Sciatica refers to the sciatic nerve, which is the largest nerve in your whole body, and is responsible for the sensation for your leg, and also for muscle strength and function for your leg.
The confusing thing about sciatica is that you often feel it down your leg, but the origin of the problem is your low back, because that’s where the sciatic nerve branches from your spinal cord. The sciatic nerve branches off from multiple points in your low back.
When the sciatic nerve is compressed or irritated, it can cause pain in the areas the sciatic nerve: low back, buttocks, hips, and down your leg as far as your feet.
Along with pain, sciatica can also cause numbness, or pins and needles or altered sensations.
Because the sciatic nerve is also responsible for controlling the leg muscles, providing strength, you may also feel weakness in your leg, have difficulty, and feel like your leg may give out on you.
Sciatica symptoms can come from both within the spine and outflow of the nerves through the spinal canals (foramen). Causes can include spinal degeneration, disc herniation and spondylolisthesis. Unfortunately, sciatica can also be caused from local nerve entrapment from various muscle groups within the low back and hip including the piriformis muscle.
Nonsurgical Treatment for Sciatica
The goals of nonsurgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or more of the treatments below are usually recommended in conjunction with specific exercises.
- For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.
- Over-the-counter or prescription medications are often effective in reducing or relieving sciatica pain. Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), or oral steroids can reduce the inflammation that is usually part of the cause of pain. Muscle relaxants or narcotic medications may also be prescribed for the short term (a few days and up to 2 weeks) to alleviate pain.
Alternative Sciatica Treatment
In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients. Some of the more common forms of alternative care for sciatica include chiropractic manipulation, acupuncture, cognitive behavior therapy, and massage therapy.
- Spinal adjustments and manual manipulation performed by appropriately trained health professionals, such as chiropractors and osteopathic physicians, are focused on providing better spinal column alignment, which in turn is designed to help address a number of underlying conditions that can cause sciatic nerve pain.
- Manual manipulation by appropriately trained health professionals can create a better healing environment and should not be painful.
- This practice is centered on the philosophy of achieving or maintaining well-being through the open flow of energy via specific pathways in the body. Hair-thin needles (which are usually not felt) are inserted into the skin near the area of pain.
Cognitive behavior therapy (CBT)
- This therapy for taking control and changing self-defeating behaviors can be helpful in managing sciatica pain, particularly in the short term. Sessions with a therapist may be face-to-face or online.
- The role of CBT and other psychology based pain management strategies has a recent resurgence in research. The use of smartphones has opened the door for alternatives to face-to-face therapy including meditation, mindfulness and awareness
- Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers).
Injection may be beneficial for this condition. These injections are given on an outpatient basis over a period of weeks. They may include:
- Cortisone (Corticosteroid)
- Platelet Rich Plasma (PRP)
- Trigger Point Injections