Sciatica - the largest nerve running from lower part of the back to the leg
Sciatica is not a disorder by itself but is a symptom of problems involving the sciatic nerve such as herniated disk (disc protrusion) or spinal stenosis (narrowing of spinal cord).
The pain due to sciatica can be very uncomfortable till it resolves automatically within a span of 4-8 weeks. Within this time, self care can help deal with the pain which includes performing home based exercises and taking appropriate medicines. Sciatic pain is a radiating pain starting at the back and extending to the leg or can also occur as leg cramp.
Sometimes ‘pins and needles’ kind of feeling, numbness, tingling can also occur. Sciatica is commonly noted in middle aged (30-50 years of age) individuals. In this age group it can occur due to normal wear and tear. Sudden pressure buildup in the spine can also cause sciatica. The sciatic pain can get worse at nights or after prolonged standing/sitting, when coughing or sneezing, when walking or bending backwards.
What causes sciatica nerve pain?
Sciatica can be caused due to a wide variety of conditions that affect the sciatic nerve. Some of these conditions include:
- Herniated disc affects 1 in every 50 people at some point in their lifetime and symptoms last greater than 6 weeks in 10% to 25% of them. Sometimes bladder and bowel control can also be lost.
- Degenerative arthritis of the vertebral bones leads to spinal stenosis which may compress nerves as they leave the spinal canal.
- Vascular problems in and around the spinal canal.
- Tumors can compress the nerves in the spinal cord.
- Trauma, infection and inflammation can also affect sciatic nerve.
Diagnosis of sciatica is based on physical examination for irritated nerve roots, X-ray evidence for disc prolapse, degeneration in discs, and narrowing of disc. MRI can be useful in identifying tumors which are responsible for nerve compression. Neuromuscular examination can be useful in identifying the abnormal reflexes or weakness in leg and foot movement.
Treatment options for sciatica nerve
Non surgical treatment
Surgery might not be required for 80-90% of people affected with sciatica as the pain heals by itself after sufficient rest and time. The treatment for such people is usually aimed at reducing the pain by using pain killers and adequate rest. Aspirin and non steroidal anti inflammatory agents like ibuprofen can be used as over the counter medication. Use of ice or hot compress can significantly decrease inflammation and provide pain relief. Usually bed rest is advised for a few days during the acute phase till inflammation subsides.
Physical therapy should be initiated as early as possible even at home to expedite the healing process. Short walking can help as activity decreases the inflammatory process and being active assists in overcoming pain. A steroidal drug like cortisone is sometimes injected into the spine in individuals who suffer from chronic or severe pain. Braces, splints and other aids like orthopedic shoes can help in compensating for the impaired function.
This treatment option is considered in those individuals who suffer from disabling sciatic pain even after 3 or more months of non surgical management. Herniated disc is the most common cause which needs surgical correction. The procedure involves relieving the pressure on the nerve by removing a part of the herniated disc.
These are aimed at relieving the pain associated with sciatica and improving the range of motion. Further, they also improve the flexibility and strength of the muscles of the lower back, upper and lower legs and other associated muscles and ligaments. These exercises also improve the recovery and enables faster return to daily activities.
Home based strategies for reducing sciatica
This is the principal of combining rest with relaxing activities like watching T.V, reading books, along with resting in the acute phase of the pain
Home based exercises can be done to strengthen the muscles of the back, leg and foot muscles as well as stretching exercises to relieve pain. These can be done on the advice of a physiotherapist to get back to fully functional state
Yoga, mediation and breathing techniques can be done at home to relieve excessive stress and improves functioning of vital organs and reduces pain associated with sciatic nerve. Application of ice packs can bring down the nerve inflammation.
Home based exercises for sciatica
Sciatica Treatment: Sciatica Nerve Pain Exercise and Stretch (Sciatica Legs and Back)
Sciatica Pain Relief - Piriformis Stretch and Syndrome Exercise
Sciatica Exercises against Sciatica Nerve Pain
Home based approach for rehabilitation of sciatica involves stretching and strengthening exercises. These exercises help in relaxing the muscles of the lower back, abdomen, and thighs. By doing these exercises the severity of symptoms of sciatica can decrease.
The following are the commonly done stretching exercise done to relieve sciatic pain:
- Piriformis muscle stretches
- Low back stretches
- Hamstring stretches
Weakened muscles are associated with sciatica. Bed rest and physical inactivity in people suffering from sciatica further worsens the pain. Strengthening exercises particularly target the muscles of the back, thighs, leg and foot and strengthens them. These exercises should be performed following adequate stretching to relieve the tension in the muscles.
These are specific exercises which are intended for particular underlying conditions such as herniated disc, spinal stenosis, or degenerative disc conditions that would have caused sciatica.
For sciatica arising from herniated disc, following exercises are advised:
- Extension exercises
- Press ups
- Upper back extension exercises
- Curl ups - intended for abdominal muscle strengthening
For sciatica from spinal stenosis:
- Back flexion exercises
- Hook lying march and
- Curl ups are recommended
Sciatica due to degenerative disc problems can be relieved by lumbar stabilization exercises like:
- Hook march and
- Bridging exercises
Low impact aerobic exercises
Biking, slow walking is also recommended in some people with not so severe sciatica for improving the overall fitness and conditioning of all the muscles.
- Maintain a proper sitting and standing posture, slouching should be avoided
- Cut down of excess calories; intake of balanced diet can help in curtailing weight gain
- Excessive strain to the leg and back during driving, lifting, etc should be avoided during the acute stage of the pain
- Post surgery strengthening exercise of the back and leg should be only started at least after a month following surgery
- Normal lifestyle and day to activities should be resumed, being inactive can also worsen the pain
- Risk rupture can always occur in persons with herniated disc problems; particularly after surgery therefore, caution should be exercised while performing strenuous activities and participation in active exercise