Sciatica is another common pain condition that GCPI commonly treat amongst our patients. If you have more questions about this condition, make sure to make an appointment with our pain management physicians.
What is Sciatica?
Sciatica is pain that radiates along the path of the sciatic nerve. This nerve runs from your lower back through your hips and buttocks and down each leg. When you experience sciatica, typically you only feel it down one side of the body.
This type of pain most commonly occurs when a herniated disk or a bone spur on the spine compresses part of the sciatic nerve. This causes inflammation, pain and often some numbness in the affected leg. Although the pain associated with sciatica can be severe, most cases resolve with just conservative treatments in a few weeks. People who continue to have severe sciatica after six weeks of treatment might be helped by surgery to relieve the pressure on the nerve.
What are the symptoms?
If you feel pain that radiates from your lower spine to your buttock and down the back of your leg, you may have sciatica. You may feel the discomfort almost anywhere along the path of the sciatic nerve, but it’s especially likely to follow a path from your low back to your buttock and the back of your thigh and calf. The pain level can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. Some people also experience numbness, tingling or muscle weakness in the affected leg or foot. You may have pain in one part of your leg and numbness in another.
What are the causes of Sciatica?
Sciatica occurs when the sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone (bone spur) on your vertebrae. More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.
How does GCPI treat Sciatica?
As with all our pain conditions, we believe in utilizing all the treatment options available, starting with the procedures best suited for your pain level. If your pain doesn’t improve with our self-care measures, our doctors may suggest some of the following treatments.
Medications can help the patient deal with the pain when all other options fail. The type of drugs that we might prescribed for sciatica pain include:
- Muscle relaxants
- Tricyclic antidepressants
- Anti-seizure medications
Once your acute pain improves, our doctors or a physical therapists can design a rehabilitation program to help you prevent recurrent injuries. Typical treatment includes exercises to improve flexibility, strengthen back muscles, and correct posture.
In some cases, our doctors may recommend injection of a corticosteroid medication into the area around the involved nerve root. Corticosteroids help reduce pain by suppressing inflammation around the irritated nerve. The effects usually wear off in a few months. The number of steroid injections you can receive is limited because the risk of serious side effects increases when the injections occur too frequently.
This option is usually reserved for times when the compressed nerve causes significant weakness, bowel or bladder incontinence or when you have pain that progressively worsens or doesn’t improve with other therapies. Surgeons can remove the bone spur or the portion of the herniated disk that’s pressing on the pinched nerve. What are some ways to help deal with my mild sciatic pain at home? For most people, sciatica responds well to self-care measures. You’ll heal more quickly if you continue with your usual activities but avoid what may have triggered the pain in the first place. Although resting for a day or so may provide some relief, prolonged inactivity will make your signs and symptoms worse. Other self-care treatments that may be helpful include:
Cold packs. Initially, you may get relief from a cold pack placed on the painful area for up 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.
Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.
Stretching. Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch and try to hold the stretch at least 30 seconds.
Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve) are sometimes helpful for sciatica.
Alternative therapies commonly used for low back pain include:
Acupuncture. In acupuncture, the practitioner inserts hair-thin needles into your skin at specific points on your body. Some studies have suggested that acupuncture can help back pain, while others have found no benefit. If you decide to try acupuncture, choose a licensed practitioner to ensure that he or she has had extensive training.
Chiropractic. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Spinal manipulation appears to be as effective and safe as standard treatments for low back pain.
It’s not always possible to prevent sciatica, and the condition may recur. The following suggestions can play a key role in protecting your back:
Exercise regularly. This is the most important thing you can do for your overall health as well as for your back. Pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment. Ask your doctor to recommend specific activities.
Maintain proper posture when you sit. Choose a seat with good lower back support, arm rests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.
Mild sciatica usually goes away given time and patience. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes progressively worse. Get immediate medical care if:
- You experience sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg.
- The pain follows a violent injury, such as a traffic accident.
- You have trouble controlling your bowels or bladder.