Sciatica Treatments: Short- and Long-Term Options for Pain Management and Healing
Sciatica or radiculopathy is the irritation or pinching of the sciatic nerve. It is only a term to describe a set of symptoms, without pointing to the cause. These symptoms may occur for various reasons. The nerve in cause goes all the way down to the pelvis, then splits to go along each leg. Pressure can irritate it and cause shooting pain. However, the way it feels can be different for each individual. In certain cases, it leads to extreme discomfort. Any slight movement can make it feel worse, as sitting or standing for a long time. There are several ways to address this issue and even self-care measures can help to a great extent. In this article we are going to explain every treatment option, as well as the best moment to employ each. Worried that you may need surgery? There is a long way to that and sciatica troubled people should know they have many solutions at hand to be tried before the radical one.
When are sciatica treatments necessary?
It may come as a surprise to many, but sciatica problems do not necessarily call for a treatment. The pain goes away by itself and the whole problem is gone in a time of about six weeks. However, it’s the disabling pain and stiffness that trouble people to such a degree that they must do something about it. It forces them to resume daily activities and even the sleep is affected. The way out of this situation is a combination of remedies and actions to fight the symptoms and of means of rehabilitation and prevention.
It is important to know that there are more solutions besides the quick and easy over-the-counter medication, which doesn’t really solve the problem. Note that knowing the cause of sciatica is essential in choosing between the many available sciatica treatments.
Medication for sciatica
Physicians usually point to oral medications or products to be applied topically, such as creams and gels. Most of these can be obtained with no prescription. These are recommended to reduce the inflammation and can be used for a maximum of two weeks when dealing with an acute crisis. The first dose needs to be high, while the following ones must be lowered. There are certain risks and complications associated with these medications, like kidney damage or stomach ulceration. One’s health history is very important in determining which is the most appropriate solution.
The helpful medications are the following:
- NSAIDs: ibuprofen, ketoprofen, naproxen (all anti-inflammatory),
- Muscle relaxants,
- Prescription medication for severe discomfort,
- Oral steroids
- Steroid medication, injected close to the spinal nerve.
Lower back pain may even be treated with antidepressants (the tricyclic type) when it is experienced as a chronic ailment.
Mind that the existing sciatica treatments based on medications may not be effective in certain cases – such as when the pain is caused by pressure, by a rupture or a disc herniation.
A word on Steroid Injection therapy
Steroid injections reduce pain when it is too intense or severe. These are different from local anesthetic injections for pain management. Besides the corticosteroids, the injected medication may contain painkilling agents as well. The procedure has several benefits. First of all, the substance gets right to the spot where it is needed. However, the needle only goes close to the muscle, so it isn’t made any more painful. Then, by avoiding medication ingestion, the patients get themselves rid of additional trouble caused by oral drugs (stomach lining irritation and other side effects). While the effects of this therapy are temporary, it still promotes a longer trouble-free period of time. It lasts from a few weeks to a whole year, which is much better than the results obtained with oral medications.
Epidural steroid injections represent the go-to treatment options for those who experience frequent crisis and who deal with acute pain that cannot be managed otherwise. Also, this allows the patient to be in a proper shape and take further action, like starting and maintaining an exercise program.
Acute pain management
Once you get a flare up, you will need to rest for one or two days, but beyond that you should consider becoming and staying active and conditioning your muscles so that they provide better support to the bones. In turn, the better aligned bones will make it better for the nerves, especially for the sciatic one. There are several ways to deal with acute pain:
- Applying heat or ice – works in the first stage. Apply the chosen remedy for 20 minutes, repeat after 2 hours. How to choose between hot or cold? Simply experiment to see which offers you relief. Once you’ve found the alternative that works, don’t alternate it with the other.
- Taking an oral anti-inflammatory pill
- Applying an ointment
- Resting in a comfortable position
- Staying hydrated
Is surgery needed?
Sciatica pain that lasts up to six weeks and doesn’t respond to treatment is a reason to go to a specialist. A situation like this may call for surgery, as any worsening of one’s condition in case of sciatica. What an intervention does is to fix the main issue – the cause of sciatic pain. Thus, herniated discs will be corrected, so they no longer put pressure on the nerve.
When the discomfort persists but isn’t severe or disabling, surgery still may not be needed. Instead, the physician will recommend physical therapy. A surgeon will address the issue only if the spine cannot be corrected in any other way. When it is possible to rehabilitate it by realigning, then a surgical intervention is unnecessary.
What matters most is to use the recommended treatment options along with regular exercise to diminish the intensity of any future crisis and keep the issue under control.
Even though most people resort to bed rest when hit by sciatic pain and it feels intuitive to do so, it’s not the best measure to take. One needs to find the position that is comfortable to them for the time being. Also, they may still be able to carry out some activities. To do the beneficial moves, a patient must identify a specialist with sciatica knowledge. This could be a physical therapist or a physiatrist.
Patients need to commit to a rehabilitation plan because future problems must be avoided. The patient will have to adopt a correct posture and commit to doing correction and maintenance exercises for the long run. This part is essential, as it strengthens the back muscles which support the spine. Should one only leave the spine to support itself, damage cannot be avoided because the vertebrae will be pressing on each other and the tension will accumulate.
It has not been uncommon for people to get sciatica relief through acupuncture for example. This technique works with the energy or qi meridians within the body. Blockages or imbalances may cause a strain in a certain bodily area. As this persists, it may lead to pain. The acupuncture needle insertions help re-balance the channels, promoting the normal flow of energy.
Biofeedback may also provide relief. The machine involved is capable of gathering information concerning specific bodily areas of health issues. It can observe and control processes like blood pressure and muscular tension. Based on the provided information, the doctor and the patient can understand the issue and take the needed measures to control the issues consciously. Biofeedback has been proven as very efficient in fighting stress and its resulting ailments.
Massage is helpful when the pain is caused by muscle spasms but not only. It is employed to reduce the severity of the issue by improving blood flow through the region. Great care is required when choosing a massage therapist – not any would know how to do this, since it is a highly specialized type.
This common approach in treating sciatica is based on adequate manipulation that restores the affected back area and adjusts the spine. Find an osteopathic physician or a professional chiropractor to align the spine – it may sound like a painful procedure, but it is never supposed to hurt. If there is any discomfort, it doesn’t last. It should be all gone once the session is ended. Chiropractic manipulation can eliminate the many issues that could cause the nerve pain. The patient must lay down on the side, in a lateral recumbent position, while the practitioner presses various areas of their back and spine and applies low amplitude impulses.
The method is used to treat sub-luxations or spinal derangement. Because the spine joints and the vertebrae are being pressed and manipulated for realignment, the patient may experience soreness. This is a natural post-treatment reaction. The discomfort caused subsides within a day’s time at maximum, especially when ice packs are applied on the sore spot. It is uncommon to experience pain for longer. Unless there is another cause for sciatica, like a herniated disc, this procedure is good enough to rid the patient of the back pain.
Nature’s remedies do not have the side effects of drugs, are mild on the body and can have a lasting effect. A well known helper in this case is the capsicum extract, which is widely employed in manufacturing plasters that heat up the painful area and heal it. This acts as an agent to stimulate blood flow and relax the muscles. Capsaicin from cayenne peppers relieves pain, at the same time heating up the troubled region. It is incorporated to creams, ointments or plasters. Experts recommend St John’s wort oil massaged into the area a few times a day, as well as nutmeg powder in sesame oil applied topically during massage sessions. Some patients take valerian root as oral supplement or infusion, because it has calming effects, relaxing both the mind and the body. The herb works as a sleep aid though, so it cannot be used too much during the day. Other helpful herbs are fenugreek seeds, white willow bark and devil’s claw.
Sciatic nerve pain can be soothed if you prepare a strong anti-inflammatory drink with turmeric. Mix a teaspoon of the bright yellow spice with one cup of milk. You may add a bit of cinnamon, too. Boil this, then sweeten it with honey. Consume once or twice a day. Repeat until you see improvement.
Exercising is essential for greater flexibility and for strengthening the core muscles. Thus, any core exercise can do good to the spine, except for the rough ones which may cause further injury. Work not only the back, but also the abdominal muscles. The focus is on lengthening the spine, as opposed to compressing it. Consider:
- General aerobic workout,
- Knee-to-chest stretches (lying flat on the back and raising one knee, grasping it and bringing it as close as possible to the chest. Variations: do this with both knees at once. Or, extend your leg before bending it)
- Back extensions (lie on the stomach, then prop on elbows to make an arch and lengthen the spine)
- Hamstring stretches (standing, raise a leg on a step, straight and with the toe up; lean forward with a straight back)
- Floor twists
- Spinal rolling
- Upper back extensions
Remember to keep these exercises comfortable. Do not cross the limits of your body and don’t push too far. Pay attention to see exactly how each exercise is done. Any errors will defy the purpose of these workouts. Learn the exercises under a professional’s surveillance, so they can corrects the mistakes. Also, an experienced practitioner will recommend the best types according to the cause of your pain.
Make this your daily routine to get relief from sciatica.
Many people suffering from low back pain believe that resting more will help them heal and avoid future problems. While this may seem like the intuitive thing to do, rest doesn’t help that much and shouldn’t be chosen as a means to healing. Being physically active is of a far greater importance. Therefore, as soon as you have managed your acute stage pain, you should resume your activity (avoiding what has harmed you or what pushes your back beyond its limits).
Unlike the medication, adequate exercising and a conscious, healthy lifestyle should be maintained at all times. Sciatica is not a problem that occurs with age. It is created by our carelessness, by improper posture, sedentary work, an inactive lifestyle and sometimes by wrong exercises. Understanding how it happens is the first and most important step to healing.