What is Sciatica? Sciatica is a persistent pain that is felt along the sciatic nerve; it runs from the lower back down to the feet. It controls the muscles to the legs and provides sensation to the thighs, legs and bottoms of the feet. Sciatica occurs most often in people between the ages thirty through fifty. It usually is caused by repetitive use type of conditions, such as sitting for long periods of time, or normal wear and tear. It is rarely caused by an acute injury.
The pain from sciatica can be sometimes debilitating it can get so severe it can be difficult for one to sit, walk or even sleep. Some people experience tingling while for others it is just a dull ache. Occasionally it can be a burning type of feeling. Pain from the sciatic nerve is usually caused by the nerve being pinched or irritated in the lower back or lumbar spine. The nerve then gets inflamed and causes a variety of symptoms that can wreak havoc with one’s lifestyle.
The most conservative type of treatment for sciatica is the application of ice. I recommend to my patients to lay flat with two pillows under the knees and apply ice to the lower back on the side of involvement for fifteen minutes. This can be repeated up to every hour if necessary. It is important not to apply the ice for more than twenty minutes at a time because this can aggravate the condition. Applying ice to the source of the problem will decrease the inflammation of the nerve and subsequently decrease pain. Although this may a temporary solution, it does offer some relief.
Manipulation of the spine to relieve the pressure on the nerve has been demonstrated in studies to be one of the most effective treatments for sciatic pain. Manipulation is the best place to start when someone has sciatic nerve pain. It is a non-invasive, drug-free treatment option. The goal of manipulation is to realign the spinal bones taking the pressure off the nerve. When the nerve pressure is alleviated one often finds great improvement with decreased pain and inflammation.
Other very effective, conservative treatment is a conservative exercise program. There are many exercises available, but these are the ones I have found in my clinical experience to be most effective. The first exercise is laying flat on your back with your knees bent. Squeeze or flex you buttocks toward the ceiling. Hold this position for a count of ten and slowly return to the neutral position. Repeat this four times. Starting at the neutral position, bring each leg to your chest with both hands one at a time. Follow this by bringing both knees to the chest bringing your head up again holding for a count of ten and returning slowly to the neutral position and repeating four times. A third exercise is laying on your stomach and arching backwards with your elbows on the floor moving from a neutral position to a comfortably flexed position arching backwards as much as you can but discontinuing if back or leg pain worsens. The fourth exercise is on your hands and knees, pushing your back toward the ceiling then pulling it to the floor, (this is often called the cat stretch). These exercises should be initiated slowly and if there is any pain or discomfort, to stop before you have pain. I would recommend doing these exercises two to three times a day.
There are many nutritional aspects to sciatic nerve pain you may not be aware. A diet that is pro-inflammatory i.e., one that is rich in meat, dairy and shellfish will promote inflammation of all nerves. An anti-inflammatory diet consists of fruits, vegetables, and fish. This is one of the most powerful ways to treat the symptoms of inflammation and relieve pain.
The nutrients that I found to be most effective in treating sciatic nerve pain are turmeric, tulsi and rosemary. These powerful herbs have been studied and found to greatly decrease inflammation. Boswellia is an herb that is a specific anti-inflammatory. This is especially helpful for arthritic patients. Bromelein is a plant enzyme found in pineapples and has natural anti-inflammatory affects. I prefer to take this with papain as well, it is essential that you take it on an empty stomach to really get the benefits of the anti-inflammatory nature. Ginger is a powerful herb that offers pain relief. You can steep fresh ginger in boiling water and use it as a tea or make a juice out of it. Evening primrose oil, black currant oil, or borage oils contain the essential fatty acids Gammalinolenic acid. These omegas will greatly reduce the inflammatory process and take down the inflammation on the sciatic nerve.
There are many ergonomically beneficial positions that will improve sciatic nerve pain no matter the cause. It is an important part of your treatment to improve your posture and use your body correctly. Good posture allows the use of the body without strain on muscles, joints, ligaments, and internal organs. Good posture must be considered in all activities: sitting, standing, resting, working, playing and exercising. It is simply not a matter of “standing tall”.
In the resting position, it is beneficial to lay flat on your back with two pillows under your knees or lay on your side with a pillow between your knees. Avoid positions like sleeping flat with no pillow, on your stomach or lying on your stomach with one knee bent up. This will cause a ‘swayback’ condition. Some simple things, such as getting up and down from bed, to get into bed it is preferred that you sit on the side of the bed bring both arms to one side, lower your side to the bed keeping your knees bent at forty-five degrees, then pull your feet into bed. Remain on one side or roll on the back. Getting up from the bed it is best to roll on your side push with the hands to the sitting position keeping knees bent and swinging legs over the edge of the bed. When sitting, avoid a chair that is too high, as this will increase swayback. When sitting, the knees should be higher than the hips as this will flatten the lumbar curvature. Avoid slouching on a chair with feet on an ottoman because this can strain the lower back. When traveling in a car the seat should be close to the steering wheel and use a small pillow for proper lumbar support. When standing, I recommend placing one foot on a stool or shelf and after a short time switch to the other foot this will flatten the lumbar curve and ease the pressure off the lumbar spine. When lifting, avoid bending at the waist. Bend the knees and carry the object close to the body. When bending, bend at the knees and push your buttocks out rather then flexing at the waist.
My final tip on stopping sciatic nerve pain is to drink plenty of water. A dehydrated body is one that will struggle to heal. It is important to drink at least six to eight glasses of water per day to keep the body well hydrated and to flush toxins built up from resulting muscle spasms of the pain and inflammation. Water will also hydrate the disc. Between your spinal bones are intervetebral discs that dry out as we age the more we can keep them hydrated, the less degenerative arthritis will occur in the spine. This is also the reason we get shorter as we age is each little disc between the vertebrae dry out, or desiccate then subsequent height loss will occur.
If you follow these simple steps for stopping sciatic nerve pain, you will go a long way to prevent any discomfort in the future and avoid any harmful drug side effects or painful surgical intervention. Remember, an ounce of prevention is worth a pound of cure.