Specific treatment approaches for sciatica always depend on what’s causing the nerve damage, to begin with, so seeing a professional is worthwhile. Some doctors choose to use medications like anti-inflammatory drugs, muscle relaxers or steroids to treat severe sciatic nerve pain, but there’s strong evidence that physical therapy, chiropractor adjustments and stretching can all dramatically improve someone’s condition.
1. Chiropractor Spinal Adjustments
There are different types of ruptured or herniated discs — some that cause more nerve pain than others. Prolapse disc bulges are less severe because the outermost layer of the disc is still intact, but extrusion or sequestration disc bulges are more drastic and usually more painful.
These types cause damage to the outer layer of the spinal disc, which leads tissue to spill out from where it’s normally constrained. When this problem progresses, the spinal tissue can disconnect from the disc altogether, while disc tissue can enter the spinal canal.
For doctors, it’s important to know what type of spinal injury someone is experiencing in order to know the appropriate treatment approach. Sciatica can be diagnosed during a physical exam by a chiropractor, or your primary doctor might choose to perform X-rays and other tests like a magnetic resonance imaging (MRI) test to investigate the damage in the spine. After diagnosis, a chiropractor can work with you to realign the spinal discs and prevent protrusion into the canal, targeting the underlying source of pain.
2. Yoga and Stretching
Moving in certain ways can aggravate sciatic pain, but in some cases, it can actually help relieve the pain. Some people find that sitting, standing for a long time and moving around abruptly tends to trigger pain. The types of movements that tend to make pain worse involve scrunching or shortening the spine, such as raising the legs up, bringing the knees toward the chests or squatting.
On the other hand, lengthening the spine through stretching, yoga or lying down can help develop good posture while reducing stiffness, inflammation and pain in a big way.
Some of the most important movements for preventing sciatic pain target the back, building strength and relaxing stiff areas. Exercises to prevent lower back pain and strengthen the core are even used in rehabilitation settings for sciatic nerve patients following surgery.
3. Acupuncture and Massage Therapy
You’re probably somewhat familiar with acupuncture — at least the fact that it involves tiny needles.
But what is acupuncture exactly?
Acupuncture is a type of traditional Chinese medicine practice that is based on achieving or maintaining better health by opening the body’s natural flow of energy. It uses tiny, virtually pain-free needles to target specific pathways in the body. It’s been approved by the FDA as a treatment for back pain and is supported by various studies for relieving chronic pain of all kinds, including sciatica.
Similarly, Rolfing and massage therapy are two other nonsurgical, holistic approaches that open muscles, tissues and channels of energy within the body, improving blood flow and fighting pain. Massage therapy is associated with a reduction in back pain, muscle relaxation and even a healthy release of endorphins, natural “feel good” chemicals that act like pain relievers.
4. Avoid Sitting for Long Periods, Get Moving!
Sitting for many hours, such as working at a desk or watching TV during leisure time, can make matters worse when it comes to bulging discs and back pain. Many sciatic treatment plans call for more movement in general, along with targeted exercises to loosen up inflamed areas.
Including specific stretches or light isometric exercises in your day can help relieve pain in the spine or legs while improving strength. When your symptoms re-emerge or worsen, you can practice certain stretches and exercises at home without the need for a doctor visit.
Try beginning by alternating periods of sitting/lying down with short walks. Aim to take more steps every day, and consider getting a pedometer or fitness tracker, which can motivate you to be more active and increase your walking distance. Then when you’re at home, work on lengthening the spine by improving your posture.
5. Use Heating Pads
Many people find relief by using inexpensive heating pads set on a low or medium setting, placed on the lower back for about 15 to 20 minutes every day. You can practice this several times a day, about every two or three hours, while at work or when you’re home.
Another similar approach that works well is taking warm baths since heat loosens up tight muscles and helps increase circulation. The best way to apply heat to the painful area is to purchase a reusable heating pad that either requires hot water or to be plugged in, but you can also buy single-use heat wraps that last for several hours at a time.
While heat can be used to dull pain, just the opposite also works for some people. Some find that applying an ice pack to the back for 10 to 15 minutes every two to three hours does the trick. If pain still doesn’t seem to go away naturally, most doctors recommend taking an over-the-counter painkiller when symptoms get very bad (like Tylenol or ibuprofen/Advil).
6. Reduce Inflammation
It’s estimated that 5 percent to 10 percent of all patients with low back pain have sciatica, but there are a few personal and occupational risk factors that raise the odds for developing sciatic nerve pain. These include older age, being tall, high levels of mental stress, being overweight or obese, sitting for long periods, cigarette smoking, and high amounts of exposure to vibration from vehicles (for example, being a truck driver for a living).
Many of these risk factors cause inflammation that makes it harder to heal from injuries and increases pain. To combat inflammation and improve your odds of feeling better more quickly, make sure to eat a nutrient-dense healing diet, avoid smoking/using recreational drugs, and get exercise and good sleep.