Sciatica

What is Sciatica and what can you do about it?

‘Sciatica’ is a term used to describe the pain or other nerve symptoms felt down the back or side of the thigh, leg and foot. The long, thick sciatic nerve starts out in the low back and buttock branching off from the spinal cord, and travels as far as the foot via the side and back of the thigh and leg which is why we feel the symptoms here. Symptoms can be caused by either pressure or irritation to the nerve from an injury or change to the chemical balance in the local area.

Symptoms are often described as a ‘shooting’ or ‘burning’ pain, pins and needles or numbness down the leg can also be felt and occasionally loss of control and power in the leg and foot. It is very important to have an examination as soon as possible to establish why you have these symptoms, and learn about what you could try and whether referral is necessary. Very often, an examination turns out to be very reassuring, putting your mind at ease as to why you’re experiencing these symptoms and giving you advice on what you should do.

If pressure on the nerve is the cause of your symptoms, doing thing like bending forward to put shoes on or sitting down for a while can aggravate the symptoms while things are very sensitive. If the nerve is extremely sensitised you may find that all manner of actions are very uncomfortable until the irritation to the nerve starts to subside. In the short term, while things are recovering, avoid the movements that make things very sore, but don’t be scared of them! You won’t do any damage with simple body movements as the back is very strong, it’ll just aggravate the pain at worst and take a little longer to settle, we’ll go through with you the movements you can do to help the sy,ptoms, movement is actually one of the very best things to do, just a little guidance is required to help you discover which ones. So, soothing the area as much as possible is a priority, and ways to do this are:

  • Hands on treatment: work can be done away from the area of pain to relax muscles and get you more comfortable, we can also help the local circulation to aid healing
  • Use heat or ice packs- Depending on your preferences for hot and cold, on the buttock and low back on the side of the leg symptoms for 20 minutes at a time, can help take the ‘edge off’. If the area feels red and hot, use cold, if it’s stiff and tight use heat. Careful not to burn yourself, wrap in towel before applying! You can try both and see what works best for you, not everybody is the same! You certainly won’t make anything worse trying both, just follow what your body prefers and go with that. Alternating between hot and cold can help boost the local circulation which can be helpful.
  • Reducing inflammation (chemical irritants around the sciatic nerve which can cause pain) by improving circulation in the area can help to ‘flush’ the build-up of inflammation, reducing pain. Regular movement of the back, hips and legs are great for this- we can help you with this passively, guide you actively in treatment sessions, and you can yourself find the movements that do not aggravate symptoms and do those regularly. Examples are moving the trunk side to side, rotating through the trunk, all gently and slowly to test first, rocking forward and back not too far, just in the comfortable areas. It’s ok to feel a bit of pain, you’re not damaging yourself! The area is just over sensitive at the moment. Trying not to sit, stand, lay down too long as the fluids/chemicals in the area build up when we’re not moving. Find your limit for staying still, and move around periodically to reduce the ‘build-up’ before resting again.
  • Find a comfortable position to allow yourself to rest and relax (important for healing)- this may be lying on one side with a pillow between your knees, laying on a yoga mat with knees bent and feet flat on the ground (remember you have to get back up again! Rolling onto all fours and using something of someone to help you up can be helpful). While in this position on the floor, some patients find putting their legs and feet up to rest on a chair at 90 degrees at the hip and knee helps.
  • Diaphragm breathing (see the video ad blog) can help relax the surrounding muscles of the back and legs around the sciatic nerve, it also relaxes your mood and tensions in the body, if you read about pain and what makes it worse you’ll understand that shallow breathing and stress ‘amplify’ pain, so this simple breathing calming exercise can turn the ‘pain volume’ down.
  • Medication- please speak to your pharmacist or GP first to get a painkiller that will be most effective for you. For some, a muscle relaxant is helpful, for others strong painkillers are required to help you move about, anti-inflammatories can be effective, but you must consider your current mediations and health before starting to take extra pain killers.
  • Gentle massage to the surrounding areas- legs, back, upper back can help you relax and feel at ease- I’m an expert at this and can also guide your other half to help you at home 😊
  • Carrying on as much as possible with activities and work where possible, but listen to your body, if you need to take a break and rest, do so, you’re only human!
  • When you sit, try not to go into a low soft chair, try in the short term to use upright harder chairs, you can pop o cushion under your bum and in the small of your back to improve your comfort while you’re in lots of pain.
  • Gentle stretching is good, as above with movement- stick to the stretches and movements that are more comfortable to do, don’t go into the super painful areas until your less sensitive.

How long Does Sciatica last for?

This really depends on the individual and how quickly their body heals, what the underlying issues are, and how you react to the pain. Generally, it can be anything from a few days to weeks, or months. Patients I’ve seen generally fall into days to a couple of weeks, occasionally it lasts a month or more. Once the cause of the initial sciatic pain has gone, things should start feeling better, but once you have been in pain for a long time, the pain becomes more ‘hard wired’ and we need to add in some pain education and getting to know what’s ‘driving’ the pain in session to help you further.