By Professional Physical Therapy with Robert Shapiro, PT, DPT, COMT | VP of Clinical Excellence
The term sciatica is used to describe pain that originates in the lower back or buttocks and travels down the leg because of a compression or irritation of the sciatic nerve. The pain can range from a mild ache to a sharp burning sensation, or even feel like an electric shock down the leg. It is most common for sciatica to affect only one side of the body at a time.
Professional’s Allison McNamara, PT, DPT says many patients are often confused when they come in with lower leg pain and get treated for their lower back. They don’t realize this can be sciatica. She tells her patients, “The sciatic nerve runs down your legs from the lower back and you can think of this nerve like a garden hose. If you squeeze the garden hose, less water comes out. So, when the nerve is compressed higher in the lower back or hip you will feel pain in the lower leg, similar to the garden hose.”
While sciatic pain can be debilitating, the good news is in most cases it clears up with treatment in a few weeks. Before we talk about solutions for pain, it is important to understand the causes and risk factors.
Common Causes of Sciatica
Sciatica affects people of all ages, but it is more prevalent in men between the ages of 30 and 50. Below are a few underlying medical conditions that can lead to sciatica. For example, a herniated disk may compress the sciatic nerve, leading to pain and other symptoms. Spinal stenosis, which is a narrowing of the spinal canal, can also put pressure on the sciatic nerve and cause sciatica.
- Herniated disks (“slipped disk”)
- Spinal stenosis, piriformis syndrome (pain in the buttocks)
- Pelvic fractures
Medical experts also say the following risk factors can cause sciatica:
- Obesity, being overweight increases stress on the spine.
- Occupation, job that requires twisting the back, carrying heavy loads, or driving a motor vehicle for a long period of time might play a role in sciatica.
- Prolonged sitting, people who sit a lot or don’t move much are more likely to develop sciatica than active people.
- Diabetes, this condition which affects the way the body uses blood sugar, increases the risk of nerve damage.
Physical Therapy for Sciatica Pain Relief
Physical therapy is commonly used as the first line of treatment for managing, relieving, and treating sciatica pain. Licensed physical therapists can create a customized treatment plan for sciatic nerve pain that consists of targeted exercises and stretching.
Physical therapy focuses on quick pain relief, but it can also identify underlying problems that cause sciatica pain, such as poor joint movement, core weakness, or poor muscle coordination. In order to prevent future problems, the physical therapist can work on strengthening core muscle groups as the pain subsides. Furthermore, the physical therapist can teach ergonomics and methods of maintaining a healthy back and spine to minimize symptoms and prevent flare-ups.
Professional PT’s Robert Shapiro, PT, DPT, COMT weighs in on a key way to prevent sciatica and says, “Back care is a key component in managing and preventing sciatica pain. This includes proper lifting techniques, regular exercise, and maintaining a healthy weight.”
Various types of physical therapy may be included in an individualized physical therapy plan, including:
- Manual therapy
- Deep tissue massage
- Hot and cold therapy,
- Direction specific exercises (McKenzie method)
- Therapeutic stretches and exercises,
- Dry needling
- Gait training
- Core strength aquatic therapy
Lifestyle and Home Remedies for Sciatica
For some people, sciatica responds to home self-care methods. Although resting for a day or two may provide some relief, staying inactive will make symptoms worse. A few things you can try at home are:
- Cold and heat. Both ice packs and heat can ease the pain of sciatica. It is recommended that you try using ice for the first few days. Heat can be used after the first week, when some healing has taken place and the pain is subsiding.
- Movement. Moving is the most important thing you can do to help your pain. It’s okay to rest for the first couple of days after sciatica pain starts, but after that, staying in bed usually makes things worse.
- Gentle stretching. Stretching exercises for the lower back might provide some relief. Here are a few stretches you can try at home. Try to hold each stretch for at least 30 seconds. It is important to note that if any of the stretches cause pain that travels down your leg, you should immediately stop the exercises and consult a physical therapist for guidance. While stretching can be beneficial for managing sciatica, it is crucial to listen to your body and seek professional help if necessary.
- Seated Forward Bend, begin this stretch by sitting in a chair and crossing your painful leg over the knee of your other leg. Bend forward with your chest and try to hold your spine straight.
- Cat-Cow Stretch, begin this stretch on all fours with your spine neutral, then inhale and arch your back moving your stomach toward the floor. Then exhale and stretch your upper back toward the ceiling. Come to a neutral position and repeat.
- Child’s Pose Stretch, start on all fours, then bring your knees together as you sink backwards, brining your hips toward your heels. Allow your arms to extend so they are outstretched or place them alongside your body in a comfortable position. Allow your forehead to rest on the ground. Don’t worry if our butt does not touch your heels.
- Over the Counter (OTC) Medications. Pain relievers such as ibuprofen are sometimes helpful for sciatica. Use only as directed.
In addition to these home remedies, there are also some lifestyle changes that you can make to reduce your risk of developing sciatica or to prevent a recurrence of your symptoms. These include:
- Maintaining good posture when sitting or standing.
- Avoiding sitting for long periods of time.
- Using a lumbar support pillow when sitting.
- Engaging in regular exercise to improve your overall health and fitness.
If you are experiencing symptoms of sciatica and are tired of struggling with sciatica nerve pain, visit one of our Professional Physical Therapy clinics near you. Get started and request an appointment for a consultation so you can feel better and get back to doing the things you love.
Mayo Clinic: Sciatica, Symptoms & Causes, Diagnosis & Treatment
Penn Medicine: Sciatica, Causes & Symptoms
Harvard Health Publishing: Sciatica Home Remedies and Self-care