3 Keys for Sciatica Relief
Dr Barry Marks, chiropractor explains 3 Keys for Sciatica Relief. Sciatica pronounced “sahy-at-ik-uh” is a painful medical condition of the sciatic nerve.
Sciatica and the Sciatic Nerve
Sharp, shooting, electrical or burning pain from the butt down the leg is called sciatica. In fact, sciatica is inflammation or irritation of the largest nerve in the body, the sciatic nerve. The sciatic nerve is comprised of a few smaller spinal nerves coming together to form a large trunk-like nerve that carries nerve messages from the lower back all the way down to the toes. Because the nerve travels that far, someone suffering from sciatica can have sciatic nerve pain anywhere from the buttocks to the toes.
3 Keys for Sciatica Relief
Unquestionably, Sciatica can be very painful and debilitating. Making matters worse is that you may suffer pain over a very large area; from butt to your toes! So these 3 Keys for Sciatica Relief might come in handy.
One: Learn the Cause of Sciatica
Sciatica symptoms can come from a misalignment in your spinal bones called a subluxation. Another cause is a tight muscle in your buttocks causing Piriformis Syndrome. Your sciatic pain may also come from a bulging or herniated disc pressing on the nerves.
Initially, a physical examination and x-rays are the first step in diagnosing sciatica. Then, if indicated on exam and x-rays, your doctor may also refer you for an MRI. Once you know the cause of your sciatica it will dictate which treatments will provide relief. Certainly your doctor of chiropractic is well trained to do the initial evaluation and provide initial treatment.
Two: Office Care for Sciatica Relief
Subluxation treatment
Chiropractors are the only doctors trained to diagnose and correct subluxations making them the natural first choice. Manual adjustments of the spine and pelvis are the primary treatment.
Piriformis Syndrome treatment
A chiropractor or physical therapist can provide treatment of this cause of sciatica. The goal is to release the tension in the piriformis muscle to relieve sciatic nerve pressure. Exercises, muscle manipulation, massage and stretching are common treatments as well as therapy modalities of heat, electrical stimulation and cold laser. The advantage of chiropractic treatment of piriformis syndrome is the chiropractor may also do spinal and pelvic adjustments to release tension in the area.
Bulging, Herniated Disc treatment
For discs that are not candidates for immediate spinal surgery, spinal manipulation, therapy modalities, stretching and exercises are often helpful for sciatica. Anti-inflammatory medications including NSAIDs or corticosteroids are commonly also prescribed. Total bed rest has been found to be bad advice for low back pain and sciatica; maintaining weight bearing and ambulation appears to speed up recovery. One study found 60% of lumbar disc herniation patients who failed conservative medical care improved with spinal manipulation to the same degree as if they had undergone spinal surgery.
Three: Home Care for Sciatica
Home care is just as important as In-Office care for sciatica. Activities and home therapies can relieve pain between visits to your doctor or therapist.
Heat > Ice for Sciatica Relief
Unless you specifically strained or exerted yourself physically causing sciatica, heat is better than ice. Heat can soothe tight muscles, bring blood to the area to help heal and heat also relieves nerve pain. The best type of heat is “moist heat.” So a moist heating pad, hot wet towels, bath, Jacuzzi or shower are the best methods of moist heat. Limit the heat to 15-20 min. Too much will lead to overheating and increased inflammation. Apply the heat to the areas where the sciatic nerve is most exposed: low back, buttock and behind the knee.
90-90 Position for Sciatica Relief
Use this position to relieve pressure from the sciatic nerve and low back. Lie on your back with a box, an ottoman or a chair turned sideways to put your hips and knees at 90 degree angles. Your toes should point straight up towards the ceiling; do not let them turn out or in. Lie in this position for 30-60 min.
If your sciatic leg is too painful to assume a full 90-90 position, place your good leg up into a 90-90 and use a pillow or rolled towel to elevate the painful leg part way. Hold this position for 10 min then see if you can make your painful leg go higher. Keep making small adjustments in height until you can get your painful leg to assume a full 90-90 position. Remember always keep your toes pointed straight up.
Massage/Deep Pressure for Relief of Sciatica
Have someone put deep pressure into the muscles on your buttocks, back of thigh above knee and on the calf. Pressing in deep and sustaining firm deep pressure over each area for approximately 30 seconds can reduce spasm and cause the sciatic nerve to calm down. You do not need to make massage motions like stroking, just deep sustained pressure. How hard? It should be enough pressure to cause some discomfort, but it should not be enough to make you cry or want to “tap out.”
Don’t have anyone to help you? Use a tennis ball to do self massage. Place ball on the floor and lie down with your buttocks over the ball and lower yourself onto it. Move around a bit until it is in the correct place and allow your body weight and gravity to cause pressure in the muscle. Repeat for each area. For the back of thigh and calf you may need to press downward with your leg to achieve enough pressure.
If lying on top of the ball is too much pressure, stand up, place the ball on your buttocks and press against a wall.
Sciatica Relief Keys:
- Proper Diagnosis of cause of sciatica
- In-Office Treatment of sciatica pain
- Home sciatica treatments
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References:
Bergmann TF, Jongeward BV. Manipulative Therapy in Lower Back Pain With Leg Pain and Neurological Deficit. J Manipulative Physiol Ther 1998 (May); 21 (4): 288—294
Gordon McMorland, DC, Esther Suter, PhD, Steve Casha, MD, PhD, FRCSC, Stephan J. du Plessis, MD, R. John Hurlbert, MD, PhD, FRCSC, FACS. Manipulation or Microdiskectomy for Sciatica?
A Prospective Randomized Clinical Study. J Manipulative Physiol Ther. 2010 (Oct); 33 (8): 576–584