Sciatica can be a debilitating medical condition which effects many people around the world. If you have sciatica, you know just how painful and disruptive it can be to your life. Basic activities like walking, sitting, going to the restroom, driving in a car, grocery shopping, having sex, playing with your children all become difficult if not impossible due to pain. It can be extremely frustrating because if it does not resolve after the first 2-4 week, the chances it it recurring and lasting beyond year 1 are quite high. Not only does it take a tremendous toll on our physical, emotional, and mental well-being, it can also be destructive to our pocketbooks. Estimates in the US alone show US$128Mill for hospital care, US$730Mill for absenteeism and US$708Mill for disablement.
Sciatica is a relatively common condition. Over the course a lifetime, roughly 15- 40% of us will be affected by it. If we think of these numbers in a different way, that means somewhere between 1 in 4 to more than 1 in 3 of us will be affected by sciatica over the course of our lives. Each year, on average 2-5% of us will develop a new onset of sciatica. It occurs slightly more frequently in male than females. The estimated frequency of sciatica among patients with chronic low back pain goes up substantially and estimated lifetime occurrence of low back pain is between 50-70%.
Unfortunately, these are not the most frustrating numbers with respect sciatica. Once an individual develops sciatica treatment success is rather low and rate of reoccurrence is rather high. Studies have shown that 30-50% of patients with sciatica continue to experience troublesome symptoms of pain, numbness, and tingling at 2 and even 3 years after initial onset of symptoms. As the sciatica becomes more chronic (> 12 weeks), or with recurrent episodes, it becomes less responsive to treatment. Recurrence within one year can occur in as many as 2/3 of all people.
The following are all elements contributing to the process of the pain associated with sciatica:
- Structural/Physical changes to the spine
- Structural/Physical changes to muscles
- Weak muscles
- Inflammatory chemicals
- Pain Chemicals
- Hormone imbalances
- Nutritional deficiencies
- Inadequate sleep
- Mood disturbances
For most people, sciatica responds to self-care measures. Although resting for a day or so may be tempting for you to provide some relief, prolonged inactivity will make your signs and symptoms worse. Remember, the sooner you begin treatment and prevention measures, the more effective they will be.
The following can play a key role in protecting your back and preventing sciatica:
Exercise regularly. To keep your back strong, pay special attention to your core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment.
Maintain proper posture when you sit. Choose a seat with good lower back support, armrests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level. Do not sit on things in your back pockets, such as a wallet or mobile device.
Use good body mechanics. If you stand for long periods, rest one foot on a stool or small box from time to time. When you lift something heavy, let your lower extremities do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward.
If you smoke, stop. Smoking promotes disc degeneration and floods your bloodstream with irritating pro-inflammatory chemicals.
If you are overweight, lose weight. Being overweight or obese places extra stress on your spine and discs, weakens the muscles of your back, abdomen, and buttocks, and floods your bloodstream with irritating pro-inflammatory chemicals.
Other self-care treatments that might help include:
Cold packs. Initially, you might get relief from a cold pack placed on the painful area for up to 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.
Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs. More specifics on contrast hydrotherapy will be given below.
Stretching. Stretching exercises for your low back can help you feel better and might help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch, and try to hold the stretch for at least 30 seconds. More specific stretches for sciatica will be reviewed below.
Alternative therapies commonly used for low back pain and sciatica include:
Acupuncture. In acupuncture, the practitioner inserts hair-thin needles into your skin at specific points on your body. Some studies have suggested that acupuncture can help back pain, while others have found no benefit. If you decide to try acupuncture, choose a licensed practitioner to ensure that he or she has had extensive training.
Chiropractic. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain. Spinal manipulation appears to be as effective and safe as standard treatments for low back pain, but might not be appropriate for radiating pain.
Massage Therapy. Getting regular professional massage therapy is a terrific way to keep muscles, joints, and nerves healthy.