Through:Rob S. Williams, MD 4. May 2017 Sciatica
If you've been diagnosed with the annoyance and discomfort of sciatic nerve pain, you may be wondering, "How can I get relief?" Treatment for sciatic pain can take a variety of forms, depending on the root cause of your sciatic problem and the severity of your symptoms.
What sciatic pain feels like
First - how do you first discover that you may have sciatica? What does sciatica pain feel like and why do you have it?
Because thesymptoms of sciaticaUsually occurring in the buttocks and leg (often below the knee), many people mistakenly believe they have suffered a leg injury. Actually, sciatic pain is a problem in the lower back. It originates in the largest nerve in the human body, theIschiasnerv. Also called thesciatic nerve, the sciatic nerve begins in the lower back and runs behind the thigh to the knee, where it joins the tibial and
So if you experience a stabbing pain or a tingling, burning sensation anywhere in your leg, the root cause of these symptoms is a part of the sciatic nerve in the lower back or buttock that is pinched, damaged, or inflamed. For example, a disc can slip out of alignment and put pressure on the nerve. Likewise, a back muscle can become swollen or inflamed from overexertion or injury, which can clog the area around the spine and put pressure on it.
The causes of sciatic pain can be varied. Sports or accidents can contribute, as can degenerative diseases of the spine. Pregnancy is also a very common cause.
Before treating your pain, your doctor will need to examine you and determine why you are having symptoms. Often, treating the underlying cause takes the pressure off the nerve and makes the symptoms go away.
What are these symptoms exactly?
Sciatic Nerve Pain Symptoms:
- Numbness, pain, or tingling that runs down the leg — sometimes to the feet and toes
- An "electric" sensation that runs down the leg (Some say it feels like a toothache - but in the leg.)
- Radiating (spreading) pain originating in the lower back
- Pain anywhere along the leg (common on the outside of the leg or along the back of the hamstrings and calves)
- Pain that is dull or sharp, stabbing or aching - or a combination of these
- Pain that jumps or stabs when you sneeze
- Weakness in one or both legs
- Inability to find a comfortable position when sitting or driving
Sciatica symptoms can vary. For many people, sciatic pain isn't unbearable — but it can be distracting and annoying. For example, if you sit in a chair at work all day and can't get comfortable, you may find it difficult to focus on the task at hand. Sciatica sufferers can also have trouble sleeping for the same reason; You toss and turn, trying to find a position that will ease the pain.
Sciatica can be distressing because its symptoms can last for a long time. Most sciatic pain goes away on its own within a month. But four weeks of non-stop, annoying discomfort can feel like an eternity. And in some people, sciatica can be chronic, with symptoms lasting longer than 8 weeks — maybe even up to a year.
Sciatica Pain Relief: Nonsurgical Options
Most patients (and most physicians) prefer to begin treating sciatic pain with conservative, non-surgical treatments. After confirming your diagnosis and the underlying cause through tests (which may include MRIs, X-rays, and physical exams), your doctor may prescribe four to six weeks of noninvasive medical treatment.
Non-surgical methods of treating sciatic nerve pain may include:
- heatandcold therapy.These therapeutic modalities can help treat swelling, inflammation, or spasms that are putting pressure on the nerve. Most sciatica sufferers are recommended to use one or both at home or as part of a prescription physical therapy regimen.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs).If the cause of your sciatic pain is inflammation, over-the-counter medications can help reduce the swelling and subsequent pain.
- deep tissue massageWhen tight muscles and tissues are pressing on the sciatic nerve, releasing tension can bring some relief.
- Ultraschalltherapie.In this physical therapy treatment, sound waves are sent far into the body to warm the muscles from within. The approach achieves results similar to heat therapy and massage, but goes deeper.
- Chiropractic Treatment.Spinal adjustments and manipulations can help improve the alignment of your vertebrae—just enough to relieve pressure on the sciatic nerve.
- corticosteroid injections.Epidural injections can flood the roots of the spinal nerves with a corticosteroid that reduces inflammation and relieves pain. Successful treatment can take months.
- Prescription drugs.Muscle relaxants can help with lower back spasms; Antidepressants can block nerve signals for pain in some cases.
- alternative treatments.Some patients find some pain relief in non-traditional Western medicine approaches such as acupuncture, acupressure, and biofeedback.
- exercises and stretches.One of the most popular avenues of treatment for sciatica is through simple movements and activities, which are described in more detail below.
Exercises and stretches to relieve sciatica pain
Sciatic pain caused by physical problems in the soft tissues — including muscles, tendons, and ligaments — can be improved with exercise and stretching. Your doctor may prescribe specific movements to work your core muscles and improve your posture. Others can help stretch and relax your lower back. These movements can help strengthen your core and lower back and relieve pressure on the sciatic nerve. Stretching can also help quell spasms.
Five commonly recommended exercises for relieving sciatica pain are:
- knees to chest.Lie flat on your back, on the floor, or on a mat. Slowly bring your knees to your chest and then wrap your arms around your knees. Relax your lower back. Hold this position for 30 seconds. As you let go of your legs, slowly bring them back down to the floor. Repeat three times. As a variation, you can do one leg at a time and hold onto the thigh to bring the knee closer to your face. This movement stretches your hamstrings and lower back. Keep your head flat on the floor to avoid straining your neck.
- rotation of the lower back.Lie flat on your back with your legs straight. Bend one leg at the knee and keep the other foot on the floor. Gently let your bent leg fall over your straight leg. Keep your opposite foot, back and hips flat on the floor. This movement stretches both the lower and middle back. Hold the movement for 30 seconds, then switch sides. Repeat 3 times.
- Quadriceps stretch.Lie on your stomach and bend one knee behind you. Reach your hand back on that side, gently grab your knuckle, and pull. This stretch relaxes your hips and the front of your thighs. Hold for 30 seconds, then switch to the other side. Repeat 3 times.
- Stretch buttocks and hips.Lie on the floor and bend both knees. Place the ankle of your right leg in front of the knee of your left leg. Gently pull your left thigh toward your face. This movement stretches the outside of the glutes and oblique hips—muscles that are difficult to stretch and often overlooked in most stretching exercises. Hold for 30 seconds and repeat three times.
- groin strain.Lie flat on your back, bring your feet together, press the soles and drop your knees (gently) toward the floor until you feel the stretch. Some call this a "butterfly position." This movement stretches the hamstrings and groin. Hold for 30 seconds and repeat three times.
Remember: Before beginning any exercise plan, consult a doctor or physical therapist. By tailoring your exercises to your medical history and current condition, you can ensure you're moving in ways that are sure to relieve your symptoms. (For example, some exercises may not be advisable for pregnant women or those with pre-existing injuries.)
An orthopedist can also advise you on activities to avoid, since these movements can compress your spine or worsen nerve inflammation. For example, you may need to skip the following:
- certain yoga movements
- Stretches that force you to bend at the waist
- Stomach cramps
- Running (especially if your form is poor)
Surgical options for relieving sciatic pain
For some patients, exercise and other nonsurgical options are ineffective in relieving chronic sciatic pain.
In a minority of cases, symptoms can also worsen and include neurological problems such as severely weak legs or problems with the lower gastrointestinal tract. In these scenarios, surgery may be the only means of solving the problem.
If your orthopedist determines that you are a good candidate for surgery, your options are:
- Laminektomy/Laminotomy.If your spinal nerves are being compressed or pinched by contact with the lamina (the spiny part of the vertebra), removing this piece of bone can relieve the pressure and eliminate sciatica. This procedure is most commonly used in cases where sciatica is caused by spinal canal stenosis, where the spine has narrowed due to injury, repetitive strain, and/or genetic predisposition.
- Between each vertebral bone is protective tissue known as an intervertebral disc. Each disc has a hole through which the spinal cord can pass. A "slipped," "pinched," or "herniated" disc is misaligned with the spine, causing this hole to press directly on the sciatic nerve. A discectomy removes part or all of the damaged disc to relieve pressure. The intervertebral disc can also be replaced with an artificial disc.
Recovery from surgery to treat sciatic nerve pain is fairly quick: you should be back on your feet in a day after a successful procedure. However, your doctor may recommend pain medication and rest for a few days or weeks while you recover. Follow your surgeon's instructions after sciatica surgeryI agree instructionsto prevent your spine from being damaged while it heals. Move slowly and carefully, eliminating as much spinal motion as possible.
Avoid lifting, twisting, or abrupt movements for at least two to four weeks after surgery. No physical activity either.
Most people with sciatic pain do not need surgery. However, those who do can look forward to a full recovery: up to 80% of patients experience relief from their pain.
If you or a loved one are struggling with back pain and would like to learn more about your treatment options, give us a callcoastal orthopedicstoday in Corpus Christi, Texas(361) 994-1166
Article written by: Rob Williams, MD
Microdiscectomy for Sciatica
It's a minor surgery where a small incision is made and the part that's pinching the nerve is removed, leaving everything else intact. It's the most common surgery solution for the issue and considered for a pain that keeps up for more than 4 weeks.
Pressure release is the best way to get rid of sciatica pain for good. Applying direct, prolonged pressure on the muscle knots in your hip muscles for 30 to 90 produces permanent results.What is the most successful treatment for sciatica? ›
Stretching and physical therapy
One of the best ways to treat sciatica pain and to prevent sciatica in the future is through physical therapy and stretching. With physical therapy, we can target and strengthen the surrounding muscles in your back to take the pressure off your sciatic nerve.
Many cases of sciatica will resolve on their own in a matter of weeks without treatment, but those with a deeper underlying cause will require proactive treatment to cure sciatica permanently.How long do you stay in the hospital after sciatica surgery? ›
Sciatica surgery is performed in a hospital operating room. You should expect to stay overnight for at least one night in the hospital. Your exact length of stay will depend on type of procedure you have. For a discectomy, laminectomy, or foraminotomy, you can expect to stay at the hospital for one to two days.Does an MRI show sciatica? ›
An MRI of the lumbar spine will show many causes of low back pain and sciatica, including disc herniations, facet arthritis, and lumbar spinal stenosis. Digital x-rays and CT scans may also be used to diagnose the cause of sciatica.What happens if sciatica doesn't go away? ›
If the sciatic nerve is damaged, it could result in numbness, tingling and, in more severe cases, weakness in the knees or legs. The longer it is left untreated, the longer it will take for numbness and weakness to go away, and they may become permanent.Can a chiropractor fix sciatica? ›
While sciatica pain can be debilitating, chiropractic treatment can relieve it gently and naturally. This care entails treating the pain without costly and harmful side effects.Is there an injection you can have for sciatica? ›
Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions. They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease. Steroid injections are only given by healthcare professionals.What is the main cause of sciatica? ›
Sciatica occurs when the sciatic nerve becomes pinched. The cause is usually a herniated disk in the spine or an overgrowth of bone, sometimes called bone spurs, form on the spinal bones. More rarely, a tumor can put pressure on the nerve. Or a disease such as diabetes can damage the nerve.
Microdiscectomy During this procedure, the neurosurgeon employs specialized microscopes to removed damage or herniated discs. If these discs are impinging on the sciatic nerve, this may relieve the sciatica.Can sciatica leave you paralyzed? ›
The most common symptom of sciatica is severe and burning pain down one leg, the buttocks, lower back, or in the foot. In the most extreme cases, the pain may be so intense that it can cause paralysis, muscle weakness or total numbness, which occurs when the nerve is pinched between the adjacent bone and disc.What kind of doctor can diagnose sciatica? ›
Neurology. Neurology specialists are experts at understanding and navigating treatments for the nervous system. Sciatica is a nerve-related condition, making a neurologist a go-to specialist to visit when getting to the root of sciatica symptoms.Can sciatica be picked up on an xray? ›
Between standard X-rays and CT scans, we can diagnose most causes of sciatica. However, an MRI is the gold standard if we need to evaluate your spinal nerves.Is Deep Heat cream good for sciatica? ›
Deep Heat - Pain relief cream
Deep Heat and Deep Heat Max Strength are the best creams for sciatica pain, their pain relief qualities are unmatched.
Again, chiropractors focus on one part of your body, the muscles, which many patients might not adjust well to. Physical therapy will always be the better option out of the two, because a physical therapist will fix the overall problem, allowing you to recover and get you back up on your feet, and active.How long does it take to recover from sciatic nerve surgery? ›
It generally takes sciatica surgery patients two to four weeks to fully recover from surgery, though recovery can take longer if your surgery involves more than one vertebra or disc.Is back surgery worth it for sciatica? ›
Yes, surgery can relieve sciatic pain. While lumbar (lower back) surgery may sound like an extreme option, it can actually be an effective way to treat spine-related symptoms in those who otherwise suffer, regardless of treatments they've received.What nerves are affected by L4 L5 S1? ›
The sacral plexus is formed by the lumbosacral trunk (L4 and L5) and sacral nerves S1, S2, and S3. The main nerves arising from the sacral plexus are the sciatic, posterior femoral cutaneous, and pudendal nerves. The lower part of the sacral plexus is sometimes referred to as the pudendal plexus.