As many as 4 out of every 10 people will get sciatica, or irritation of the sciatic nerve, at some point in their life. This nerve comes from either side of the lower spine and travels through the pelvis and buttocks. Then the nerve passes along the back of each upper leg before it divides at the knee into branches that go to the feet.
Anything that puts pressure on or irritates this nerve can cause pain that shoots down the back of one buttock or thigh. The sensation of pain can vary widely. Sciatica may feel like a mild ache; a sharp, burning sensation; or extreme discomfort. Sciatica can also cause feelings of numbness, weakness, and tingling.
Pain may be made worse by prolonged sitting, standing up, coughing, sneezing, twisting, lifting, or straining. Treatment for sciatic pain ranges from hot and cold packs and medications to exercises and complementary and alternative remedies.
Medications for Relief of Pain From Sciatica
Several types of medications may be used for sciatic pain. Oral medications include:
- Over-the-counter pain relievers such as acetaminophen, aspirin, or NSAIDs (such as ibuprofen [Advil, Motrin], ketoprofen, or naproxen [Aleve])
- Prescription muscle relaxants to ease muscle spasms
- Antidepressants for chronic low back pain
- Prescription pain medications for more severe pain
Do not give aspirin to a child aged 18 years of age or younger because of the increased risk of Reye’s syndrome.
In some cases, a steroid medication is injected into the space around the spinal nerve. Research suggests these injections have a modest effect when irritation is caused by pressure from a herniated, or ruptured, disc.
Physical Therapy for Sciatica
Sciatica pain may make it difficult to be active. But bed rest is not recommended as a mainstay treatment. To manage new sciatica pain, you may find that certain positions and activities are more comfortable than others.
If symptoms are not severe but persist beyond a couple of weeks, your doctor may recommend physical therapy. The proper exercises may actually help reduce sciatic pain. They can also provide conditioning to help prevent the pain from coming back.
The exercises recommended will depend on what’s causing the sciatica. It’s important to work with a specialist who has experience working with people with sciatica. It’s also important to do the exercises exactly as directed.
To get the proper direction, you will most likely work with one of the following specialists:
- Physical therapist
- Physiatrist — a doctor who specializes in physical medicine
Complementary and Alternative Remedies for Sciatica Pain Relief
Some people find pain relief from complementary and alternative therapies such as biofeedback and acupuncture. Keep in mind, though, that these therapies have not been shown by scientific studies to help sciatica.
Biofeedback is a technique that helps make it possible to control bodily processes such as heart rate, blood pressure, and muscle tension. It works by using a machine that provides information about the process being addressed. Having that information displayed, the person is often able to find ways to achieve conscious control of these processes. Probably the most common use of biofeedback is to treat stress and stress-related conditions.
Acupuncture is a treatment that uses fine needles inserted at specific locations on the skin called acupuncture points. The points are located along meridians, or channels. The channels are thought to conduct qi, which is said to be the energy or vital force of the body. The theory behind using acupuncture is that pain is thought to result from imbalances or blockages of the flow of qi. Acupuncture is supposed to remove those blockages to restore the balance.
One theory is that stimulating these points produces an effect by stimulating the central nervous system. This, in turn, would trigger the release of chemicals that either alter the experience of pain or produce other changes that promote a sense of well-being.
Surgery for Sciatica
Only a very small percentage of people with sciatica will require surgery. If pain from sciatica persists for at least 6 weeks despite treatment, you may be referred to a specialist. At that point, surgery may be an option. The goal for surgery is to remedy the cause of the sciatica. For example, if a herniated disc is putting pressure on the nerve, then surgery to correct the problem may relieve sciatica pain.
If sciatica symptoms are severe or become progressively worse, then immediate referral to a specialist is necessary.
- American Academy of Orthopaedic Surgeons: “Sciatica."
- JAMA Patient Page, July 8, 2009.
- National Center for Complementary and Alternative Medicine: “Acupuncture for Pain."
- Koes, B. BMJ, June 23, 2007.
- NYU Langone Medical Center: “Sciatica," “Biofeedback," “Acupuncture."
- Beth Israel Deaconess Medical Center: “Sciatica: More than Just Back Pain."
- Hospital for Special Surgery: “Symptoms and Causes of Sciatica."
- Healthfinder.gov: “Sciatica Relief May Depend on How Steroid Shots Are Delivered."
- Spine-Health: “Sciatica Exercises for Sciatica Pain Relief."
- The University of Chicago Medical Center: “Acupuncture."