Tips for Managing Sciatica

Sciatica is a common problem involving the sciatic nerve, which is the biggest nerve in the body and runs from the spine with branches to the foot of one leg. 

An estimated 10 to 40% of Americans will have sciatic pain during their lifetime. The annual new incidence is 1 to 5%.

The pain is the result of changes in the spine and can be felt in the center of the back, buttocks, back of the leg, knee, and calf down to the foot. It’s most common between the ages of 40 to 65. Men are three times more likely than women to experience sciatica.

Cause of Sciatica

The most common cause is inflammation of the sciatic nerve, usually caused by compression of the nerve, either by a bulging herniated disk in the spine or a bone spur of the spine.

The bulging disk or bone impinges on, or pinches, the nerve roots leaving the spine that form the sciatic nerve. When the roots become irritated and inflamed, they cause pain and sometimes numbness along the path of the sciatic nerve. Misalignment of vertebrae and muscle spasm in the back and leg can also cause sciatica. 

Certain occupations or lifestyle choices that involve prolonged sitting or heavy lifting predispose someone to sciatica. Other risk factors include age, smoking and obesity.  

Diagnosis of Sciatica

A layperson can often diagnose sciatica. Pain and/or numbness anywhere along the sciatic nerve is a symptom. The pain can be mild, sharp, or burning. It can also feel like an electric shock and is usually worsened by coughing.  

Treatment of Sciatica

You can treat your sciatica, at least initially, with gentle exercise and nonsteroidal anti-inflammatory medicines. First, avoid any position or activity that causes pain, such as prolonged sitting and standing.  

Erect posture and sitting with support at the base of the spine can be helpful. Regular, light exercises such as walking or swimming, along with specific exercises that strengthen the core muscles can help protect the sciatic nerve (see tips below).   

Over-the-counter medications such as Ibuprofen (Advil/Motrin,) naproxen (Aleve) or high-dose aspirin can be used for no more than seven to 14 days. Use these medications precisely as instructed on the label and only for the recommended duration to treat the pain.   

Together, medication and exercise should “calm down” the acute episode of sciatica and help you avoid seeing a physician. If pain persists for longer than two weeks or worsens, you should see a physician for further diagnosis or treatment. A physician will do a physical exam to elicit the pain, usually involving certain positions such as having you lie flat on your back and raising each leg.  If the pain persists for more than six to eight weeks, an X-ray, MRI, or CT scan may be required to rule out other problems such as epidural abscess, hematoma, or tumor. Your doctor may prescribe stronger medications or even recommend if a herniated disk is diagnosed as the cause. If bowel or bladder dysfunction or inability to walk occurs, seek help immediately.

Exercises to Help Sciatica 

Exercise strengthens muscles in the back, buttocks and leg, which keep the spine aligned and from impinging on the nerve roots that form the sciatic nerve. These exercises must be done daily, up to three times a day. The temptation is to quit doing them when the pain resolves, but this is a mistake because sciatica can return. 

Most sciatica pain will resolve in four to six weeks with the treatments recommended. If it persists, contact your physician. 

To learn how to exercise correctly, watch a video. Using Google, or your preferred browser, search for “sciatica pain exercises video” and you’ll find more than two million.

Concerned about sciatica? It’s best to see your primary care physician for an assessment! Schedule an appointment by using this link.