'Sciatica' is a term used to describe the pain down the back or side of the thigh, which can extend down to the foot. You may also experience pins and needles along the leg and foot and occasionally weakness and numbness in the leg. This area down the back and side of the leg and foot is the path that the sciatic nerve follows, it is a very thick, long nerve that starts out in the low back and buttock from the spinal cord.
The symptoms felt can feel like shooting pain or burning pain, pins and needles down the leg which can extremely debilitating and last for days weeks or months depending on the underlying cause. It is very important to have an examination and case history as soon as possible to establish why you have these symptoms, and learn about what you can do.
Causes of sciatica can be something compressing the nerve- stopping full signal getting down the leg and toes- symptoms of sensory change or loss can be felt, it can also be inflammation or irritation to the nerve from healing helpers in the blood working on something that has been injured etc, as these can cause pain down the leg when they build up around the sciatic nerve, normally near the top of its path.
Aggravating actions can be slumping in the low back- as this causes stretch on a sensitised area, bending forward- for the same reason, sitting or staying still for a while – this is due to a build up irritative chemicals around the nerves of the low back that build up when we’re not moving and getting our circulation going. Straightening the leg- this puts the sciatic nerve on more stretch- while it is sensitised, this hurts. Putting weight on to one side- puts ‘pressure’ on a sensitised area.
Osteopathic treatment can help you with the physical and emotional elements of your symptoms to help reduce the pain and discomfort and give you the right advice and guidance for short and long- term self-help.
Getting an idea of what’s causing the symptoms can be very reassuring and have a positive effect on your symptoms so that you’re armed with more information about your situation.
Osteopathic treatment aims to get you moving more freely and with less discomfort.
Keeping moving as much as you can within your limits is really beneficial; walking, pottering about, very gently and slowly moving the back into all of its pain-free ranges- this all helps circulation which can reduce inflammatory chemicals irritating the nerve.
Being in pain all the time is exhausting, physically and mentally. Getting yourself comfortable when resting, or in bed, is important as your body repairs more quickly when we can relax. If it is more comfortable laying on your side, place a pillow between the knees- can take pressure off of the low back and hip.
If you can get down onto the floor onto a yoga mat (knowing you have to get back up again afterwards.. getting onto all fours can help in getting up, rolling onto your side 1st), laying on your back, use a pillow for your head if more comfortable, place your feet flat on the floor with knees bent upward, this is a neutral position for the spine. While in this position, if it feels comfortable to, you can hold one or both knees and hug them towards you gently, you may also like to rest your legs on a chair so that you can relax your legs in an upright position.
While laying on your back with knees up and feet flat on floor, practice some diaphragm breathing- take a breath down into the stomach rather than the upper ribs, gently feel the breath pushing the tummy out and your back going flat against the floor, repeat a few times; it helps you to relax as well as freeing up the lower back.
Taking pain killers temporarily to take the edge off- consult you pharmacist or GP on the type appropriate for you or if you need further advice or stronger pain relief.
Use heat on the low back and buttock if your body reacts well to heat, use a covered hot water bottle or wheat bag for 20 minutes at a time. Use cold only if you find it soothing- make sure you cover cold packs to prevent cold burns- again only 20 minutes at a time.
Don’t sit in a low squishy chair, this can aggravate symptoms and be horrid when you try to get up again, try not to sit for too long, potter about every so often to keep the inflammation chemicals from building up again. Sit in a firm upright chair with a pillow in the small of you back for support and comfort but only if this feels good. Don’t feel bad about resting, it’s good to rest but try not to stay in one position too long, depending on the severity of your symptoms- your body soon lets you know when it’s due to move about again.
If the sciatica is aggravated when walking, take care to not over tense the muscles of the back, buttocks and legs as this could be aggravating it more, try a little piriformis stretch- use only if it is pain free and feels like a nice stretch- sitting on a chair, hold a knee and raise it up towards you and the opposite shoulder, you can also turn the upper body towards the knee, just until you feel a nice stretch then try the other side. Practice ‘letting go’ of buttock, leg and back muscles so that they’re not over guarding all the time as this causes further discomfort.
If you feel you'll be able to get up from the floor, you can try placing a pillow on the floor on a yoga mat, lay face down- go slowly, lowering yourself to all fours, then lay with your stomach supported on the pillow, arms where ever comfortable, you can relax in this position for 5-10 minutes, but only if it’s comfortable, it can help drain the inflammation towards the blood vessels of the back.
Keep as upbeat and busy mentally, as you can- focusing on something other than the pain really helps, being socially active, even a hug from a friend is amazingly beneficial, this is your natural pain killers getting to work and distracting you from the discomfort so your body can get busy healing and relaxing.
This really depends on the individual and how quickly their body heals, what the underlying issues are, and how you react to the pain. Generally, it can be anything from a few days to weeks, or months. Patients I’ve seen generally fall into days to a couple of weeks, occasionally it lasts a month or more. Once the cause of the initial sciatic pain has gone, things should start feeling better, but once you have been in pain for a long time, the pain becomes more ‘hard wired’ and we need to add in some pain education and getting to know what’s ‘driving’ the pain in session to help you further.