When I felt the pain zing down my leg, I fell. I was putting something into the oven and burnt my arm pretty bad. I had no idea what happened, but I was sure that I wouldn’t be able to walk again. I came to learn that what I experienced was sciatica pain, but what were my treatment options? This article is a comprehensive guide to sciatica pain treatment options, as well as the condition itself.
Throughout your life, you’ve likely gone through a variety of aches and pains. While pain tolerance is subjective, even the most hardened people can be knocked down by both acute and chronic sciatica pain. How hurting affects our daily lives can range from mild discomfort to agony that severely disrupts everything.
Sciatica is a common ailment affecting millions of people around the globe. Somewhere around 40% of people worldwide will suffer from this condition at some point. Sciatica is a condition affecting the sciatic nerve. The causes, symptoms, prevalence of pain, duration of the condition and treatment options vary from patient to patient, however.
Symptoms of Sciatica
Just stating that you are in pain is a vague symptom. You’ve probably heard someone say, “no two people experience pain the same.” This is partly true because the throbbing can be due to varying causes. Lower back pain is not sciatica, although the two can be associated. So how can you tell?
You can actually get an idea from these general symptoms:
- The sting originates from the lower back and extends to your butt down the back of your leg which is the sciatic nerve pathway.
- Pain in these areas gets worse when you sit or lie down in a specific position or for a specified period.
- The severe twinge in the sciatic pathway often makes standing difficult after a period of sitting or lying down.
- There is a constant aching on either side of your buttocks.
- Burning or tingling sensation in the sciatic areas.
- Weakness and numbness during a painful episode.
- If you have difficulty moving or walking, especially during a flare-up or after sitting for too long.
- In some cases, the pain might extend to the feet.
- Pain flares up when you cough or sneeze.
- Lose of bowel or bladder control is a more severe symptom where you should see your doctor right away.
Typically, sciatica only affects one side of the sciatic pathway. In some cases, the pain is tolerable and fades over time. Many patients who suffer from sciatica experience a sharp, stabbing pain that progressively worsens.
The pain is so intense for some folks that it alters regular day-to-day movements. You might even find that you need help for ordinary things such as rising up from bed or sitting to standing positions. There have been many occasions when I just wanted to go to sleep and forget about the pain, but it keeps you awake instead. If this is you, poor sleep quality adds up to the stress that the body is already experiencing.
When your pain symptoms are this intense, you need to get to a doctor so you can get your life back on track. For me, my doctor prescribed gabapentin to, “quiet the nerves” as he said it. It has worked miracles for me, but I know that the side effects can be too much for others. Follow your doctor’s prescribed medication for your condition. The sciatica pain needs to under control for physical therapy to work to heal the anguish.
Why Did I Get Sciatica?
There could be several causes. The degree of pain you are experiencing depends on the source of pressure on the sciatic nerve. Some underlying reasons could be more severe and require more rigorous treatments. This is why it is imperative to seek medical help if you are experiencing symptoms of sciatica. The worst cases might need surgery while mild sciatica can be treated with over-the-counter medicines and other prescribed treatments such as physical therapy.
The pain you experience from sciatica is coming from an irritated sciatic nerve that could be caused by either a herniated disk or bone spur.
A herniated disc is also known as a slipped or ruptured disc. For sciatica, it occurs when one of the discs in our lower back bulges or breaks open. This can certainly happen in any part of the spine, but it usually occurs in the lumbar region where the sciatic nerves are located. When the affected disc puts pressure on the sciatic nerves, you feel pain in the sciatic pathway.
A herniated disc can be caused by an injury, or the normal wear-and-tear that happens with the aging process. When we were young, our discs that cushion the bones in our spine are thicker and more resilient so, they can support the spine well. But they grow weak after years of lifting heavy objects, sedentary lifestyle, and other activities that apply too much pressure on the spine for sustained periods.
Bone spurs are also part of getting older. It can be related to the slipped disc because damaged discs may lead to bone spurs growing along the edges of the joint. This condition is common in the weight-bearing joints such as the spine or feet.
Risk factors of sciatica include:
- Being over the age of 30.
- Being overweight.
- Being tall.
- Having diabetes.
- Being pregnant.
- Sedentary lifestyle.
- Excessive physical activity such as repeatedly lifting of heavy objects, and frequent bending and twisting.
- Driving for prolonged periods.
- Spondylolisthesis (occurs when one vertebra slips forward over another vertebra).
- Lumbar spinal stenosis (the narrowing of the spinal canal in the lumbar region).
How to Find Out if You Have Sciatica
If by now, you’re thinking, “I have all of the signs and symptoms, this must mean that I have sciatica!” I would suggest not coming to this conclusion on your own. When do you need to make an appointment with your doctor? Experts encourage you to try over-the-counter pain remedies, rest and ice the affected areas first. Seek medical help if the sciatic pain progresses into severe, intolerable pain that lasts more than a week.
Tip: I usually schedule the appointment at the first sign of pain for a few days or a week away. If I start to feel better, I can cancel the appointment. Otherwise, I will get examined to make sure that it’s nothing serious.
During the examination, you will be asked to describe the nature of your pain. I always find it hard to explain my suffering, but you should try to be as specific as possible. Point out the exact locations you’re feeling it. You will also, specify the intensity (on a scale of 1-10 usually) and type of pain you’re experiencing (aching, throbbing, stabbing, etc.). Your doctor should ask if you experience other sensations such as numbing and weakness.
You’ll also want to discuss your daily activities such as how often you exercise, the type of exercises you perform, the kind of work you do, the amount of time you spend sitting, and other lifestyle-related details. It’s important that you be honest and open with your doctor. Not being truthful, or keeping relevant details to yourself hurts you in the long-run.
Other health conditions that you currently have will also be considered since sciatica is also associated with diabetes and other diseases.
After this discussion, you should have a physical examination. You’ll be asked to perform a few exercises and movements. One very common physical exam is raising one leg while you’re lying on your back. This may seem like torture, but it is essential for an accurate diagnosis. The way I see it is, the better diagnosis and treatment that I get the first time means less pain and trips to the doctor in the long-run. And it’s not a test of strength, if you are doing something and it hurts, tell your doc. He or she wants to know what hurts and when.
These are the fundamental ways of diagnosing sciatica in a patient. However, severe sciatica will probably require imaging to see what’s going on more clearly. If this is you, you’ll undergo any or several of these tests:
- CT scans
- Electromyography (EMG) test
Sciatica Pain Treatment Options
If you have made it this far, I have good news! That is most sciatica patients experience relief after trying one medication (gabapentin in my case) or a combination of non-surgical treatments such as chiropractic and physical therapy. With these non-invasive therapies, the symptoms gradually recede until the sciatica is completely gone. Your medical professionals will discuss the proper treatment options for your case.
Here is a breakdown of some of the treatment options for sciatica pain:
Over-the-counter pain relievers
Taking these should be the first step to alleviating sciatica symptoms. Mild sciatica usually fades away after using over-the-counter pain relievers and proper rest.
Examples of over-the-counter medicines are:
These medicines should not be used for an extended period. Taking pain relievers for too long can pose other health risks and complications. It is wise to avoid alcohol and to always openly discuss the medicines you take with your doctor to prevent dangerous interactions and developing other issues in the long run.
If over-the-counter medication is not working to alleviate your pain, your doctor may prescribe a muscle relaxer, prescription anti-inflammatories, antidepressants (duloxetine is approved for back pain as well as depression), amitriptyline, anti-seizure medications (gabapentin), and/or steroid injections.
There are a lot of options for medical intervention, so don’t give up hope. Everyone is different, so what works for someone may not work for you. Finding the right treatment is often trial and error. Openly communicate with your doctor about everything that you are feeling and thinking. They’ve heard it all, trust me!
When the symptoms of sciatica are under control, your doctor may suggest that you undergo physical therapy. You will be referred to a licensed physical therapist who will help you restore strength, balance, and flexibility through various low-impact exercises, stretches, and movements. Physical therapy is recommended in almost all sciatica cases as part of rehabilitation.
Surgery (The Last Resort)
If the non-invasive treatments don’t work, you might have discussions with your doctor about surgery. If your sciatica is making you lose control over your bowel movement and bladder, this is a medical emergency that will require surgery. This condition is called cauda equine syndrome, and the sooner you get treatment, the less chance for permanent nerve damage. I can’t stress this enough, if you are experiencing this, you should not postpone seeking medical attention. In fact, it is an emergency situation that requires immediate surgery!
The two typical surgical procedures for sciatica are:
- Discectomy. In this procedure, the slipped disc or bone spur that is causing your sciatica will be removed. At times, the entire disc is removed, and the two vertebrae are fused together.
- Laminectomy. The lamina, a portion of the ring of bone that covers your spinal cord will be removed, along with the tissue that’s irritating your sciatic nerve.
Your surgeon will explain to you the nature of the surgical operation to be performed on your spine. Don’t be afraid to get a second opinion as I did. Undergoing surgery is a rare scenario that only 5% to 10% of sciatica patients are candidates for.
Natural Sciatica Pain Treatment Options
There is research that supports safe and natural remedies as an option for sciatica pain that is effective in many patients. Some report that natural remedies worked when conventional medicine failed. They talk about dramatically restored strength, vitality, and the flexibility that make daily living more comfortable.
Here is a breakdown of natural remedies for sciatica:
Chiropractor Spinal Adjustments
A physical exam by a chiropractor along with imaging will hopefully reveal the extent and type of spine injury that you have. Based on these results, the chiropractor will work on adjusting your spine back to a healthy state. One of the benefits of this will keep the disc tissues from entering your spinal canal to avoid the sciatic zing.
Chiropractor spinal adjustments can reduce the prevalence and severity of pain in the lumbar region.
I’ve never tried this, but it sounds like something I may want to try in the future. Biofeedback works by training the brain to have better control over the nervous system and automatic processes such as blood pressure, heart and breathing rate, skin temperature, sweating, and muscle activity. Biofeedback is known to relieve symptoms caused by migraine, high blood pressure, incontinence, and chronic pain.
Biofeedback uses finger sensors or electrodes attached to your skin and are connected to a monitor. As the monitor receives signals from the sensors, a display of a sound, light, or image representing the status of your body’s involuntary processes will be shown.
Involuntary processes will change as your body experiences stress. To normalize these functions, your biofeedback therapist will help you practice specific relaxation exercises targeting your health issue. Typically, a biofeedback therapist will teach you deep-breathing exercises, progressive muscle relaxation, guided imagery, and mindfulness meditation.
After 10 to 20 sessions, depending on your health issue, you’ll start feeling the therapy’s benefits. Eventually, your brain will begin controlling your involuntary functions on its own without the need for biofeedback. Because of the brain’s ability to calm the body, it is said to be effective in reducing the amount of pain that sciatica patients go through.
Let me know in the comments below if you have tried this, and how it worked for you.
Massage therapy is my favorite method of alleviating all my body aches, but especially back pain. After an hour of massage therapy, there is no denying its benefits. Massage relieves muscle tension, revitalizes the body, promotes healthy blood flow, reduces pain, and stimulates the release of endorphins, the body’s natural painkillers.
For someone with sciatica, massage therapy should be carefully done. Look for a therapist who is knowledgeable in performing massages to alleviate back pain and sciatica. The wrong technique may intensify the pain or worsen the issue!
Acupuncture is a part of traditional Chinese medicine that has been around for thousands of years. It is used to treat many ailments. Acupuncture has gained popularity around the globe. There is even research that backs up its effectiveness for back pain and sciatica.
Acupuncture uses tiny needles inserted on specific skin areas, with the goal of opening the body’s natural flow of energy. You might have already seen through images and videos how it’s done. It is not as painful as it might seem. Acupuncture is virtually pain-free. In fact, many individuals find it relaxing and consider it as helpful pain relief.
Yoga and Stretching
Specific yoga poses work very well for people experiencing sciatic pain. Some would argue that it’s one of the best exercises for this condition. And there is some research to back up its claims to alleviate low back pain. Yoga helps promote good posture, reduces swelling and stiffness, builds strength and flexibility, and improves blood flow.
A stretch that I like for sciatic nerve pain is the reclining pigeon pose which helps relieve pressure against sciatic nerves.
Heating Pads and Ice
A classic home remedy is applying a heating pad to your lower back. You can do this for 15 to 20 minutes several times a day.
I find that a cold compress or ice works better. My chiropractor recommends cold packs to the aching areas for the first few days, followed by heat for the next few days. The cold will keep the swelling and inflammation down for the initial few days. Then the heat will open up the blood vessels so that nutrients can enter the area to heal and repair.
Life with Sciatica
It should go without saying that sciatic nerve pain requires giving your lower back the special care it needs. Even if you do everything prescribed, the symptoms will likely recur if you keep breaking the dos and don’ts of living with sciatica. I will admit that even I am guilty from time to time!
Here are your new rules to live by:
Avoid heavy lifting
Seems obvious, but I’ve been guilty of lifting a heavy garbage bag with the wrong posture, and ZAP! Heavy lifting can aggravate the discs and joints cushioning the bones of your spine. Aside from prescribed exercises and stretches, avoid doing strenuous physical activities as much as possible.
When you’re advised to avoid strenuous physical activities, it is not a prescription to lie around all day. Yes, rest is needed when severe pain attacks. But our bodies were meant to move. So once it subsides, move around. Go for a walk. Do low-impact yoga poses designed to strengthen your lumbar region.
I have some easy exercises with videos >>here<<
Avoid driving long distances
My last few jobs had me driving a lot. Could be why I have so much pain now. Vibration from driving puts further pressure and impact on your lower back, especially when you drive for long hours. Avoid long-distance trips if it is not necessary.
Smoking is terrible for many reasons, and we all know it. Studies establish a strong connection between smoking and degenerative lumbar spine problems. I probably don’t need to say much more on the subject. Talk to your doctor about progressively quitting smoking to avoid sciatica pain and further damage to your body.
Get sufficient, quality sleep each night
Sleep is the body’s natural way of healing itself. So, make sure to get adequate, quality sleep each night as an additional and useful measure to your ongoing treatment.
For a guide to the best sleep positions for back pain click >>here<<
Avoid wearing high heels
Wearing high heels is really bad for sciatic nerve pain. Wearing high heels shifts your body weight forward, and so, your spine goes out of its normal alignment. This adds pressure to your lower back and legs. Look for comfortable shoes with good arch support. My chiropractor prescribed me orthotics that have helped my posture when I walk.
Avoid sleeping on a soft mattress
For me, soft mattresses are the most comfortable, and I had a good one. It was super comfortable and easy to fall asleep in, but I always woke up in terrible pain. Turns out, sleeping on a bed that’s too soft puts further strain on your spine because there is no support. This could actually result in a slight bend in your back. To avoid worsening sciatic pain symptoms, opt for a medium-firm bed.
I did a full write-up on what to look for in a mattress >>here<<
Stress takes a toll on your health much like like smoking. Excessive stress aggravates my pain. In fact, when you’re stressed, you’re likely to feel more pain though sometimes, the pain level you perceive might not be accurate to what’s wrong with your body. This is why in biofeedback therapy, you are taught to practice mindful meditation which encourages you to release negative feelings and think more about happy and positive thoughts.
My colleague, LT Turner wrote a great article on the health benefits of meditation, which can be found >>here<<
Eat anti-inflammatory foods and aim for a healthy weight
Sciatica can be caused by excess weight and diabetes—issues that could be avoided or even reversed through a change in diet and lifestyle. Some foods are naturally anti-inflammatory and some could worsen sciatica symptoms.
Foods that are bad for sciatica:
- Refined sugars
- Saturated fats
- Trans fats
Anti-inflammatory foods that are good for sciatica:
- Magnesium-rich foods (you can also take a supplement)
- Foods rich in vitamin B-12 (you can also take a supplement)
- Foods that include a generous amount of Vitamin A, C, and K (citrus fruits, green leafy vegetables, carrots, mangoes, sweet potatoes, tomatoes, etc.)
Take warm baths
Warm, relaxing baths work very similar to heating pads. Soaking yourself in a warm tub relaxes the muscle and can ease aches and pains in your body. Bonus: a warm bath also promotes a night of restful sleep.
So there you have it. I’ll keep the conclusion short, as this has been quite a long article. I wanted to give you the ultimate guide to sciatica, and I hope that I have. Along with your physician’s prescribed treatment and therapy, follow this guide to sciatica pain treatment options to ease the pain. I hope that you get better soon.
Please leave me a comment to tell me about your experience with sciatica and share this article with friends so that they may benefit as well.
Peace and good spirits be unto you…Jerimy
Also, note – I am not a doctor, and anything written here should not replace the medical advice of a professional.