The sciatic nerve is the longest and thickest nerve in the body. As many as 4 out of every 10 people will get sciatica, or irritation of the sciatic nerve, at some point in their life. Sciatica results from irritation of the roots of your lower lumbar and lumbosacral spine.
Treatment for sciatica pain will almost always involve a controlled, progressive exercise program. The exercise treatment helps address, resolve, and prevent recurrences of the underlying cause of pain.
What Is Sciatica?
Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from your lower back down the back of each leg.
What is Dorsalgia?
The word dorsalgia comes from the words “dorsal,” which means back, and “algia,” which means pain. Dorsalgia generally refers to back or spine pain.
However, Dorsalgia includes back pain that begins in the back muscles, nerves, and joints.
What is the sciatic nerve?
Sciatic nerve pain can be so excruciating and debilitating that you don’t even want to get off the couch. The sciatic nerve begins at your lower back, your hips, and your buttocks, going down each of your legs and bending at the knees.
Sciatic pain happens when there’s a problem anywhere along this pathway.
Sciatica Symptoms
However, common symptoms of sciatica include:
- Lower back pain
- Hip pain
- Burning or tingling down the leg
- Weakness, numbness, or a hard time moving the leg or foot
- Constant pain on one side of the rear
Sciatica usually affects only one side of the lower body. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.
Sciatica Causes and Risk Factors
However, Sciatica results from irritation of the roots of your lower lumbar and lumbosacral spine.
Additional common causes of sciatica include:
- Lumbar spinal stenosis
- Degenerative disk disease
- Spondylolisthesis
- Muscle spasm in the back or buttocks
So, other things that may make you more likely to have sciatica include:
- Aging
- Diabetes
- Being overweight
- Not exercising regularly
- Wearing high heels
- Smoking
How Sciatica diagnose?
If your doctor thinks you have sciatica, you’ll get a physical exam so they can check your reflexes and see how strong your muscles are. If your pain is severe, the doctor might order imaging tests to check for bone spurs and herniated disks. You could get tests like:
- X-ray, which makes pictures of the inside of your body, to check for bone spurs
- CT scan, which combines a series of X-rays to get a better look at your spinal cord and spinal nerves
- MRI, which uses radio waves and magnets to create pictures of your insides to get a detailed look at your back and spine
- Electromyography, which measures how fast nerve signals travel through your body, to check for things like a herniated disk
What is the Treatment of Sciatica?
Most people with sciatica feel better after self-care activities or at-home remedies like:
- Using cold or hot packs
- Stretching
- Taking over-the-counter pain medication
But if your pain isn’t getting better, your doctor might suggest other options.
Medication
However, your doctor might recommend a few different types of medication, including:
- Anti-inflammatories
- Anti-seizure medications
- Muscle relaxants
- Narcotics
Physical therapy
A physical therapist can show you how to do exercises that will improve your posture and make you more flexible. They’ll also make the muscles that support your back stronger.
Here are 6 exercises that do just that:
1) Reclining pigeon pose
The reclining pigeon pose is one of several pigeon stretches that can help stretch the piriformis muscle.
The reclining pigeon pose is a common yoga pose. It works to open the hips. There are multiple versions of this stretch. The first is a starting version known as the reclining pigeon pose. If you’re just starting your treatment, you should try the reclining pose first.
- While on your back, bring your right leg up to a right angle. Clasp both hands behind the thigh, locking your fingers.
- Lift your left leg and place your right ankle on top of the left knee.
- Hold the position for a moment. This helps stretch the piriformis muscle, which sometimes becomes inflamed and presses against the sciatic nerve, causing pain. It also stretches all the deep hip rotator muscles.
- Do the same exercise with the other leg.
Once you can do the reclining version without pain, work with your physical therapist on the sitting and forward versions of the pigeon pose.
2) Knee to Chest
Purpose: To help reduce nerve compression in your low back, which may help alleviate lower back pain.
Lie on your back.
Starting with either your left or right knee and use your hands to gently pull the bent knee toward your chest.
Hold for 10 seconds.
Repeat the movement with the opposite knee.
Perform the movement 3 to 5 times holding the position for 10 seconds each time.
Next, use your hands to gently pull both knees toward your chest.
Hold for 10 seconds.
Repeat the movement with both knees 3 to 5 times holding the position for 10 seconds each time.
3) Pelvic Tilt
Purpose: To strengthen the lower abdominal muscles and stretch the low back.
How to perform a pelvic tilt:
- Lie on your back.
- Exhale and tighten your abdominal muscles while pushing your belly button toward the floor and flatten your lower back.
- Hold the position for 5 seconds.
- Repeat the pelvic tilt 10 times holding the position for 5 seconds each time.
How can I tell if I’m doing the pelvic tilt right?
- Place your pinky finger on your hip bone and thumb on your lowest rib.
- As you tighten your abdominal muscles, the amount of space between your pinky finger and thumb should get smaller.
4) Lower Trunk Rotations
Purpose: To increase your spine’s mobility and flexibility.
- Lie on your back with both knees bent upright and both feet flat on the floor (called the hook lying position).
- While holding both knees together, rotate your knees to one side and hold for 3 to 5 seconds. You will feel a gentle stretching sensation in the opposite side of your lower back and hip area.
- Next, contact your abdominal muscles and rotate both knees to the opposite side and hold for 3 to 5 seconds.
- Repeat up to 10 times on each side.
5) Inner Thigh/Short Adductor Stretch
- While sitting on the ground, put the soles of your feet together in front of your pelvis.
- Hold your ankles with the opposite hands.
- Gently push downward with your knees with the effort to touch the ground with them. You need to stop right before any pain occurs, which means that if you feel pain, get back an inch or two and stay there.
- Hold for 30 seconds, release, and flutter your legs in that position for 30 seconds.
6) Side-Lying Clam
- Lie down on the side of your body that isn’t in pain.
- Bend your legs back, holding one foot over the other and keeping your legs parallel to each other. You should be creating an “L” shape.
- Keeping your feet together, lift the top knee while keeping the rest of your body in the original position.
- Slowly bring your knee to the initial position.
- Repeat 15 times.
Steroid injections
Your doctor might recommend you get steroid injections, like a cortisone shot. They’ll give you a shot that has medicine to help with inflammation around the nerve, which can help reduce your pain. The effects usually last a few months, but they’ll wear off over time.
Do You Need Sciatica Surgery?
Most patients with sciatica symptoms respond well to non-surgical treatments, such as medication or exercises.
However, sciatica or dorsalgia can be serious and require surgery. However, surgical treatment is recommended for patients with:
- Loss of bowel and bladder function.
- Severe leg weakness
- Non-surgical sciatica treatment is ineffective.
- Progressively worsening pain
