Learn Everything You Need to Know About Sciatica Treatment
Do you or a loved one suffer from lower back pain? Are you frequently bothered by tingling or numbness that starts in the buttocks and runs down to your foot? If so, you may need sciatica treatment.
Sciatica describes symptoms typically felt along the sciatic nerve, which runs from the lower back through the buttock, lower leg, and foot.
So, what causes sciatica, and how does sciatica treatment work? Read on to learn about sciatica’s symptoms, causes, preventative measures, and treatment options.
For a deeper investigation into this topic, Download The Sciatica Survival Guide by Dr. Anthony Galante!
What is Sciatica?
Sciatica isn’t a disease. Rather, it’s a common set of symptoms. Thus, doctors cannot technically diagnose sciatica. Instead, physicians must determine the underlying problem that is causing the sciatic nerve pain.
Sciatica most frequently affects people aged 30-50. However, we have also seen it in patients as young as 18 or older than 60.
What Causes Sciatic Nerve Pain?
Since sciatica describes a set of symptoms and not the source of the pain, there are a variety of underlying causes that can lead to this condition. We will discuss a few of the most common causes below.
Disc herniation is the most common cause of sciatica. It develops in the lower lumbar spine, where discs sitting between the bony vertebrae act as shock absorbers. When the outer cartilage of those discs wears down, weaken, bulges, or tears, herniation can occur. As a result, the inner gel-like fluid breaks through and compresses the sciatic nerve, causing pain, weakness, and numbness.
Disc herniation can result from lifting, coughing, bending, falling, motor vehicle accidents, or any other sort of trauma. Many patients aren’t sure about the specific cause of their herniation.
Lumbar Degenerative Disc Disease (DDD)
This disease develops with age. Over time, discs in the lower back weaken and deteriorate. This decay irritates the nerve root, creating pain.
Lumbar Spinal Stenosis
Lumbar spinal stenosis happens when the spinal canal narrows and compresses the nerve roots. This narrowing causes pain that’s usually positional, meaning it occurs during some activities and goes away during others. Stenosis most frequently affects people over the age of 60.
In most people, the sciatic nerve runs under the piriformis muscle in the buttock. However, in 15% of people, it goes through the muscle instead of under it. As a result, the muscle can shorten due to overuse and compress the sciatic nerve. This compression can also happen if you carry a thick wallet in your back pocket and sit on it often.
A slipped disc is another type of disc herniation. In this case, the discs come out of their normal position and press against the nerve root, causing the symptoms associated with sciatica.
Spondylolisthesis occurs when one vertebra slips forward over the one below it. This misplaced vertebra compresses the spinal nerves and causes pain. Stenosis can develop as a result.
An external force like an injury, fall, or car accident can directly impact the spinal nerves and result in sciatica symptoms.
What are Sciatica Signs and Symptoms?
The symptoms of sciatica include pain, burning, sharpness, tingling, and numbness. You can feel these symptoms anywhere along the sciatic nerve, including the lower back, buttock, leg, and foot. While it’s rare for a sciatica patient to experience pain only in a leg and not in the back as well, it’s possible, and still indicates a problem originating in the back.
However, these symptoms can also indicate a different condition called peripheral neuropathy. If you’re unsure whether your symptoms are caused by sciatica or peripheral neuropathy, consult our guide to telling the two apart.
When these symptoms are present due to sciatica, they will often vary based on your level of activity. Here are some of the situations in which sciatica tends to flare up:
- When You Wake Up in the Morning—When you lie down at night, you don’t bear any weight, which removes pressure from the spinal discs. The discs then absorb fluid, which stretches out the already irritated disc fibers and increases your pain.
- When You Sit Down—Sitting increases the pressure on your lumbar discs, causing you more pain. Patients with sciatica feel better when they keep moving because prolonged periods of sitting intensify the symptoms.
- When You Cough or Sneeze—These actions create spikes in pressure in your spinal canal, which can push a herniated disc into sensitive nerve fibers. So, if you have sciatica, you should always brace yourself when you feel a cough or sneeze coming.
- When You Bend Over—Think of the sciatic nerve is a rubber band running down your back and into your feet. Anything that stretches the rubber band will cause you pain, including bending over.
- When You Roll Over in Bed—Movement in bed can increase the pressure on your discs, causing them to push on your sensitive sciatic nerve. Therefore, you may frequently wake up throughout the night.
All these symptoms are clear signs that you need sciatica treatment. So, the question now becomes, what can you do to treat the condition? Read on to discover how you can control your pain.
What Can I Do to Control My Sciatica Pain?
There are things you can do to take an active role in your sciatica treatment. These include simple exercises, gentle stretches, home therapies, and strategic body positioning. We will look at each of these categories below.
Simple Exercises for Sciatica Pain
When you have sciatica, your first instinct may be to put yourself on bed rest. However, you should resist this urge at all costs! Sitting or lying down for long periods will only intensify the pain and weaken your muscles.
The fastest way to decrease morning pain is to get moving. Work your way up from knee-to-chest stretches and pelvic tilts to getting up and walking. The weight you bear will force fluid out of the disc, decreasing pressure on sensitive disc fibers.
One of the most effective exercises you can use to combat sciatica is the tennis ball exercise. This exercise is especially effective if you’re having pain in your hip or buttock area.
To do the tennis ball exercise, get a tennis ball and lie down on your back. Place the tennis ball under your buttock on the side that hurts. Then relax and let your body weight compress the muscles. Leave the ball in place for 20-30 seconds before moving it to the next affected area.
Keep in mind that you should perform the tennis ball exercise with caution. Pay attention to how your muscles feel, and if they are especially tender, do the exercise on a bed instead of the floor. Once your muscles strengthen, you will be able to do it on the floor.
Best Stretches for Sciatica Pain
Along with exercises, there are many gentle stretches you can do for sciatica treatment. Of course, as a rule, if any stretch aggravates your pain, you should stop immediately because it’s a sign your irritating the sciatic nerve.
Here are some good stretches you can do to relieve sciatic nerve pain:
- Knee-to-Chest Stretches—To do this stretch, lie on your back. Then interlock your fingers over one knee and pull it gently toward the same shoulder. Hold for 10-30 seconds. Then do it again but pull the knee toward the opposite shoulder. Repeat this exercise 2-3 times.
- Figure-4 Stretches—To do this stretch, lie on your back. Then cross one leg over the other, placing the outer side of the ankle on the knee. Interlock your fingers under that knee and pull. If done right, you’ll feel a strong stretch in the buttock. Hold for 10-30 seconds and repeat 2-3 times.
Home Therapies for Sciatica Treatment
Beyond exercising and stretching, you can also treat your sciatica with home remedies. Here are two effective therapies that we often recommend our patients do at home:
- Cold Therapy—A good way to alleviate your sciatica is by applying something cold to it. You can use an ice massage, cold pack, ice cubes in a baggie, or even a bag of frozen vegetables. The most convenient method is to strap an ice pack around your waist. This way you can still perform daily activities. If you don’t have a proper strap, you can secure it with an elastic bandage or a towel. Keep it on for 15 minutes, then off for 1-2 hours at a time.
- Topical Analgesics—Apply these where it hurts, and they can take the edge off a bit and make your pain more tolerable. Our favorite brand at Algonquin Chiropractic Center is BioFreeze, but you can try over-the-counter brands as well.
Strategic Body Positioning
There are also precautions you can take to make living with sciatica more tolerable. By strategically positioning your body during daily activities you will experience much less pain than you would otherwise.
One daily activity that especially requires your attention is sleeping. Whether you sleep on your back or your side, there are things you can do to protect yourself from pain.
If you sleep on your back, you should place a pillow under your knees. Doing so will gently flex your back, relieving the pressure on your intervertebral discs.
Conversely, if you sleep on your side, you should bend your knees up into a fetal position and place a pillow between your knees and ankles. The pillow will help keep your pelvis properly aligned to avoid pelvic rotation.
There are also precautions you can take to avoid pain when getting up in the morning. First, you should roll onto your side by the edge of the bed. Then slowly and carefully slide your legs off the edge and push up with your arms.
Another way to get up is to roll onto your stomach. From there, rotate your body until your legs are off the bed, then push up with your arms.
By positioning your body in these ways, you will make your mornings a lot more pain-free and enjoyable.
Positions for Long Car Rides
People with sciatica are aware of what nightmares long car rides can be. Fortunately, there are things you can do to make your car ride go smoother.
First, you should be careful of how you get in and out of the car. To get in, face away from the car seat. Then slowly and carefully lower your torso and sit down. Next, turn your whole body so that you face the front of the car. To get out, perform the same motion in reverse, first rotating in place to face the doorway and then sliding out without bending forward.
If you are going to be driving during the long car ride, then there are many things you should do to make driving more tolerable. One thing you can do is move your seat forward an inch to flex the knees and lower back. You can also try moving your backrest either further up or further back.
One method that is especially effective is placing a rolled towel behind your lower back to support the lumbar spine. You can also place a towel that is 2-3 inches thick under the buttock on the non-painful side to open the spine up a bit.
These preventative measures should make your long car ride much smoother.
Getting Up from a Seated Position
One final everyday task that requires your attention is getting up from a seated position. To do this, you should scoot yourself to the edge of your chair and plant your feet firmly below you, staggered. Place your hands on your thighs and then stand straight up. Avoid bending from the waist.
By standing straight up without bending from the waist, you will prevent any unwanted wear and tear on your sciatic nerve.
Beyond Home Remedies
All the home remedies listed above are great effective tools you can use to control your sciatica pain. However, we’re guessing you don’t just want to learn to live with your sciatica. Instead, you want to overcome sciatica altogether. To achieve this, you will need professional sciatica treatment. We will discuss professional treatment options in the next section.
What Professional Treatment for Sciatic Nerve Pain is Available?
There are many different types of sciatica treatment available to the general public. The options are:
- Medical doctors and pain medication
- Pain doctors and epidural steroid injections
- Orthopedic surgeons and spine specialists
- Physical therapists and active exercise
- Doctors of chiropractic and the cox technic
We will briefly discuss each of these options below and then explain why we think the chiropractic option is the best treatment for sciatica.
Medical Doctors and Pain Medication
Medical doctors use medicine to treat sciatica and other forms of back pain. Some of the medications they commonly recommend include over-the-counter painkillers like acetaminophen, muscle relaxants, anti-inflammatories, and prescription pain medications.
Included in that last category are dangerously addictive opioids like oxycodone, hydrocodone, and methadone. Recently, opioids like these have caused a nationwide epidemic of addictions and overdoses. In 2017, prescription opioids accounted for more than 35% of all opioid overdose deaths according to the CDC.
Besides the risk of addiction, these drugs are not even the best option for sciatica treatment since the condition is musculoskeletal and not chemical. However, many medical doctors prescribe them as their first line of treatment. And although they may cover up your symptoms a bit, they won’t do much to counteract your sciatica in the long-term.
Pain Doctors and Epidural Steroid Injections
Your doctor might also send you to a specialist who provides medications and injections for controlling pain and inflammation. However, of patients who receive this sciatica treatment, 50-75% experience short-term relief but only 25-57% experience long-term relief.
That’s because epidural steroid injections don’t heal the nerve or repair damaged tissue—they just dry up inflammation.
Still, these injections have their place, but it’s not as the first line of defense. Instead, a Doctor of Chiropractic might use epidural steroid injections as part of his or her treatment plan.
Orthopedic Surgeons and Spine Specialists
If you go to an orthopedic surgeon or spine specialist, they should spend most of their time suggesting various treatment options and turn to surgery as a last resort.
A 2012 Spine Journal study found that for patients who received spine surgery, 10.5% had complications during surgery, 73.5% had complications after surgery, 39% had their stay extended due to complications, and 1% died.
However, for all those risks, patients who receive surgery don’t have substantively better outcomes than conservatively treated patients one and two years later. To be sure, there are specific red flags that may signal a need for surgery. However, for most sciatica patients, surgery is expensive, risky and ultimately not the best route.
Physical Therapists and Active Exercise
Your medical doctor or orthopedic surgeon may recommend physical therapy. However, a 2006 European Spine Journal study showed that patients with leg pain and numbness did significantly better when treated with chiropractic care than with physical therapy. The chiropractic patients showed “significantly lower pain scores” after one year. Other studies have produced similar results for patients with sciatica.
Doctors of Chiropractic and the Cox Technic
The other option you have is to visit a Doctor of Chiropractic, who will use a natural treatment for sciatica known as the Cox Technic. This nonsurgical, drug-free treatment gently stretches the spine to decompress the spinal discs and nerves relieving pressure and pain.
We would recommend this type of treatment over all other options for many reasons. First, Doctors of Chiropractic using the Cox Technic have achieved some of the highest patient satisfaction ratings of any health care provider. Research shows that about 91% of patients report finding the relief they were looking for, and pain ratings on average decrease from an average of 7.6 to an average of 1.9 after treatment.
Plus, the Agency for Health Care Policy and Research approve of the Cox Technic in their AHCPR Guidelines. They say the Cox Technic is safe and effective, and many high-profile athletes agree, including Joe Montana, Scottie Pippen, Max Scherzer, and Jonathon Toews. All of them have used chiropractic care not only to relieve their pain but to boost their performance.
In short, we believe chiropractic care is the right sciatica treatment option for you because it will give you the long-term results you’re looking for.
Are You Suffering from Sciatic Nerve Pain?
We hope this guide has been a helpful resource for helping you understand sciatica. The most important thing we want you to take away from it is you don’t have to deal with sciatica alone. There is plenty of help available, and you can find relief from the pain.
So, if you or a loved are experiencing symptoms that you think may be related to sciatica, please don’t hesitate to reach out. We at Algonquin Chiropractic Center has been offering sciatica treatment in Algonquin, IL for over 20 years. Give us a call today at (847) 854-2000 to schedule an appointment.
For more information on causes and treatment for sciatica, please download our FREE ebook: The Sciatica Survival Guide by Dr. Anthony Galante!