Symptoms and signs of Sciatica include pain in the leg or foot, numbness, pins and needles or burning sensation in the foot and muscle weakness in the leg. One or all of these may be present. Most of the time sciatica occurs together with low back pain but not invariably so.
Causes of Sciatica
Muscle spasm from back strain is the usual cause. Prolapsed disc is less common. Arthritis of the spinal joints can cause sciatic nerve impingement as can vertebral collapse through osteoporosis. Rarely, sciatica may be caused by problems within the pelvis.
Self-help Methods of Treatment
- Stretching: as sciatica results mainly from back problems, gentle stretching exercises which help the back will aid recovery. When doing back exercises it’s usual to feel stiffness and some soreness in the muscles – this is normal; however if you experience exacerbation of your leg pain you should stop that particular movement.
- Hot and cold therapy: a hot (not too hot) or cold compress over the lower back on the affected side can provide comfort. Some people recommend cold, others hot. Try alternating hot and cold five minutes each for twenty minutes.
- Posture: good posture, particularly when sitting if you have a sedentary job, is important for the back. Having the correct chair, being supported in an upright and relaxed position will speed recovery and help prevent recurrence.
- Exercise: swimming, walking, yoga and tai chi are all helpful. Some you may not be able to do in the acute stages of sciatica but as soon as you can, try any of the above that suit you best.
- Acupressure and trigger points: although normally handled by health practitioners, with the aid of a book or a chart you can obtain relief by massaging these points or getting a friend to do it for you on the spots you can’t reach.
- Self-medication: it’s always best to stick to pain-killers with the least side-effects – paracetamol (acetaminophen) is one of the safest. If you know you can tolerate non-steroidal anti-inflammatory drugs (NSAIDS) then these are worth a try. NSAID creams and gels for applying to the skin may be helpful.
Complementary Therapy
- Massage and manipulation: mainly carried out by chiropractors, osteopaths and physiotherapists, can be helpful in freeing up the lower back and taking pressure off the sciatic nerve.
- Acupuncture: some sciatica sufferers have found acupuncture very effective. The needles probably do three things – control the pain via endorphins, reduce local inflammation and relax muscle.
Medical and surgical interventions.
- Joint injections: injection of steroid and long acting local anaesthetic into the area around the affected nerve roots can bring considerable relief. Sometimes this relief can be permanent.
- Surgery: if a scan shows that the nerve roots are being pressed by a prolapsed disc, then surgery is an option. This is usually the last resort however, when all the above have failed, the patient’s pain is severe and constant or when the leg muscles are becoming weak. There are good reasons for this. Surgery entails some risk (a very small one these days), the results aren’t always as good as wanted and most cases of sciatica due to disc prolapse get better anyway – although it can take many months, which, to anyone suffering from sciatica will seem like forever.
This article is for information only. If you think you have sciatica you should consult the appropriate health professional.
John Richard Roberts - I am a practicing osteopath and acupuncturist living and working in the UK. I hold a Master's degree in Clinical Neuroscience. I have ...
