What is sciatica and how can you manage it?
24 May 2019
Sciatica is possibly one of the most misunderstood ailments out there, yet also one of the most common. It is estimated that up to 40% of us will experience sciatica at least once in our lifetimes, with the likelihood becoming more pronounced with age, weight gain and a sedentary lifestyle.
So, what actually is sciatica, and how can it be managed and prevented? Good question, and this brings us to the first myth around sciatica.
Myth 1: Sciatica is a condition.
Sciatica is the name for a group of symptoms caused by the irritation of the sciatic nerve, which has its origins in the lumbar (lower) region of the spine. The sciatic nerve is the longest and widest nerve in the body, running from the lower back, through your bum and down your legs, ending just below the knee. Sciatica is not its own condition, just the expression of pain and other symptoms.
Sciatic pain can manifest anywhere along this route and can radiate along it too. Many people report the sensation of numbness or pain all the way down one leg and/or in your lower. The type of pain can vary from a dull ache or numbness to tingling or sharp pain – at its most severe it can make simple movements such as standing or even lying down difficult.
The estimated recovery time for a bout of sciatic pain is approximately six weeks. For some people one instance is all they will ever have, but for others the pain becomes a returning, reoccurring presence in their lives.
Myth 2: Sciatica is a sign of something worse.
Technically this actually isn’t a myth, but it also is.
Let us explain.
Sciatica is rarely a sign of a serious medical problem, although the pain can be very disruptive and difficult to manage, which can take its toll on your mental health and general wellbeing.
The reason this is also technically not a myth is that something has occurred, often within your spine, to irritate the sciatic nerve. It is important to note that the pain doesn’t necessarily mean that significant damage is being caused, even though it can be unbearably uncomfortable – the pain just proves that your nerve is really good at working and communicating when it’s being pinched! The most common cause is a slipped or bulging disc, which accounts for an estimated 90% of cases. Other causes tend to be either medically-based or lifestyle based. There is a long-standing myth that pregnancy increases the likelihood of sciatica; this is not the case, although back pain (which is a separate condition) is very common in pregnant people.
Medical causes include:
- Piriformis syndrome, which places pressure on the sciatic nerve.
- Spondylolisthesis – a condition where a disk slips forward over the vertebra below it
- Pinched nerve
- Tumours within the spine, benign or otherwise
Lifestyle causes include:
- A sedentary lifestyle, including a desk-based job
- Being overweight or clinically obese
- Physical inactivity
- Age – people in their 30s and 40s have a statistically higher risk of developing sciatica, although it is important to note that it is not inevitable – there are things that you can do to prevent it. Which brings us to our third myth:
Myth 3: Sciatica is inevitable, or just a sign of ageing.
No, it’s not!
Yes, statistics show that the likelihood of experiencing sciatica increases with age, but this does not mean that you can’t take preventative steps to reduce your individual chances. Remember – sciatica itself is a set of symptoms, not a condition.
If your lifestyle falls into any of the above listed traits, you should strongly consider changing your habits. You can also prevent the likelihood of sciatica by taking excellent care of your spine and properly supporting your posture. It’s never the wrong time to make a change and start paying attention to your overall wellbeing; if you do not make time for your wellness, you will be forced to make time for your illness.
5 Tips on Managing & Preventing Sciatica
There are a number of ways to both alleviate and relieve the pain from sciatica. Many of these can also help to prevent it in the first place, or prevent a future flare up. Of course, it is always better to treat the root of the cause and prevent these things from happening in the first place, so we would recommend implementing these regardless of if you’ve ever suffered with a bout of sciatica.
1. Keep Moving
This is the biggest piece of advice from all major healthcare sources. It may be difficult, or even painful, which makes the temptation to stay seated or laid down in one position very strong, but you absolutely must not. Extra bed rest is out, I’m afraid!
Work within your own threshold for pain, but move as much, as gently, and as often as you can. In the unlikely event that moving makes the pain worse, please seek medical advice as soon as possible. The NHS recommends that ‘studies have shown that longer periods of rest and avoiding activity actually leads to more pain and longer recovery times’. Many of the major recommendations around managing and preventing sciatica revolve around this basic premise of gently moving more.
This follows on from the recommendation to keep moving. It may make your back feel a little sore at first, but it doesn’t cause any harm; in fact, the opposite.
Low-impact activity and exercise will help to strengthen the weak muscles that support the spine, which in cases of slipped disc can help to prevent a further episode. Start gently, with stretches, walking and short periods of mild exercise, and work your way up. Even if all you can manage is walking the dog, that’s an excellent start! This guide from Dr Liji Thomas can give you more in depth information about exercising with sciatica.
3. Hot & Cold Packs
Exercise caution around this one if numbness is one of your symptoms, but making use of alternate hot and cold packs on your lower back, or at the epicentre of your pain, can provide some relief. Use these in 20-minute stints, alternating between hot and cold each time. You may find it helpful to protect your skin with a flannel or a cloth to avoid harm to yourself, as if you experience numbness you will be less able to accurately gauge what is comfortable, too hot, or too cold.
The traditional recommendation from medical sources is to take anti-inflammatory painkillers to relieve the discomfort from sciatica and enable sufferers to go about their lives as normally as possible. However, painkillers come with their own set of issues and side-effects, and many people report finding no relief from sciatica even with strong, prescription-only medication. We recommend trying more natural anti-inflammatories such as turmeric, which you can buy in capsules from Holland & Barratt or any other good health store. Many coffee shops also now offer turmeric lattes, which are delicious (Coffee #1 does a great one). Turmeric is often recommended for people with osteoarthritis for the very same reason – it’s a natural alternative to alleviate swelling which causes discomfort.
In addition, we recommend significantly reducing the amount of salt and sugar in your diet, both of which have inflammatory properties. This will make you feel good in more ways than one!
5. Manual Therapies
There are a very limited number of medical interventions for sciatica, except in extreme circumstances, and these can be very invasive. Many people find relief from sciatica through manual therapies such as chiropractic, which work directly with the site of the problem in the spine to restore movement and function, and reduce pressure on the nerve.
Dr. Ryan Stephenson, a chiropractor from Willow Chiropractic’s clinic in Bedminster, Bristol, advised us that ‘misalignment is the central cause of the symptoms associated with sciatica’. Chiropractic adjustments will restore function to the area that is affected, allowing the body to communicate effectively and heal from within.’ Additionally, massage can help muscle spasms that often occur along with sciatica.
Some people may find Cognitive Behavioural Therapy (CBT) helpful for dealing with the mental health effects of a bout of sciatica – your GP can refer you to these services. Sciatica can be a very disruptive ailment and cause a lot of pain and discomfort, but it is very treatable and manageable with the right care and attention.
If you are suffering with sciatica we can help. Book a consultation with one of our Bristol chiropractors today.