The sciatic nerve is made of fibers from nerves in the low back. This large nerve runs from the low back, down the glutes, into the back of the thigh, and down the legs. Â
Treatments for sciatic nerve pain usually involve stopping compression on the nerve or repairing the damaged tissue. Traditional sciatica treatments include hot and cold compresses and physical therapy with stretching. More recent techniques have also been developed for pain relief. Here we review some of them.
Exercise
There are many different exercises you can do to relieve the pain of sciatica. The first step is to find the right posture. Try lying on your back with your palms on the floor and your legs straight. Focus on tightening your muscles as if you’re trying to touch your belly button to your backbone. Hold this position for about a minute. Repeat this exercise as many times as needed.
The next step is to find an exercise that can help you strengthen the muscles in your lower back. This is called core stabilization, and it can help ease sciatica pain. You can start with exercises that target the SI joint and the piriformis. You can also try exercises such as the lumbar rotation or supine piriformis stretch.
Strength-training exercises such as the plank can help reduce the load on the sciatic nerve. These exercises strengthen your core, allowing you to engage your whole body and keep your low back in a neutral alignment. You should do these exercises twice a day. You may be able to perform them everyday, if your pain does not interfere with your ability to do them.
Another exercise that can help with sciatic nerve pain is the knee raise. This exercise involves bending your knee while placing it on the knee of the other leg. Try to hold this position for 30 seconds. Then, slowly lower your leg while keeping your back straight.
Chiropractic adjustments
Your chiropractor will perform a physical exam to determine the severity of the issue and document your pain. This exam may include reflex tests and muscle strength tests. A physical examination will reveal whether the pain is a result of a misaligned joint, a muscle spasm, inflammation, a herniated disk, arthritis, or something else. The exam should include imaging such as an x-ray of the low back and/or pelvis. Your doctor may also recommend advanced imaging such as an MRI.
Chiropractors can assess whether a patient is suffering from sciatica or not and then design a treatment program tailored to the patient’s specific pain. This treatment will help the patient move and strengthen the affected area and restore proper function and independence. Chiropractors can also help treat sciatica by helping patients adjust their position, posture and activities.
Manual therapy for sciatic nerve pain relief involves specific exercises that promote movement in the spine. Exercises such as the bridge hold, plank and bridge hold can help patients with lower back pain. They are specifically tailored to the patient’s needs and their preferred direction of movement. They are a key component of the McKenzie Method, also known as mechanical diagnosis and therapy.
Trigger point injections
Trigger point injections can be an effective way to alleviate sciatic nerve pain. This quick and minimally invasive procedure involves injecting a combination of cortisone, saline, and dextrose to numb the area. This can provide long-lasting pain relief and sometimes multiple trigger points can be treated at once.
Trigger point injections are also useful for treating other muscle pain, such as fibromyalgia and tension headaches. The procedure can also relieve pain caused by myofascial trigger points. Trigger point injections can be performed in a single appointment.
Trigger point injections are administered using a very tiny needle. In some cases, a corticosteroid, local anesthetic, or saline solution is used. In either case, the injection will render the trigger point inactive, relieving the pain. The procedure typically takes a few minutes and requires only one office visit.
Medications
Non-steroidal anti-inflammatory drugs (NSAIDs) can be used for sciatic nerve pain relief. These drugs work by increasing the levels of two chemicals in the central nervous system. These chemicals block pain signals and affect many receptors throughout the body. They are effective for reducing pain but may cause side effects and should be used under the supervision of a doctor.
Some people may experience pain relief from taking over-the-counter pain relievers such as ibuprofen or paracetamol. In more severe cases, however, pain relief may require the use of prescription medications. Antidepressants may also be used, along with cortisone injections near the spine. Other treatments may include manipulation and specific exercises. Physical therapy can also help patients develop a rehabilitation plan to prevent future injuries.
The American Pain Society (APS) has published a clinical practice guideline for patients with sciatica. The guideline recommends surgery if the pain is persistent and disabling. This guideline is based on the results of large randomized clinical trials. These studies included the Peul et al trial, which included 283 patients, and the Weinstein et al study, which included 501 patients. Other studies have been conducted with small samples, and follow-up has been brief.
The most common cause of sciatica is a herniated disc. A herniated disc pinches the sciatic nerve. The condition usually clears up within six weeks, though some people’s symptoms can continue for longer.
Cold therapy
Cold therapy reduces inflammation and reduces swelling by slowing tissue metabolism. Inflammation occurs when cells around a damaged area release chemicals that cause nearby blood vessels to leak fluid. The tissues in the area begin to metabolize this fluid and produce swelling. This inflammation can push the blood from the blood vessels into soft tissue and cause pain. Cold therapy reduces the amount of fluid that leaks by constricting the blood vessels. Cold therapy is most effective for pain caused by sciatica. Using ice packs, frozen gel packs, or vegetable bags can help reduce swelling and inflammation. Cold therapy should be applied for 15 to 20 minutes at a time.
While heat and cold therapy may work as standalone treatments for sciatic nerve pain, combining the two is often more effective. Heat and cold therapy target different aspects of the pain and should be prescribed by a medical professional. Cold therapy can also be used to treat sciatica after physical activity.
After a period of rest, use an ice pack or heating pad on the affected area. It is important to keep the skin warm and moist to ensure that the cold doesn’t irritate the area further. After about two to three days, alternate the application of heat and ice. This method can provide pain relief for several days, depending on the severity of the pain.
Yoga
Yoga can help people with sciatic nerve pain. By strengthening and aligning the lower back, it helps to reduce pain and other symptoms associated with herniated or bulging disks. It also decompresses the spine and encourages blood and lymphatic circulation. As an added benefit, yoga may prevent sciatica from returning in the future.
People with sciatica often experience pain and tenderness in the lower back, buttocks, thighs, and calves. These symptoms may come and go, and some people may experience pain or weakness in only one area. Other symptoms include leg weakness, numbness, and a pins-and-needles feeling. The pain is also often accompanied by reduced reflexes, including knee and ankle flexing.
When practicing Yoga for sciatic nerve pain, make sure to choose gentle stretches and poses. If the pain is severe, you may need to modify some of the poses. For instance, you should avoid forward bends and any pose that puts pressure on your lower back. Also, if you’re taking sedative medications or have hypermobility, it’s best to consult a physical therapist or yoga instructor before attempting poses that are challenging for your condition.
Although many people have experienced pain relief from yoga, different poses may not work for everyone. It’s recommended to try a few poses before finding the one that works for you. If you don’t find any yoga poses to be effective, you should try another type of low-impact exercise.