What is Sciatica?
Sciatica is a symptom and not a condition in its own right. It is pain from the sciatic nerve, most commonly caused by irritation of the spinal nerve root(s) in the lower back often referred to as the lumbar region.
The sciatic nerve is the largest and longest nerve in the body. Several nerves join together to form the sciatic nerve in the buttock, which then runs all the way down the leg to the foot.
Sciatica most commonly causes pain in the buttocks and legs, especially when sitting down, but pain can be experienced anywhere from the lower back to the foot.
Who gets Sciatica?
People over the age of 40 are most likely to suffer from sciatica, and it can range in severity, from annoying to excruciating and debilitating. Unfortunately the older we are the more likely we are to experience sciatic pain symptoms. In our experience older people are the most likely to get sciatic pain symptoms
Although seniors are more likely to experience sciatic pain, younger to middle aged people are afflicted in greater numbers having significant impact in their working and social lives. Sciatica can be debilitating for younger or middle aged people who have jobs where sitting is unavoidable in say an office environment and this is particularly the case where driving is involved and you do not have the ability to get up and walk around.
Around 50% of pregnant women get pregnancy related low back pain. Some of this is standard lumbar pain that may lead to sciatic pain symptoms, but more is related to pelvic girdle pain (PGP).
How long does Sciatica last?
Recovery can take up to six weeks and there’s no quick-fix solution. If the sciatic pain goes beyond six weeks it can take several months to recover and in rare cases can lead to chronic pain. Healing is not always easy, and for many the pain can be difficult to manage without the right help and reassurance.
How can it affect your lifestyle?
If it’s not properly managed sciatica can begin to impair your quality of life and lead to mood swings, depression and a sense of hopelessness. Pain medication can help to manage the pain, but these alone cannot help you to heal and can spiral into increasing levels of dependence. Fortunately, there are many simple and effective ways of managing the condition and the road to recovery. It’s a matter of finding the right approach for you.
Treatment for Sciatica
Treatment will depend on the severity of your condition. In nearly all cases you will be recommended some exercise therapy. If the pain is severe then you may be given pain relieving medication, but these will not help your sciatic nerve to heal.
Activity Modification
Remaining as active as your pain will allow you is important. The worst thing you can do is to just lay down and rest. The secret is to move as much as you are able and cause as little pain as you can. It sounds obvious but avoiding activities that aggravate your sciatic pain is important. The more you irritate the sciatic nerve the longer you will take to heal.
In an acute attack of sciatic pain as Ian says, ‘If it falls on the floor it stays on the floor and if it’s up high it stays high.’
Exercise Therapy
It may seem like a bad idea to exercise when you are in a lot of pain and you may not feel like it. Long-term this is definitely beneficial and if you exercise within your limits it will be in the short-term too. The key is knowing your limits. Physiotherapists will usually set your exercises and make sure you are safely able to do them. Here are examples of stretches for sciatica provided by the NHS. Make sure you consult with a health care provider before starting any exercises.
It is not a good idea to attempt some of the stretches demonstrated by flexible people on the internet. Most of us cannot do those stretches without sciatica never mind with.
Pain Medication
We naturally have an aversion to taking pain medication and rightly so because there can be side effects and if used inappropriately can lead to dependencies.
If you can manage without taking medication good, but that said don’t struggle and suffer needlessly. The priority is to get the sciatic nerve to calm. Make sure any medication is taken under the supervision of a Doctor, so that you are taking the right type of medication at the right stage for your sciatic pain.
Manual Therapy
Manual therapy uses hands on techniques to help soothe your pain and recover. You might visit a physiotherapist, chiropractor, osteopath or massage therapist. Our personal favourite is massage therapy – but then we are biased! Everyone will have their personal favourite type of therapy.
During manual therapy the use of hot and cold therapy combined with massage and gentle stretching can be very effective in reducing pain symptoms.
You may have heard stories of people raving about miracle cures or how much worse someone was following treatment. A good manual therapist will give appropriate treatment based on the stage you are at with your sciatic pain symptoms.
Surgery and Injections
A few chronic cases of sciatic pain ends up with injections or surgery on the lower back, although the incidence of this type of intervention is decreasing. Hopefully this is a road you will not have to travel.