Sciatica refers to pain felt along the sciatic nerve. The sciatic nerve is the longest and thickest nerve in the body, running from the lower back (lumbar spine) through the buttock and ending just below the knee. From here, the nerve branches off into other nerves that continue into the lower leg and foot. You have a sciatic nerve in each leg; usually, only one of these is affected. This is why the symptoms of sciatica are usually felt on only one side of the body.
Sciatica pain is commonly described as sharp or jolting and usually radiates from the lower back or buttock down the leg to the calf or thigh. The pain may vary from mild to severe and can result in muscle weakness, numbness, and tingling in the lower body.
Sciatica occurs when the sciatic nerve becomes pinched, often as a result of a herniated disk, muscle spasm, or bone spur in the back. Common risk factors for sciatica include:
- Age: As tissue and vertebral disks wear down with age, the risk of a herniated disk or pinched nerve increases.
- Obesity: Excess body weight places extra pressure on the spine, which can lead to a strain, herniated disk, or a pinched nerve.
- Occupation: Active, physical jobs that require a lot of twisting or heavy lifting can put you at risk for low back problems, such as sciatica.
- Sitting: On the other hand, jobs requiring prolonged sitting periods, or people with an inactive lifestyle are at increased risk of sciatica.
- Diabetes: Diabetes increases your risk of nerve damage, which can lead to the development of sciatica.
Sciatica may develop over time or appear suddenly. Nearly 40% of American adults experience symptoms of sciatica at some point in their lives. In general, low back pain is one of the three most common reasons for doctor visits in the US. Most people will recover and rehab from sciatica after a few weeks of treatment. For some, symptoms may occur for over a year. If you are experiencing sharp and shooting pain in your lower back, talk to your doctor right away.
Most mild to moderate cases of sciatica can be treated with over-the-counter pain relievers and self-care strategies. For severe and persistent pain, more concentrated treatment may be needed. Below is a list of treatment options for sciatica. During your appointment, talk to your provider about what treatment plan is best for you.
Many people can treat sciatica with a few simple self-care strategies. These include:
- Hot & Cold therapy: Use ice packs to reduce inflammation in the affected nerve and relieve pain. This can be done for 20 minutes several times a day. If you don’t have an ice pack, wrap a package of frozen vegetables in a cloth. After 2-3 days of cold therapy, begin to apply heating pads or a hot pack to the affected area. If the pain doesn’t subside after a few days, alternate hot and cold packs throughout the day.
- Gentle stretching: Gently stretch your back and lower body to help relieve pressure on the pinched sciatic nerve. Do not bounce, twist, or jerk your back while stretching, as this can make the injury worse. Talk to your doctor or a licensed physical therapist to learn the best stretches for sciatica.
- Strengthen your core: Performing simple, low-impact exercises like planks can help strengthen your cure. This can help take pressure off the back and relieve pain caused by sciatica. Talk to a physical therapist or your doctor about what core strengthening exercises are best and safest for you.
Medication can be used to relieve pain and reduce inflammation caused by a pinched sciatic nerve. For most people, over-the-counter pain relievers such as ibuprofen (Advil, Motrin) and naproxen (Aleve) effectively treat the symptoms of sciatica. If you are unable to take nonsteroidal anti-inflammatory drugs (NSAIDs) like the ones listed above, acetaminophen (Tylenol) can also effectively lessen pain.
For those experiencing persistent and severe sciatic nerve pain, doctors may prescribe a muscle relaxant or prescription anti-inflammatory medication. Talk to your doctor about the adverse effects of these medications and whether or not they are the right treatment option for you.
Chiropractic spinal manipulation has been shown to effectively improve mobility and reduce muscle tightness in the back. This can help treat pain and stiffness caused by sciatica.
Working with a licensed physical therapist can help introduce stretching and strengthening to improve mobility in the back while building up musculature to manage pressure put on the lumbar spine. Once the sharp pain caused by sciatica begins to improve, you can work with a physical therapist to create an individualized routine that will improve your quality of life and relieve pain.
Talk to your doctor or health care provider about recommendations for a chiropractor or physical therapist.