area. The pain can start right from your abdomen and spread downwards to your legs and thighs. However, different people experience different types of sciatica pain. Here are some of the common origins of this pain:
Sciatica from the L4 Nerve Root
The L3 and L4 nerve roots are located around the lower spine. Symptoms of this kind of pain may vary from one patient to another. However, most of the time you may experience some numbness or pain around your medial lower leg and foot. The muscles around the foot will also get weak making hard for you to bring the feet up and down as normal. Some patients may experience some knee-jerk reflexes. This kind of pain will most definitely make it impossible for you to walk on your heels.
Sciatica from S1 Nerve Root
The S1 nerve root is also located along the lower spine. Sciatica pain in this area will have some unique symptoms. First, the patient will experience some pain or numbness on the lateral or the outside of his or her feet. The pain can sometimes weaken the feet muscle to an extent the patient is unable to lift it off the ground. The pain will also prevent you from tiptoeing. However, there is a reduced knee-jerk reflex.
Sciatica L5 Nerve Root
When the L5 nerve root is affected by sciatica pain, the patient will start to experience weakness in the extension of the big toe. This may spread over to the ankles too. This condition is commonly referred to as foot drop. The L5 nerve root is found on the lower back area on your body. Symptoms for this kind of pain include numbness or pain at the top of the foot especially on the web between the big toes and the second toe.
It is important to note though that these symptoms are not universal. Each case of sciatica is different and it would be best to seek additional diagnosis just to be sure what you are dealing with.
Conditions That May Lead to Sciatica Pain
There are a number of lower back conditions that may lead to the occurrence of sciatica pain. However, a lumbar herniated disc is the most common condition that leads to severe sciatic pain. Other common disorders that may cause this pain include lumbar degenerative disc disease, spinal stenosis, spondylolisthesis, and arthritis affecting the spine.
Conditions with Symptoms Similar to Sciatica
There are also a few conditions out there that may have similar symptoms to sciatica pain.
Here they are:
The Increased Pressure Around the Sacral Nerve Roots Caused by Sacroiliac Joint Dysfunction. Sacroiliac joint dysfunction may have some sciatica-like symptoms. Patients who have this condition may experience pain or numbness in the legs and feet. Sometimes the ache may feel as if it’s within the feet than linear.
Piriformis Muscle Problems and Its Pressure on the Sacral Nerve. The Piriformis muscle problem will normally increase the amount of pressure on the sacral nerve. This pressure will then tighten and irritate the sciatic nerves. This will lead to pain or numbness on the leg that gets more intense around the knee. The pain will also start on the leg’s rear instead of the lower back. The only good news about this is that more often than not pain and numbness will not be experienced on the lower back.
In addition to these conditions, a sudden increase in body weight can lead to sciatica pain. Pregnant women, in particular, may run a bigger risk of this.
The Difference Between Sciatica Pain and Referred Pain?
To put it more simply, sciatica is simply used to classify any kind of pain that radiates directly into the leg. However, even referred pain may be classified as pain radiating directly into the leg. So, this is how to differentiate between the two.
The sciatic nerve causes the pain in sciatica. If the pain on your leg is coming from the nerve, then this can be defined as sciatic pain.
However, if the pain on the leg is simply referred to from a joint issue, then you cannot use sciatic pain to classify this kind of pain.
Referred pain often comes from arthritis and other joint related issues. Although this pain may feel or have the symptoms of sciatica, it’s not really a sciatic pain. In addition to this, there are some additional unique sciatica pain symptoms that can easily be identified by a professional physical therapist. These symptoms will, however, vary based on the severity of the pain and where it’s originating from.
Can Sciatica Pain Be An Emergency Condition?
As we have indicated above, most of the time sciatic pain can be treated with simple homemade solutions that relieve the pain after a while. However, there are some cases where this pain may, in fact, be an emergency condition. But it’s something very rare.
There are two types of symptoms that may indicate your sciatica needs more immediate medical attention. Here they are:
Cauda Equina Syndrome
If the patient is experiencing bowel or bladder incontinence as part of the sciatica pain, then they may need to seek more help. Weakness and loss of sensation on the legs is also another sign of Cauda Equina syndrome. This condition simply causes significant compression of the nerve sac around the lower spine. This puts you at significant risk and you must get treated immediately.
In some cases, muscle weakness in the legs and numbness may indicate some nerve damage. In such a situation getting professional help is highly advised. When your sciatic pain becomes more severe than normal, you should have it checked too. Sciatic pain is mostly caused by a small irritation of the nerve. This is not something to worry about. The pain will gradually go away after a few days and you will be fine. However, if the pain is severe and persistent for some time, you will need surgery to fix damaged nerves.
Although not everybody suffers from sciatica, there are some risk factors out there that may expose you to this condition. It doesn’t matter whether you are an athlete or a less active person, sciatica affects all people. Nonetheless, people who live a sedentary kind of lifestyle are more likely to develop sciatica than those who exercise a few days in the week. However, too much exercise may cause sciatica pain. For example, endurance athletes are easily susceptible to sciatica pain due to overworked and overstretched muscles.
Aging is also a very significant risk factor. In fact, it is the most common cause of sciatica pain. People between the ages of 30 and 60 will experience spinal degeneration as part of the natural aging process. These people may also experience other conditions such as bone spurs, herniated disks, and joint dysfunction. All these conditions may lead to sciatic pain. People who suffer from obesity and diabetes will also have a bigger risk of experiencing the condition.
What’s the Good News?
Well, even though the pain of sciatica will be excruciating, you will be happy to know that there is treatment. You need to see a physical therapist though. The professional will help you determine whether your sciatica can be relieved easily using traditional treatments such as Chiropractic adjustment, cold therapy, or static stretching. A lot of people tend to respond better to simple treatment techniques and will feel way better after a few days.
Chiropractic adjustment and simple massage treatments are two common simple options that can be used. These procedures may also help to align your spine which will help address other underlying conditions you don’t know about. Massage also improves the circulation of blood leading to better relaxation. These factors will reduce the risk of sciatica reoccurrence in the future. In case you are only experiencing some minor pain and numbness, you can get cold and heat treatments to help.
In cases where noninvasive measures have failed to work or produce the required results, your doctor may be forced to recommend surgery as a treatment option. However, surgery is not always the best choice for everyone. The Cleveland Clinic, in fact, notes that sciatica can go away even without any treatment. This will take the best part of two months but it’s often less risky compared to surgery.
The biggest advantage you get with surgery is that it provides almost instant relief. Most nonsurgical treatments will need time to take full effect. Regardless of your condition, it is important to note that treatment has to be personalized to the needs of the patient. Talk to your doctor and see what options work best for you.
Improving Core and Back Strength
The musculature on your spine and abdomen is very important but at times it may get weak or too tight. This prevents it from supporting your body as needed. Poor posture and sick muscles are some of the common causes of spine misalignment. These factors will increase your risk of sciatica and other back pain conditions.
However, you can avoid all this by strengthening your core using simple and gentle exercises. This will help improve your posture and your ability to respond to stress in these areas. Eventually, you will reduce the risk of sciatica significantly. But people who are recovering from sciatica must avoid intense high impact exercises such as plyometrics and run until they are fully healed.
Increasing Hamstring and Hip Flexibility
Glutes, stiff hamstrings, and hips play a significant role in altering your posture. If not in good shape, they may also increase the stress on your lower back. This will increase the risk of sciatica pain. In order to deal with this, create a simple stretching routine targeting your hips and your hamstring areas. This routine will also be very beneficial to your piriformis muscle. The piriformis muscle is simply a small muscle in the body attached between the base of your spine and just above the sciatic nerve. If the muscle is weakened, it can lead to aggravation and pain. Nonetheless, a simple and regular stretching routine will help you deal with all these issues.
Physical therapy is often the first real option for people who are suffering from sciatica. However, there are still a few other medical options that can be explored. This becomes necessary if you don’t feel any relief from the pain after physical therapy. The most common drugs used to treat sciatica include the following:
- Anti-inflammatory drugs
- Muscle relaxants
- Anti-seizure medications
- Epidural steroidal injections
- Tricyclic antidepressants
The anti-inflammatory drugs will come handy in relieving the pain that is caused by sciatica. Anti-inflammatory drugs may include both steroidal and non-steroidal. Some of the common non-steroidal drugs are ibuprofen and naproxen. You may also get a prescription of COX-2 inhibitors. The inhibitors help to relieve pain by blocking the production of the pain hormones in the body.
The role of muscle relaxants is to help loosen up the tightened muscle caused by sciatica. Narcotics too can help relax muscles but mostly they tend to relieve the pain. The same goes for the epidural steroidal injections. The tricyclic antidepressants and the anti-seizure medicine are also going to help alleviate the symptoms of sciatica. However, this is not their primary goal. This practice is called off-label drug use. It is the process in which a drug approved by the FDA is used for a different purpose other than what it’s meant for. In that case, these drugs must be administered with strict advice from your doctor to avoid any issues in the future.
Chiropractic, Acupuncture, and Massage Treatments
There are also other alternative treatments that you can use. Chiropractic treatment, in particular, can really help relieve the pain if done by a professional. The main goal of chiropractic treatment is to adjust your spine in order to increase the rate of spinal movements in the body. This can go a long way in alleviating the pain resulting from sciatica. Chiropractic treatment may also help deal with back pains too but it’s often less effective for radiating pain. Massage will help to loosen up the tight muscles caused by sciatica. There is also some research suggesting that regular sessions of acupuncture can help relieve sciatica. However, you must always visit a licensed acupuncture practitioner to avoid any issues.
Heat and Cold Treatments
The moment you start experiencing sciatica pain, you can apply a cold pack on the area affected. This will provide a soothing feeling that will eventually help relieve your pain. Simply wrap up a cold pack in a towel and gently apply it on the painful area. Make sure you do this on a regular basis. Three times a day for about 20 minutes should help you get relief from the pain eventually.
In case the cold treatment did not work, you may try heat instead. You will need a heat lamp for this. Set it on the lowest settings possible and then gently pat the affected area for about 20 minutes. You may also use a hot pack or a heating pad for this. If there is still pain after this try using both cold and heat treatments at the same time, simply alternate each treatment and see if this helps.
Exercises to Help Deal with Sciatic Nerve Pain
Exercise is an important lifestyle choice that can help deal with sciatica symptoms and prevent its future reoccurrence.
Here are six major exercises that you can try:
Reclining Pigeon Pose
The pigeon pose is mostly used in Yoga. Although there are multiple versions of this pose, it is used to simply open up the hips. The reclining pigeon pose is often the easiest beginner version. If you have never done this before, start with this one.
Here are some tips on how to pull it off:
- While flat on your back, bring up your right leg to form a right angle. Clasp both of your hands just beneath your thighs and then lock your fingers.
- Secondly, lift your left leg and gently place it on top of the right ankle.
- Hold this position for a few minutes, once you are done repeat the steps above for the left leg too.
In case you are recovering from sciatica, you will need to do the beginner reclining pigeon pose until the pain is fully gone. After that, you may consider more advanced pigeon poses listed below.
Sitting Pigeon Pose
The sitting pigeon pose is far more advanced than the reclining pigeon pose. Here is how to do it:
- Sit on a flat surface with your legs stretched out in front of you. Make sure they are as straight as possible.
- Bend your right leg and put the right ankle on top of your left knee.
- Lean forward and try to reach your thighs with your body. Try to go as far as you can.
- Hold this position for about thirty seconds and repeat the same procedures for the other leg.
The Forward Pigeon Pose
This is also another advanced technique. To do it, follow the following steps:
- Kneel on all fours on a flat surface
- Gently pick up your right leg and steadily move it forward. The lower leg should be rooted on the ground. Make sure the lifted right foot is in front of the left one.
- Stretch the leg as far as you can. Shift your body weight gently now from your hands. Do it until the legs support your body without the hands.
- Lock into this position and take a few deep breaths before trying it on the other foot.
Knee to Opposite Shoulder
This simple exercise will help to loosen up the gluteal and piriformis muscles and, in the process, it will help relieve sciatica pain. Follow the following steps:
- Lie on your back and extend your legs and your feet upwards.
- Gently bend your right leg and lock your hands around the knee
- Pull the leg across your body gently towards your left shoulder. Try to reach as close to the shoulder as you can and then hold this position for about 30 seconds.
- Return to the starting point and repeat this for the other leg. 3 reps on each side should be enough.
Sitting Spinal Stretch
Sciatica pain will normally be triggered when the vertebrae are compressed. This exercise is simply designed to create space within the spine in order to decompress it and relieve the pain.
Follow the steps below:
- Start by sitting on a flat surface. Extend your legs out and flex your feet upwards.
- Bend your right knee and make sure your foot is flat on the floor.
- Place your left elbow on the right knee and then try to move your body to the right.
- Move as far as you can to the right in this position and hold it for about 30 seconds. Repeat the exercise for the other leg.
Standing Hamstring Stretch
This stretch will ease the pain on your hamstring. Here is how you do it:
- Find an elevated surface and place your right foot. A chair can work in this case. Simply lie on the floor and raise your foot to it.
- Once you are in position bend your body forwards lightly. For a beginner, you don’t need to go further. No need to push your body to the limit too especially if you are still in pain.
- Hold this position for 30 seconds and then repeat it for the other foot.
Be Cautious When You Exercise
You should never assume that you are fit or flexible enough to pull off all these stretches or exercises. Don’t also believe everything you watch on YouTube. The exercises we have listed above can be very tricky and it would be best to take it easy at first before getting into it. Besides, many physical therapists believe that exercises to relieve sciatica pain should be personalized. There is simply no one-size-fits-all routine. You need to find that one simple stretch that is working for you. In addition to this, exercise may not always work. In that case, if you are experiencing sciatic pain for more than 30 days get medical help immediately.
There are also a few natural sciatic pain treatments but they all depend on what is causing the pain in the first place. You may need to also consult your doctor before seeking any natural treatment option. In addition to this, natural treatments too must be administered by licensed and qualified practitioners. Here are some of the common natural sciatica treatments that you can explore:
Chiropractic Spinal Adjustments
Chiropractic spinal adjustment is not just designed for sciatica pain. It can also help address a number of other spinal issues including back pains. Nonetheless, before spinal adjustment is done the chiropractor must do a complete diagnosis to know the kind of spinal injury they are dealing with. There are physical exams that can be done at the chiropractic clinics to determine whether you have sciatica or not. X rays and MRI scans are however more commonly used since they are far more accurate in detecting issues with the spine.
One study done in the US found that participants in the study who suffered from sciatic pain got significant relief from the pain after undergoing chiropractic care.
Movement can sometimes aggravate sciatic pain but it may also help in other cases. For most people, sitting for far too long or standing for a long time triggers the sciatica pain. Others may also feel the pain if they move abruptly. Movements that shorten the spine like raising your legs or bringing your knees towards your chest will often trigger sciatic pain. However, movements that lengthen the spine will offer relief. Lying down or yoga can help with this. There are so many studies that have linked regular yoga to sciatic pain relief. Give it a try.
Massage Therapy and Acupuncture
Most people are of course familiar with the concept of acupuncture. We all know it involves tiny needles but has you ever wondered what’s the science behind it? Well, this is, in fact, a traditional Chinese treatment that is designed to open up the body’s natural flow of energy. This, on the other hand, helps to improve blood flow leading to pain relief. The same effect can also be achieved with massage therapy. Massage will help stimulate blood flow. It will also help in muscle relaxation leading to pain relief from sciatica.
Avoid Sitting for Long Hours
Being active can also help reduce sciatica pain. This may also lead to severe back pains if you’re sitting posture is not good enough. Try to move around if you can. If you can fix in a quick light exercise routine in your schedule, that will be even better. You don’t even have to do it every day. Two or three days of simple exercises can help a lot in relieving sciatic pain.
Try Using Heating Pads
Heat treatment is very common in dealing with sciatica pain. Simply get a heating pad and set it on the lowest settings possible. Place it in the area feeling the pain and gently pat it for a few minutes. Normally, it takes 15 to 20 minutes for the best results. Try and also make this a regular thing. Practice it three or four times a day and your pain will soon be gone.
Studies show that at least 10% of all people who suffer from regular back pains have sciatica. Nonetheless, there are other risks factors that may lead to this. For example, sitting for long periods, driving a truck for long hours, being tall or even being overweight may all lead to sciatica pain. However, most of the time it starts like a normal inflammation. Dealing with these inflammations as soon as possible will help reduce the risk of sciatica pain in the future.
Sciatica is a painful condition that will make everyday life quite unbearable. The only good news you can take from this is that treatments are available and many of them are quite effective in dealing with the pain. In case you are suffering from this condition, talk to your doctor and see what treatment options are ideal for you.