Sciatica pain is the pain that radiates down the path of the sciatic nerve, goes from the lower back through the hips and buttocks and down the both legs, and that makes the most ordinary and dull actions feel like torture.
Sciatic pain can be a symptom that most frequently appears when a herniated disk, a narrowing of the spine, or a bone spur compresses the sciatic nerve, but it can also be caused by piriformis syndrome (when the piriformis muscle, which helps in rotating the hip, spasm and irritates the sciatic nerve), as well as by pregnancy, when a woman’s expanding uterus presses on the nerve. Go to your primary-care doctor and ask them to pinpoint the source of your sciatica, and then, consider one of the following methods to get rid of that pain.
It may seem tempting to throw the cover over your head when sciatic pain flares up, but you need to know that prolonged bed rest does not aid you to resolve the symptoms faster, says Mark Milstein, MD, a neurologist at Montefiore Medical Center in New York City. This is why you are recommended to try physical therapy. Dr. Milstein says that this treatment is efficient for the most patients suffering from sciatica pain, and given the regular restrictions o pharmacologic treatment during pregnancy, it is even more important for pregnant women. You just need to find a licensed physical therapist to guide you through the exercises that are going to assist you get up and stay up via the American Physical Therapy Association.
Acupuncture is a popular method used by numerous people for pain reduction. This method works by increasing endorphins (which help people become more resistant to pain) and by reduction of the level of inflammation, says Jiang-Ti Kong, MD, an anesthesiologist and pain specialist at Stanford Health Care Institute in California. This method is also a great complement to other sciatica-management strategies, adds Dr. Kong. It is an optional extra to physical therapy or even injections, and it can contribute to making these therapies much more effective. Moreover, this treatment is rather safe and it almost does not have side effects and risks. Try to find a practitioner with the professional initials DABMA (meaning that they have been certified by the American Board of Medical Acupuncture).
Heat or ice
If the sciatica pain in your case originates from a muscle spasm, as with piriformis syndrome, try applying either an ice pack or heat (in the form of a heating pad, with a temperature of about 104 degrees F), whichever feels best to you. Hold it for fifteen to twenty minutes at a time, so that you give your skin an opportunity to recover, especially if you’re using ice, suggests Farah Hameed, MD, a sports and spine specialist and the medical director of Women’s Health Rehabilitation at Columbia University Medical Center in New York. She also says that the more local the pain is, the more efficient the application of heat or cold will be.
A lumbar pillow
According to Dr. Milstein, prolonged sitting has been related to increased risk of developing sciatica, and this is why it is important for people to maintain a good posture while they are sitting at the desk. He suggests that you put a pillow against your lower back, as it will support its natural curve and it will prevent hunching forward. According to Dr. Hameed, you should buy yourself the McKenzie Lumbar Roll (you can find it on amazon.com for $16), which is a bolster-shaped cushion that will help you sit a little more upright. You should place this cushion behind you in your chair at the office, in your car while you are driving, or any place you sit.
A bathroom break
According to Dr. Hameed, sitting for too long worsens the sciatic pain and pressurizes the disks, so you are recommended to move more as it can help a lot. The doctor suggests that you get up at least once per hour and walk around for at least five minutes to get a glass of water, to go to the bathroom, or to do anything else. When you sit back at your desk, you should do a quick stretch: stand up and cup your lower back using your hands, and then lean backwards to the end of your scope of motion, supporting the muscles of your lower back with your hands. According to Dr. Hameed’s explanation, this way you are putting your spine into the reverse position of when you are sitting.
A sit-to-stand desk
People who suffer from sciatica pain as a result of prolonged sitting are recommended a sit/stand desk. According to Dr. Hameed, this desk will help them get up more. If you are buying some office furniture, find an adjustable-height workstation at which you could alternate, for example, half an hour of sitting and half an hour of standing. This will give you the relief your aggravated nerves in your lower back need. These hydraulic desks can be rather expensive (those lifting and lowering mechanisms do not come cheap), but their ergonomics is dramatic.
Once you experience sciatica pain, you should keep in mind that you need to maintain a moderate exercise regimen as a crucial part of the recovery process. As we already said, bed rest can make the pain worse only after a day or two, and, on the other hand, regular activity conditions and strengthens the back muscles and the spinal structures. Now you wonder how much you need to exercise. Dr. Hameed explains that you need to exercise for half an hour at least five days per week. The exercises you should practice should be of moderate intensity (that is, where you have sufficient breath to say a few words but would have trouble belting out a show tune). These exercises and activities include walking, swimming, and gardening. You should also practice doing exercises that target the core, as they are especially beneficial.
Sometimes, when it comes to a first-line treatment of sciatica pain, a highly efficient remedy can be a short course of non-steroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen. If you use oral NSAIDs for prolonged time period, you can increase your risk of gastrointestinal ulcers and cardiovascular issues. However, these medications are still a safer alternative than narcotic pain medications such as hydrocodone (Vicodin) or oxycodone (Percocet and OxyContin), which are related to a serious risk of addiction, as well as numerous side effects, including itching, drowsiness, vomiting, nausea, constipation, and so on.
A lacrosse ball
In case of targeted relief for pain related to a certain muscle (for instance, ‘runner’s butt, as piriformis syndrome is sometimes called), one of the best mobility tools is also one of the simplest. You should get yourself a lacrosse ball (for $11 on amazon.com), which is ideal for pressing against the flesh of the specific area that feels uncomfortable to you, explains Dr. Hameed. First, put the ball on the ground, lie on the top of it, and then roll to knead pain out of your sore spots. In case you find this too uncomfortable or hard on your tissue, swap down to a tennis ball, which has more give.
Studies have shown that oral steroids do not seem to help with sciatica pain, however, steroid injections are believed to be efficient form of short-term relief for some patients. You do not think there is a difference? Well, there is. Localized steroid injection actually targets the medication to the structure with the problem, says Dr. Kong. Cortisone injections also contain smaller amounts of the steroid, which could lower the risk of some of its side effects, like insomnia and mood changes. Even though studies suggest that injections are not efficient when it comes to long-term pain relief, it is one step ahead if you ease the pain even at short terms, and as a result, you will be able to take on physical therapy more easily, says Dr. Milstein.
The comfrey is the bushy, flowering shrub present in the traditional medicine and utilized as a remedy for centuries. Even nowadays, comfrey is being utilized in topical treatments for sprains, bruising, arthritis, pulled muscles, and more. A study review from 2012 has revealed that comfrey is an efficient, fast-acting solution for relieving back pain. Also, it is important to note that the extract from this plant contains both beneficial anti-inflammatories and alkaloids that can accumulate over time and lead to liver damage, so that is why it is important for you to make sure to consult with your doctor and confirm that this plant is a safe option in your case.
Prescription pain patches
Lidoderm patches are highly beneficial as their active ingredient, lidocaine, is a topical anesthetic that blocks pain messages from the irritated nerves. The flector patches contain diclofenac epolamine, a topical non-steroidal anti-inflammatory drug – NSAID, which belongs to the group of ibuprofen and naproxen. Neither of these patches was made to address sciatica pain in particular, but they can be pretty helpful for some people, practice shows. Dr. Kong explains that the lidoderm patch is specifically approved for people who experience burning after recovering from shingles, and flector is mostly used for acute pain which is a result of sports injuries.
According to Dr. Hameed, the majority of the massage therapists are well-equipped to provide short-term relief from sciatica pain, as it is such a common problem among people. In case you have already been at the masseuse, it would be even easier for them to help you, as they are already familiar to what alleviates the tension for you and they would be able to regulate the symptoms while you seek to resolve the pain you feel. It is important to note that your masseuse needs to stick to moderate pressure when it comes to relieving sciatica pain, as aggressive, deep-tissue stimulation can in fact cause the symptoms to flare, which annuls the purpose of getting on the table in the first place.
Once you have discovered the source of your pain with the help of your doctor, try some yoga poses that target the parts of your body that need special attention. According to Dr. Hameed, the best two are the ‘figure four’ (or thread the needle) and the ‘classic plank’. The former stretch releases tension from the piriformis muscle and it is ideal after a long day of sitting. In order to do it, you should lie on your back, cross your right ankle over your left thigh, and then connect your hands behind your left hamstring and pull toward your belly for about ten to fifteen seconds, and then repeat the same thing on the other side. The latter will make your core stronger and it will alleviate the pressure on stressed-out disks pinching the nerve in your lower back.
If the unbearable sciatica pain you experience is caused by a herniated disk, and this pain radiates down your lower back, a conservative treatment would not be able to relieve it. This means that you might be a candidate for a diskectomy, the medical term used to describe the surgery performed in order to eliminate the damaged part of the disk. What is positive about this method is that diskectomies can be minimally invasive and are pretty safe. The negative side of it is the fact that even though early surgery can provide immediate pain relief for people with herniated discs, researchers have discovered that a year after the process, improvements in pain and disability were not considerably greater for patients who have undergone diskectomy compared to the patients who received long-term non-surgical care. If you cannot decide whether you should undergo a diskectomy or not, consult your doctor and they will tell you if this procedure is a good fit for you.
The practice of visiting a chiropractor is a non-invasive and non-pharmaceutical approach to this type of pain, and it has a lot going for it. A study from 2010, for instance, has revealed that 60 percent of people suffering from sciatica pain that originates from a herniated disk and who had had to find success with non-surgical treatment experienced the same relief from chiropractic care that other patients enjoyed from surgery. This therapy is also often complementary to other approaches for relieving sciatica pain. You just need to find a licensed doctor of chiropractic (DC), and the American Chiropractic Association can help you with that.
A maternity support belt
Pregnant women who experience sciatica pain are suggested to wear a pregnancy belt that helps lift the uterus, claims Hilda Hutcherson, MD, a professor of obstetrics and gynecology at Columbia University’s College of Physicians and Surgeons in New York City. The basic, regular belly bands may work better when it comes to sitting positions, but maternity belts that cradle a pregnant wearer’s belly and relieve tension on the lower back provide more relief from sciatica while standing and walking. Moreover, according to Dr. Hutcherson, sciatica pain that is the result of pregnancy usually gets better shortly after giving birth. However, you need to know that you should not turn to a back brace in you are not pregnant, as this ‘support’ will prevent your core and back from developing the muscle mass you need.
The last thing on the list that is also efficient when it comes to sciatic pain treatment is stem-cell therapy. The scientist have gotten excited after they had done some testing on animals and found out that it is possible to use stem cells to treat sciatica by triggering nerve regeneration. Further researching is needed, as this is yet in the experimental phase, says Dr. Milstein. However, for now, take heart from several stats via Dr. Kong: 80 percent of people who suffer from acute lower back pain or sciatica recover within one month, and 90 percent recover within three months. You see, it is very likely that you are already on the road to recovery.
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