Sciatica (acute): Symptoms, Stretches, Pain Relief and Treatment
Author MUDr. Peter Bednarčík CSc.
Revision
Are you gripping your back in pain at the lumbar spine? This may be due to sciatica – inflammation of the sciatic nerve. Severe, stabbing and very uncomfortable pain in your lower back can be caused by a cold or a slipped disc. It can severely limit your quality of life.
How to deal with it a and how to help yourself from symptoms such as pain or swelling that accompany this disease? Read more here.
Sciatica symptoms
The main symptoms of sciatica, commonly known as sciatic nerve pinch, are:
- Pain in the lower back (hip, lower back) that goes to the buttocks or the back of the thigh.
- The pain varies in intensity – from mild to sharp burning pain.
- Problems usually affect only one side of the body.
- Prickling.
- Tingling.
- Muscle weakness. [1]
Only a doctor can make a correct diagnosis. Do not use this or any other article on the internet to make a diagnosis. Don’t put off seeing a doctor and address your condition early.
Description and causes of sciatica
What is sciatica?
It is a painful condition caused by irritation of the sciatic nerve (nervus ischiadicus). Commonly known as sciatic neuritis and lumbago. The cause is usually a protruding lumbar disc, which gets out of its normal position between the vertebrae and compresses the sciatic nerve. Other causes can be, for example, a non-standard bone growth on the spine, narrowing of the spinal canal or a tumour pressing on the sciatic nerve.[2]
It affects up to 40% of adults at some point in their lives. A hereditary burden may also contribute to its development. [3]
Photo Gallery - What does sciatica look like?
How long does sciatica last?
The pain caused by an inflamed sciatic nerve is strongest in the first few days after the problem starts. Pain in the lower back and legs usually persists for several weeks and gradually fades. After 3 months, about half of the patients improve significantly. For some people, the problems persist for a long time. But the exact course always depends on the cause of lumbago. [4]
Diagnostics or how to recognize sciatica?
Typically there is pain in the lower back that shoots down into the buttocks, thighs or even calves. Pain also occurs in the hip area and can make it difficult not only to walk but also to stand. Weakness or reduced sensitivity usually affects only one side of the body and occurs on either the left or the right. The sciatic nerve is not always pinched in the same place, so the pain can “move” from the back to the toes.
The exact diagnosis is always made by a doctor. Before starting the examination, they need to know the exact description of the pain, its intensity and the situations when the problems are worst. The doctor will then check the reflexes and assess how the muscles in the affected area are working. [5]
What happens during such an examination?
- Walking or standing on your heels and toes will show muscle strength and balance.
- The doctor will have you gradually lift one and the other leg in a lying position. In lumbago, the pain in this position usually worsens. [6]
- Other tests are also used to diagnose lumbago: X-ray, magnetic resonance imaging or CT (computed tomography).
- Another examination method is EMG – electromyography. During this, the doctor evaluates the electrical activity of muscles and nerves. The results will tell the severity of your condition. [7]
All these examinations are gentle and painless.
Risk factors for sciatica
It can affect a very wide group of adults. The main risk factors are considered to be:
- Advanced age (changes in the spine are often related to ageing),
- obesity (more weight means more strain on the spine),
- lack of exercise and sedentary jobs (passive lifestyle impairs overall mobility),
- diabetes (the disease generally increases the risk of nerve damage),
- back-straining activities (lifting loads or repeatedly turning your back in one direction),
- Walking in high heels (heels put more strain on the back and demands a correct posture),
- poor quality sleeping mattress (too hard or soft). [8]
Sciatica in pregnancy
Pregnancy is also considered a risk factor. However, buttock and leg pain may not be caused by problems with the intervertebral discs, but rather by the overall strain on the muscles and joints during pregnancy. The muscles are tighter and the ligaments in the pelvic area are less tight than outside of pregnancy. The pressure on the sciatic nerve in pregnancy may also be related to the position of the fetus in the uterus. For example, gentle stretching exercises, massage or swimming can bring relief. [9]
Did you know?
- A pinched sciatic nerve most often affects people in their forties.
- Gender, on the contrary, does not play a significant role; it appears in both women and men. [10]
Complications when left untreated
If it is not treated, various complications can occur that can affect quality of life and cause permanent nerve damage.
- Loss of leg strength and mobility: if caused by nerve compression, paralysis or loss of muscle strength may occur.
- Chronic pain: can cause problems with daily activities and impair quality of life.
- Urinary or stool disorder: if these symptoms occur, it is important to see a doctor immediately, as this can be a serious complication.
- Psychological effects: chronic pain can have a negative effect on the psyche and cause depression, anxiety or insomnia.
Loss of strength and mobility
Chronic pain
Urinary or stool disorders
Depression
We recommend not delaying treatment of sciatica
Do not delay treatment for lumbago and see a specialist if you have any health problems or doubts about your health. This will prevent unnecessary health complications.
Sciatica treatment
Various regimens are often sufficient to relieve the symptoms of sciatic nerve inflammation. Cold and warm compresses or stretching exercises can help. However, it is always up to the doctor to make an accurate diagnosis and recommend the right course of action.
- The treatment involves the use of anti-inflammatory analgesics, corticosteroids, antidepressants and anticonvulsants. In acute pain, a lumbar spine spray may be performed.
- Rehabilitation (physiotherapy) helps after the acute phase is over and serves as a prevention of further problems. Its aim is to improve posture and strengthen muscles.
- The last resort is surgery. If rehabilitation or lifestyle modification does not help and the problem worsens, the doctor may recommend surgery. Surgery on a herniated disc or removal of another mechanical obstruction that is oppressing the sciatic nerve can resolve lumbago permanently. [11]
Beware
Treatment for lumbago can only be determined by your doctor after considering your overall health. Therefore, do not use this article as a guide to treatment, which can only be determined by a doctor.
Home remedies
Home remedies for lumbago are accompanied by one common myth – stay in bed and do not move. However, most patients find it much more beneficial to stay active and focus on stretching exercises recommended by their doctor or an experienced physiotherapist. [12] Prolonged passivity and lying down can cause complications and make the symptoms of lumbago worse. [13]
How to unblock the sciatic nerve?
- In the acute phase, cold compresses help. They can be repeated several times a day.
- After 2 to 3 days, you can switch to warm compresses.
- Add adequate physical activity to the compresses – walking and exercise.
- You can control the pain with painkillers. An ointment containing diclofenacum epolaminum is recommended as an ointment for sciatic nerve inflammation. However, consult your doctor for the duration of use. [14]
Prevention of sciatica
One of the most important measures to prevent lumbago is to avoid unilateral back loading.
In addition, as part of prevention, you should think about:
- regular exercise and sport,
- correct posture and sleeping position,
- relief positions when sitting or standing for prolonged periods,
- the correct way to lift heavy objects.
Exercises for sciatica
Rehabilitation exercises are an important aid in the prevention and treatment.
These include:
- Pulling the knees to the opposite shoulder in the lying position,
- stretching the muscles on the back of the thighs in a standing position,
- Gentle backbends over the bent leg in a seated position. [15]
For all exercises, it is important that you perform them correctly and sensitively, taking into account your state of health. Only in this way can they have a long-term effect and bring relief from pain. It is therefore a good idea to practice the correct execution with a physiotherapist who will demonstrate the correct sitting exercises.
Sciatica and massage
Massages bring relief from various types of pain. They can therefore also help. A well-chosen massage will soothe tense muscles that put pressure on nerves – including the sciatic nerve – because of the tension. Discuss the choice of a particular type of massage with your masseur, as each person may prefer a different approach.
What else helps with lumbago?
If you are one of those people who want to resort to alternative methods for pain caused by sciatic nerve inflammation, then you may want to use apple cider vinegar. This natural remedy has strong anti-inflammatory effects and relieves muscle pain of various origins. It is mainly used for foot baths. [16]
- Herbs such as frankincense, elder, St John’s wort or horseradish will also provide relief from pain and inflammation. [17]
- Acupuncture and other procedures based on traditional Chinese medicine (Chinese massage and exercises) can also be used for lumbago. [18]
Important information when dealing with sciatica
Try to move appropriately and do not wait for relief while sitting.
Strengthen your back muscles.
Avoid one-sided loading.
Summary and recommendations in the management of sciatica
See your physician
Treatment for lumbago is always determined by your doctor based on a general examination, an assessment of your condition and an accurate diagnosis.
Causal treatment of sciatica
After a general examination, your doctor will recommend treatment for the cause of your lumbago. They will also advise you on possible lifestyle adjustments and the next course of action.
Relieving pain, swelling and muscle spasms
Symptomatic treatment focuses on the manifestations or signs (symptoms) of the disease. Such treatment can significantly improve your quality of life and support comprehensive treatment during the course of the disease.
Sources, references and literature
[1] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
[2] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
[3] Davis D., Maini K., Vasudevan A. Sciatica. StatPearls, Treasure Island (FL): StatPearls Publishing; January 2022. https://www.ncbi.nlm.nih.gov/books/NBK507908/
[4] Dobson A. Ten sciatica facts. South Tees Hospitals, NHS Foundation Trust, October 2022. https://www.southtees.nhs.uk/resources/10-sciatica-facts/
[5] Nazario B. et al. Sciatica. WebMD, 16. September 2020. https://www.webmd.com/back-pain/guide/sciatica-symptoms
[6] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
[7] Nazario B. et al. Sciatica. WebMD, 16. September 2020. https://www.webmd.com/back-pain/guide/sciatica-symptoms
[8] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435,
Nazario B. et al. Sciatica. WebMD, 16. September 2020. https://www.webmd.com/back-pain/guide/sciatica-symptoms
[9] Freutel N. Sciatica During Pregnancy: Symptoms, Causes, Treatments. Healthline, 13. November 2016. https://www.healthline.com/health/pregnancy/sciatica-pain-stretches#causes
[10] Davis D., Maini K., Vasudevan A. Sciatica. StatPearls, Treasure Island (FL): StatPearls Publishing; January 2022. https://www.ncbi.nlm.nih.gov/books/NBK507908/
[11] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435,
Nazario B. et al. Sciatica. WebMD, 16. September 2020. https://www.webmd.com/back-pain/guide/sciatica-symptoms
[12] Fischer K. 9 Myths About Sciatica. Everyday Health, 7. August 2022. https://www.everydayhealth.com/sciatica/myths-facts/
[13] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
[14] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
[15] Heitz D, Cirino E. 9 Stretches for Sciatica Pain Relief. Healthline, 18. October 2022. https://www.healthline.com/health/back-pain/sciatic-stretches
[16] 5 Ways to Reduce Inflammation. Express Chiropractic & Wellness. https://expresschiropracticfortworth.com/5-ways-to-reduce-inflammation
[17] 5 Ways to Reduce Inflammation. Express Chiropractic & Wellness. https://expresschiropracticfortworth.com/5-ways-to-reduce-inflammation, Ischias. Herbs for all. https://www.bylinkyprovsechny.cz/vyhledavani?searchword=ischias&searchphrase=all
[18] Sciatica. Mayo Clinic, 13. September 2022. https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435
How to control pain, swelling, inflammation and promote healing?
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