Thursday, August 11, 2022

How To Handle Sciatica Pain

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Surgical Treatment For Sciatica

How to Deal with Sciatic Pain

For the small number of people that when the pain is severe or does not get better with conservative treatment, a more structured treatment approach, and possibly surgery, may be the best option for finding pain relief and preventing or minimizing future pain and/or dysfunction.

Surgery should be a last resort and is sometimes necessary, especially if bowel and bladder control is affected. If your chiropractor has any doubts about the cause of your problems or whether they can help you they will refer you to your doctor or a spinal surgeon for another opinion.

Surgery for sciatica is considered when the patient has the following:

  • Severe leg pain that has persisted for greater than six weeks
  • Pain that is not relieved after all non surgical treatment such as chiropractic, drug treatment and injections
  • Severe Limitations on the patients ability to participate in normal everyday activities

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Exercise And Physical Therapy

Moving is usually the last thing people dogged by sciatica want to do, but it’s important to be physically active. “Lying in bed makes it more likely that the pain will last longer,” says Ruppert. “Exercise increases blood flow to the disk and the nerve, helping to get rid of the chemicals causing the inflammation.” Take 15- to 20-minute walks. If that hurts too much, give swimming or water aerobics a try there’s not as much pressure on the back when you’re in the water, says Ruppert. It may also be worth seeing a physical therapist, who can prescribe stretching exercises to restore flexibility to the back or moves that strengthen core muscles, helping to stabilize the spine and reduce the likelihood of a similar injury.

Best Sciatica Exercises To Do At Home

Sciatica pain can be painful and debilitating but there are some great sciatica exercises to do at home that you can start using today to relieve your pain. The radiating pain that travels from your back down through your hip and into your leg is the signature pain associated with sciatica which impacts about four in ten people at some point. If youre currently experiencing sciatica pain, these home sciatica exercises can help you to start feeling better today.

In this video, Dr. Blake, Jane, and Ashley will demonstrate and explain exactly how to do the 4 best sciatica exercises to do at home for pain relief. These sciatica exercises wont take much time at all and theyll provide you with instant pain relief.

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Which Treatments Have You Already Tried

There are several ways to manage sciatica without surgery, depending on the cause. They may include pain relief medications, steroid injections, physical therapy, aquatic therapy, meditation and nerve blocks, among others. What works for one person may not be as effective for someone else.

There are several types of doctors who treat sciatica pain. If you feel like you have exhausted your options with your primary care physician, consider making an appointment with a rehabilitation physician or a pain medicine specialist before calling a surgeon. Because every person experiences pain differently, it often takes working with the right specialist to find the combination of treatments that works for you.

What Is Sciatic Nerve Pain

How to handle Sciatica Pain

When certain nerves become pinched in the lower spine running along the sciatic nerve which is the largest single nerve in the human body intense pain can develop that runs the entire length of the legs. Sciatic nerve pain is usually repetitive, felt primarily in one leg and can be described as intolerable by most people who experience it . What makes matters worse is that many people dont know how it developed in the first place or what they can do to prevent lower back pain from returning. Plus, it can difficult to discern between sciatica and arthritis, often making it difficult to diagnose.

While many people turn to pain-reducing medications or even surgery to correct the problem, studies have actually found that less invasive treatment options like chiropractic spinal adjustments can be just as effective for healing sciatic nerve pain. In fact, a 2010 study published in the Journal of Manipulative Physiological Therapies found that nearly 60 percent of patients with sciatica who failed other medical treatments benefited from spinal manipulation just as well as if they had undergone surgical intervention!

And theres more good news: Acupuncture, yoga and massage therapy are other alternative treatment approaches that been have proven to help act like natural muscle relaxers and kick this type of debilitating pain for good.

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When Should You Call The Doctor About Foot Drop

If you are having trouble moving your feet, or you notice that you are adjusting the way you walk in order to avoid dragging your toes, contact your doctor. He or she will examine you to determine whether you have foot drop.

Last reviewed by a Cleveland Clinic medical professional on 11/09/2018.

References

Do You Know What Causes Your Sciatica

Sciatica may have a variety of causes, each of them requiring a slightly different treatment. Whether or not surgery would get rid of your sciatica will depend on why the sciatic nerve is inflamed in the first place. Possible reasons may include:

  • A herniated disc in your lower back
  • Spinal stenosis narrowing of the space inside the spinal canal
  • Spondylolisthesis slipped and misaligned vertebrae
  • Degeneration of the spine due to wear and tear, which may result in bone spurs
  • A cyst or a tumor in the spine
  • Although most of these causes can be addressed with surgery, it is rarely the first line of treatment. The type of surgery would depend on the problem.

    In addition, sciatica-like pain may result from irritation of the sciatic nerve by the piriformis muscle in the buttock. This condition is called piriformis syndrome and rarely requires surgery.

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    Some Specific Causes Of Buttock Hip And Leg Pain

  • Intervertebral disc herniation looms large in our collective imagination, and it probably is the most common cause of sciatica 85% of cases2 but also probably not quite as much to blame as we fear, and certainly not as simple. Although its mostly about applying pressure to the roots of the sciatic nerve in the low back, there is obviously more to it, because disk herniations are asymptomatic surprisingly often. Pressure alone doesnt do the trick it probably has to be combined with inflammation, which is in turn affected by many other aspects of our health.3
  • A common non-neurological cause of sciatica-ish pain is probably muscle knots or trigger points. When flared up, these mysteriously sensitive patches of soft tissue in the low back and gluteal musculature can cause symptoms that can spread down the back of the leg. Much more on trigger points below.
  • Also allegedly common is impingement of the sciatic nerve by the piriformis muscle deep in the buttock, the elusive piriformis syndrome, which is as unproven as Bigfoot, but with a lot more credible sightings.4 A piriformis muscle contracted enough to cause this problem invariably contains trigger points that also radiate pain down the back of the leg, and so the two problems often overlap. It can be difficult to tell the difference between symptoms of the nerve pinch, and symptoms of piriformis and other muscular trigger points.
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    Are Restless Leg Syndrome Multiple Sclerosis Carpal Tunnel Syndrome Plantar Fasciitis Shingles Or Bursitis Related To Sciatica

    Managing Sciatic Pain: What a Pain in the A**!!

    While all these conditions affect either the spinal cord, nerves, muscles, ligaments or joints and all can cause pain, none are directly related to sciatica. The main causes of these conditions are different. Sciatica only involves the sciatic nerve. That being said, the most similar condition would be carpal tunnel syndrome, which also involves a compression of a nerve.

    A final word about sciatica. . . .

    Most cases of sciatica do not require surgery. Time and self-care treatment are usually all thats needed. However, if simple self-care treatments do not relieve your pain, see your healthcare provider. Your healthcare provider can confirm the cause of your pain, suggest other treatment options and/or refer you to other spine health specialists if needed.

    Last reviewed by a Cleveland Clinic medical professional on 03/25/2020.

    References

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    What You Should Know About Back Pain And Acupuncture

    Acupuncture is a safe procedure and therapy when you see a professional certified acupuncturist.

    Avoid receiving acupuncture from someone who is not qualified or certified. It helps to do background research on a practitioner. Or, talk to someone you trust who has seen an acupuncturist for back pain. Ask them about practitioners they would recommend or refer.

    People who have received acupuncture sometimes report soreness, bruising, and minor bleeding at puncture sites. These issues should clear up and go away in a few days. It also poses little to no risk to overall health.

    If youre pregnant, certain types of acupuncture could stimulate labor and delivery. Talk to your acupuncturist about your pregnancy beforehand.

    If you take blood thinners or have a bleeding disorder, acupuncture poses some health risks. Make sure to discuss your issues and medications with your acupuncturist before therapy. Bleeding can happen during the therapy, though this is rare.

    Needles must be sterile and disposable. But, make sure to keep puncture sites clean after each session to prevent risk of infection. Risk of infection is small if you see a well-trained professional.

    What Can Be Done To Help Sciatica

    It is important to treat the cause of the sciatica and not the symptoms. Medication may help to numb the pain and decrease the inflammation, but it does not treat the cause of the pressure or irritation on the sciatic nerve. Here are important tools for you to relieve sciatica pain:

  • Change your position frequently. Many episodes of sciatica stem from prolonged sitting, poor posture and weak core muscles. If you have a flare-up of sciatica, make sure to alternate between sitting, standing and lying down positions. Try alternating every 15 minutes if possible.
  • Do not sit for long periods. Sitting causes increased pressure on the sciatica nerve as it travels below the gluteus muscles down to the leg. Avoid sitting on a soft couch for a long time or hard chairs. If you can, try walking 10-15 minutes outside or on a treadmill at a comfortable speed.
  • Improve your hip mobility and strength. Our hips move through a very large range of motion. However, with frequent sitting throughout the day at a computer or watching TV, our ligaments and muscles around the hips tighten up, leading to loss of motion. While this loss of motion may not appear obvious, it does change the stress and strain on your spine. Improve your hip mobility and strength to relieve the pressure on the sciatica nerve. Talk to one of our physical therapists about which exercises are safe to improve your hip flexibility and strength.
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    Pearls And Other Issues

    Clinicians should always look for and inquire about red flags when evaluating sciatica or in patients who present with any low back pain. Simple sciatica is a benign disease, and the presence of red flags would prompt much more consideration of the differential diagnosis to ensure a more serious underlying medical or surgical cause of the back pain is not present. A history of IV drug abuse is a risk for epidural abscess and seeding of bacteria anywhere in the body . Additionally, those with HIV, diabetes, or who are immunocompromised have a much higher risk of all infections, and epidural abscess must be considered. Any history of bowel or bladder incontinence, urinary retention, or lower extremity weakness suggests acute neurologic deficit and should prompt a more aggressive workup. Anticoagulant use is a risk for all sources of bleeding, including epidural abscess. A history of trauma, malignancy, or tuberculosis may suggest fracture, metastasis, and more serious causes of the back pain should be ruled out before a simple diagnosis of sciatica is used. And lastly, fevers, night sweats, chills would not be typical symptoms seen in simple sciatica and thus should prompt further consideration in the workup.

    Conservative Care In The First Few Days

    How to Manage Sciatica Nerve Pain and Reduce Leg Pain ...

    Within the first few days of an acute flare-up of sciatica, you should rest, use an ice pack and keep your spine in a neutral position as shown here.

    You may be wondering where you should put the ice pack because the painful area is so broad. The ice pack should be alternated 15 minutes over the spine at your low back and 15 minutes over the painful area of your buttocks.

    Ice decreases inflammation, which will be present in both your low back and buttocks. The pain in your leg is a symptom of the inflammation in your back and buttocks therefore, you may notice a decrease in leg pain immediately after using ice. You can use ice for 15-20 minutes at a time, many times throughout the day for pain relief.

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    A Burning Radiating Pain

    Sciatica is a condition that feels like a shooting pain down your lower back and legs. Its caused by a pinched or inflamed sciatic nerve, which runs the length of your lower back, down the leg and into your toes. The pain can range from mild to severe, but it often goes away with treatment.

    Most women experience some sort of back pain during their pregnancy .

    Its very common in pregnancy and often develops in the third trimester, but it can really occur anytime throughout the pregnancy, says ob/gyn Rebecca Starck, MD.

    How To Manage Sciatic Pain

    For many people, sciatica responds well to self-care. Rest for a couple of days after a flare-up begins, but dont wait too long before resuming activity. Long periods of inactivity will actually make your symptoms worse.

    Applying hot or cold packs to your lower back may provide temporary relief. You can also try these six stretches to help relieve sciatic pain.

    Over-the-counter medication, like aspirin or ibuprofen , may help reduce inflammation, swelling, and alleviate some of your pain.

    If your symptoms are severe and home remedies arent reducing your pain, or if your pain is getting worse, see your doctor. They might prescribe medications to relieve your symptoms, such as:

    Your doctor may also suggest that you attend physical therapy after your symptoms improve. Physical therapy can help prevent future flare-ups by strengthening your core and back muscles.

    You doctor might also suggest steroid injections. When injected into the area surrounding the affected nerve, steroids can reduce inflammation and pressure on the nerve. You can only receive a limited number of steroid injections, though, since theres a risk of severe side effects.

    Surgery may be recommended as a last resort if your pain hasnt responded to other treatments. It may also be an option if your sciatica is causing loss of bowel or bladder control.

    There are some things you can do to prevent future sciatica flare-ups:

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    How To Treat Sciatica At Home 8 Effective Ways Included

    Sciatica has sadly become common and is marked by pain radiating down the buttocks and legs from the lower back. If left untreated, the pain can be incapacitating. Thus, it is wise for those having sciatic nerve pain to consult a healthcare provider for diagnosis and treatment.

    However, what most of us do not know is that the initial sciatica pain, which is usually mild or moderate and is not accompanied by tingling or numbness, can fade in three months with a few natural treatments at home. So, lets go through the most recommended home remedies.

    When Your Sciatica Warrants A Visit To Your Doctor

    How to Deal with Sciatica | Back Pain Relief

    Its important to recognize when at-home therapies arent easing your sciatica. If these treatments dont help you, it may be time to see your personal doctor or spine specialist.

    People avoid the doctor for a variety of reasons. Maybe youre unsure about how to use your health insurance or you dont have any. Or perhaps you simply dont like visiting the doctor and prefer an ignorance-is-bliss approach.

    Whatever the reason, some sciatica symptoms truly warrant medical attention. In rare cases, delaying medical care could lead to or cause permanent nerve damage.

    If you experience any of the following, please see your doctor as soon as possible:

    • You have severe pain in your low back and legs
    • You experience nerve-related symptoms, such as weakness, numbness, tingling, or electric shock-like pain
    • Your pain doesnt improve after 2 weeks
    • Your pain gets worse, even when using at-home therapies
    • You have loss of bowel and/or bladder control

    Easing the extreme pain of sciatica doesnt always require an extreme treatment approach. Relieving sciatic nerve pain at home with gentle exercise, ice and heat therapy, proper posture, and medication may go along way to speed your recovery. But the most important thing you can do for your low back and leg pain is to take it seriouslyalways call your doctor if you arent experiencing relief.

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    What Are The Symptoms Of Sciatica

    The symptoms of sciatica include:

    • Moderate to severe pain in lower back, buttock and down your leg.
    • Numbness or weakness in your lower back, buttock, leg or feet.
    • Pain that worsens with movement loss of movement.
    • Pins and needles feeling in your legs, toes or feet.
    • Loss of bowel and bladder control .

    Take A Break When Driving

    When we say take a break, it doesnt mean that you have to stop in the middle of the road! But, kidding aside, we recommend taking a few minutes break so you can relax and rest your back from sitting on the chair. Your arms and legs will also thank you for giving them a period of rest from doing repetitive movements.

    Taking a break is vital because whenever you drive, you are exposed to whole-body vibration, and you are prone to blood circulation restriction.

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