Sciatica describes pain that radiates down the back of the thigh and into the lower leg. It may be caused by irritation of one or more of the lower spinal nerves. The pain can be mild or severe, and often develops as a result of wear and tear on the lower spine. The good news is that sciatica is most often relieved through conservative methods within a matter of weeks and without requiring surgery. Working to improve your back and core strength while increasing flexibility throughout your hips and lower body will significantly reduce your chances of experiencing lower back pain and other symptoms of sciatica.
The symptoms of sciatica can vary from a mild ache to excruciating pain that radiates along the pathway of your sciatic nerve, which runs from your lower back down past your hips and into each leg. These symptoms can include numbness, tingling sensations, or muscle weakness that travels down the back of your thigh and into your calf or foot. It’s often worse with coughing or sneezing. Typically, people affected with sciatica will experience symptoms on only one side of the body. Although the pain may be severe, sciatica can most often be relieved through physical therapy, chiropractic and massage treatments, improvements in strength and flexibility, and the application of heat and ice packs.
There are many factors that can leave you susceptible to sciatica, which affects both athletes and those who are less active. People who lead a sedentary lifestyle are more likely to develop sciatica than active people. However, endurance athletes are also prone to experiencing sciatica from overworked and stiff muscles.
Age is also a significant factor, as those between the ages of 30 and 60 often experience age-related degeneration in their spine, including herniated disks, bone spurs, and joint dysfunction in the hips. Obesity and diabetes are other common contributors, according to the Mayo Clinic.
A physical therapist can help you to determine whether sciatica can be relieved through conservative methods such as chiropractic adjustments, static stretching, and cold therapy. Most people respond well to simple techniques and are pain-free within a matter of weeks. Chiropractic adjustments and massage therapy may help improve the alignment of your spine and address other underlying conditions while also improving blood circulation and muscle relaxation. Minor pain can also be treated with the application of heat and cold.
While some doctors may recommend surgery as a treatment for sciatica after noninvasive measures have failed, experts say it’s not always the right choice for everyone. In fact, according to the Cleveland Clinic, nearly 50 percent of people with sciatica report their symptoms improving within 1.5 months of their diagnosis. Nonsurgical treatments may include a longer period of recovery. However, surgery comes with its own risks, which include infection and blood clots. It’s important to talk with your doctor about your sciatica to determine which treatment is best for you.
The musculature around your spine and abdomen may be weak or overly tight, preventing it from supporting your body as needed. Poor posture and compromised muscles can impact the alignment of your spine, increasing your risk for lower back pain and sciatica. Gentle strengthening exercises that target your core and back will improve your posture and ability to respond to stress, reducing the likelihood and severity of back pain. While you’re recovering from sciatica, you may want to avoid high-impact exercises, such as running and plyometrics.
Stiff hamstrings, glutes, and hips can alter your posture and increase the stress on your lower back, which may contribute to sciatica. Most types of sciatica will benefit significantly from a stretching routine that targets the hips and hamstrings and relieves an overused or inflamed piriformis muscle. The piriformis is a small muscle that attaches at the base of the spine and runs just above the sciatic nerve. Prolonged inactivity or sitting compresses the piriformis over the sciatic nerve, which can lead to aggravation and pain. Reverse the effects of tight hips and hamstrings by adopting a simple stretching routine or incorporating yoga into your overall fitness regimen.
Here are two ways to stretch your piriformis muscle and relieve pain.
- Lie on your back with both of your knees bent and your feet on the ground.
- Lift one leg and cross it just above your knee.
- Hold the thigh of the leg with the foot on the ground and pull up to your chest until you can feel the stretch in your buttocks.
- Hold for 10 to 30 seconds.
- Repeat on the opposite side.
- Lie on your back with both legs straight out.
- Hold one knee with your opposite hand and pull your knee up and over to the opposite shoulder.
- Hold for 10 to 30 seconds.
- Repeat on the opposite side.
Physical therapy is often the first line of treatment for sciatica. However, if your symptoms don’t improve, your doctor may recommend you take medications. The most common types of drugs prescribed for sciatica pain include:
- anti-inflammatory drugs
- muscle relaxants
- epidural steroidal injections
- tricyclic antidepressants
- antiseizure medications
Anti-inflammatory drugs can reduce inflammation and sciatica symptoms. They can include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). They also include COX-2 inhibitors, which stop pain by blocking hormones in the body.
Muscle relaxants loosen muscles tightened up by sciatica, and narcotics help to ease sciatica pain. Epidural steroidal injections can also reduce pain. With this option, a corticosteroid and anesthetic numbing drug are inserted into the space between two vertebrae.
Tricyclic antidepressants and antiseizure medications can sometimes effectively treat sciatica, although it’s not their primary purpose.
Off-label drug use is when a drug that’s been approved by the U.S. Food and Drug Administration (FDA) for one purpose is used for a different purpose that it hasn’t been approved for. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.
Alternative treatments for sciatica can also provide some pain relief. A chiropractor can adjust your spine in a way that increases spinal movement, which improves spine function and decreases pain. Chiropractic treatment can also relieve lower back pain caused by sciatica, but is less effective for radiating pain.
You may have tight muscles as a result of sciatica pain. Massage can help loosen up your muscles, alleviating some pain and improving mobility and flexibility.
Some research suggests that acupuncture can help relieve sciatica. If you’re interested in acupuncture, be sure to visit a licensed practitioner.
Heat and cold therapy
When you first start experiencing sciatica pain, applying a cold pack can provide a lot of relief. Wrap a cold pack or a bag of frozen peas in a clean towel, and apply it to the painful area a few times a day for up to 20 minutes each time.
If your sciatica is still bothering you after a few days, then it can be helpful to try heat instead. Apply a heat lamp on the lowest setting, a hot pack, or a heating pad to the painful area.
If your pain persists, try alternating between cold packs and hot packs.
Sciatica is a painful condition that can make everyday life more challenging. The good news is that there are a lot of ways to treat it, and many of them are quite effective at reducing symptoms. Talk with your doctor to determine which treatments are best for you.