Fix Bad Sciatic Pain

Sciatic pain, or sciatica, is pain radiating along the sciatic nerve, which starts in the lower back from different levels of spinal nerves and comes together as one big nerve that travels through each side, from buttock to hips to legs. The pain can occur in any location along the nerve, and can be very intense, depending on what is pressing on the nerve, such as spasm muscle, abnormal disc, or other cause, and which location. Pain is usually on only one side and is often specific to a particular posture (such as sitting). It may last for a period of a few days to a few weeks, depending on the cause. Sciatic pain can be caused by any condition of the lower back or spine which irritates or exposes the sciatic nerve, such as a herniated disc or pregnancy. Managing sciatic pain at home can be accomplished with a combination of simple techniques and common medications. Medical treatment of the symptom depends on the underlying cause of the sciatica, and requires the expertise of a physician.

Steps

Coping with Sciatic Pain at Home

1. Rest your back. For the first day or two following the onset of your sciatic pain, you should feel free to take it easy. This should grant you some relief from the pain, allowing your muscles to relax and avoiding agitating your sciatic nerve with too much activity. However, you should not remain in bed for longer than a day or two. Prolonged inactivity will weaken the muscles responsible for supporting the bones in your back making it easier to further irritate your sciatic nerve, and leading to increased pain over time.
   • While it is important to remain active following your initial resting period, be careful not to agitate your sciatic nerve. Avoid strenuous activities such as lifting heavy objects, or sharply twisting your back.
2. Take anti-inflammatory medications. Irritation of the sciatic nerve can lead to inflammation, which can worsen and prolong sciatic pain. Many over-the-counter anti-inflammatory drugs are available, and may help you reduce your sciatic pain. Ibuprofen and naproxen are two popular and effective choices. Be sure to follow the dosage instructions on the products packaging.
3. Treat sharp pains with cold. Most patients find that cold therapy is most effective in reducing sciatic pain when the pain is sharpest, usually 2-7 days following the onset of sciatic pain. Apply an ice pack (or an alternative source of cold such as a zip-lock bag of ice cube, bag of frozen peas, etc.) to the location of your pain for 20 minutes at a time, repeating every two hours.
   • Make sure to wrap your ice pack in a cloth or towel. Applying the ice directly to your skin may cause discomfort similar to a burn.
4. Use heat to soothe dull pain. Many patients find that their pain becomes less sharp 3-7 days after the onset of sciatic pain. Heat, rather than cold, may be more effective in reducing your pain during this phase. Apply heat to the location of your pain using a hot water bottle, an electric or microwaveable heat pad or by taking a warm bath. Apply the heat for 20 minutes at a time, repeating every two hours.
   • Make sure to follow all manufacturer's instructions for your heat source.
   • While many patients report a preference for cold therapy during the beginning of sciatic pain, and heat during the later stages, this is by no means universal. If one or the other does not seem to be effective in reducing your pain, try alternating hot and cold therapies every two hours.
5. Stretch your lower back. Gentle stretching of your legs, butt, and lower back muscles will help reduce tension, leading to decreased irritation of your sciatic nerve. It is best to consult your doctor or physical therapist for guidelines on safe and effective stretches. While many variations are available, the simplest and most popular stretch for alleviating sciatic pain is a simple knee-to-chest stretch:
   • Laying flat on your back, lift up one knee until you can wrap your hands around the front of your knee or behind your knee or thigh, gripping it with interlocking fingers.
   • Gently pull your knee towards your chest until you feel a gentle tugging in your butt and lower back.
   • Hold for 20 seconds, being sure to breathe deeply.
   • Slowly release your leg, allowing it to return to its starting position on the floor.
   • Repeat the stretch up to three times, then stretch your other leg in the same way.
6. Make an appointment to see your doctor. Most sciatic pain dissipates on its own after a couple of weeks. If your pain does not reduce on its own, or if the pain is very intense and at-home methods have failed to alleviate it, make an appointment to talk to your doctor about treatment options. Rarely, more serious symptoms will develop which require immediate medical attention. Contact emergency medical assistance if you experience:
   • Numbness in one or both legs
   • Pronounced weakness in one or both legs
   • Sudden loss of control of the bladder or bowels or inability to urinate or have a bowel movement

Treating Sciatica

1. Consult your doctor. Sciatic pain can be caused by many conditions of the lower back and spine. Your doctor will know how to test you for these conditions. The types of tests and examinations your doctor chooses will depend on your symptoms and state of health, but may include both simple physical examinations, as well as imaging techniques such as an X-ray or MRI. Be as detailed as you can when describing your symptoms to your doctor, as this will help them determine which tests to perform.
   • Common causes include: herniated or slipped disc, piriformis syndrome, spinal stenosis, or spondylolisthesis.
2. Treat pain and inflammation with prescription medication. Normally, sciatic pain dissipates after a few weeks. If your doctor determines that surgery is not needed, they may still recommend medications to provide relief from the pain while you recover from your sciatica. Typical choices include:
   • Oral steroids, which provide powerful anti-inflammatory effects, reducing inflammation and irritation in the region surrounding the sciatic nerve.
   • Muscle relaxants or narcotic pain medication to reduce pain.
3. Receive steroid injections for more severe or debilitating pain. Steroid injections work much like oral steroid medications, temporarily reducing inflammation and irritation surrounding your sciatic nerve. Injections are more invasive than regular medication, but are also more effective. Your doctor may recommend steroid injections if your pain is sufficiently severe.
4. Consider surgery for severe cases. Sciatic pain can be caused by a variety of factors and conditions, most of which do not require surgery to fix. When sciatic pain is due to discs or bones in the spine physically contacting and "pinching" the sciatic nerve, however, your doctor may recommend surgery to correct the problem. Two types of surgery are most common:
   • For herniated discs (this is when the discs that cushion the important movements of the spine develop a weak area and the inner core pushes out), microdiscectomy may be performed. In this procedure, the piece of the herniated disc which is in contact with, and irritating, the nerve is removed.
   • For lumbar spinal stenosis (narrowing of the discs of the spine causing them to "pinch" the nerve), lumbar laminectomy may be recommended. This is a more serious surgery in which the disc is reshaped to allow the nerve to rest comfortably once again.
5. Visit a physical therapist. After your doctor has recommended medication, and potential surgical solutions for your sciatic pain, they may recommend that you begin working with a physical therapist. Your therapist will help you learn exercises and stretching routines to strengthen your core, and support your spine. Creating strength and stability in the lower spine is the first step to permanent relief from sciatic pain.
6. Visit a chiropractor. Many sufferers of sciatica find that treatment by a chiropractor helps to relieve their pain. Although more research is required to confirm the effectiveness of chiropractic care, recent studies have shown promising results for many patients with sciatica.
7. Explore alternative treatment options. If traditional treatment methods have failed to alleviate your sciatic pain, talk to your doctor about less typical options. Here are some suggestions of alternative therapies to talk to your doctor about:
   • Therapeutic massage to relieve tension and inflammation
   • Yoga classes, to promote core strength and flexibility
   • Cognitive behavioral therapy to teach strategies for pain management
   • Acupuncture, or other traditional therapeutic methods

Sources and Citations

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