Sciatica Pain Relief – Natural Cures, Remedies, Treatments

The sciatic nerve is the largest and longest nerve in the body. It supplies sensation from the lower back to the foot. The nerve originates in the lumbar region of the spinal cord. As it branches off from the spinal cord, it passes between the bony vertebrae (the component bones of the spine) and runs through the pelvic girdle (hipbones). The nerve passes near the hip joint and continues down the back of the leg to the foot.

Sciatica is a fairly common disorder. Approximately 40% of the population suffers from it at some point in their lives; however, only about 1% experience any sensory or motor deficits. Sciatic pain has several root causes, and its treatment is directed to the underlying problem. Of the identifiable causes of sciatic pain, lumbosacral (LS) radiculopathy and back strain are the most frequently suspected. The LS area is the lower part of the spine, and radiculopathy describes pain radiating from pressure on a spinal nerve roots. This area between the vertebrae (hard bones) is cushioned with a disk of shock absorbing tissue. The spinal canal, comprising the spinal cord and other nerve roots, is hollow and lies in the middle of the spinal column. It is the disks between the vertebrae that enable the back to bend or flex.

A “ring” of cartilage is found the outer edge of the disk (the annulus). The disk’s center (nucleus) is a substance like gel. When a disk ruptures, or herniates, it does so because of wear-and-tear, excessive weight, poor posture, injury (perhaps due to improper lifting), or disease. The center nucleus pushes the outer edge of the disk into the spinal canal, putting pressure on the nerves. The spinal nerve root may become compressed by the shifted tissue or the vertebrae.

This compression of the nerve root sends a pain signal to the brain. Although the injury is actually suffered by the nerve roots, the pain may be perceived as originating anywhere along the sciatic nerve. Further, if fragments of the disk lodge in the spinal canal, the nerves that control bowel and urinary functions may be damaged. Incontinence may result.

Sciatica is largely a symptom of a herniated disk. However, compression of the sciatic nerve can also present as muscle spasms in the lower back (back strain). In this case, pressure is placed on the sciatic nerve. In rare cases, infection, cancer, bone inflammation, or other diseases may cause pressure. Another possible cause of sciatica is piriformis syndrome.

As the sciatic nerve passes behind the hip joint, it shares the space with several muscles. One of these muscles, the piriformis muscle, is closely associated with the sciatic nerve. In some people, the nerve actually runs through the muscle. If this muscle is injured or has a spasm, it places pressure on the sciatic nerve, in effect, compressing it.

In many sciatica cases, the specific cause is never identified. About half of affected individuals recover from an episode within a month. Some cases persist and may require aggressive treatment. In other cases, the pain returns or becomes chronic.

Causes and symptoms

Patients with sciatica may experience low back pain, but the most common symptom is pain that radiates through one buttock and down the back of the leg. The most frequently identified cause of pain is compression or pressure on the sciatic nerve. The extent of the pain varies. Some patients describe pain that centers in the area of the hip; others feel discomfort all the way to the foot. The quality of the pain also varies; it may be described as tingling, burning, prickly, aching, or stabbing.

Diagnosis

Establishing the diagnosis requires taking a thorough medical history and performing a focused physical examination. The patient is asked about the location, nature, and duration of the pain, and the details of any accidents, injuries or unusual activities that may have occurred prior to the onset of sciatica. This information provides clues that may point to back strain or injury to a specific location.

Treatment

Pharmacological therapy—initial treatment for sciatica—focuses on pain relief. Regardless of the cause of the pain, analgesics (such as acetaminophen) may help relieve pain. Muscle relaxants are also used, but it hasn’t been proved whether they really work. Furthermore, the side effects of muscle relaxants may be greater than their benefits, particularly in the elderly. Generally, pain relief is accomplished with non-steroidal anti-inflammatory drugs (NSAIDs). It should be noted, however, that anti-inflammatory medications should be administered generally for only two to four weeks, and only if no medical contraindications are present.

If the pain is unremitting, opioids may be prescribed for short-term use or a local anesthetic may be injected directly into the lower back. Massage and heat application may be suggested as adjunct therapies.

If the pain is chronic, different pain relief medications are used to avoid long-term dosing of NSAIDs, muscle relaxants, and opioids. Antidepressant drugs, which have been shown to be effective in treating pain, may be prescribed in conjunction with a short-term course of a muscle relaxants or a NSAID. Local anesthetic injections, or epidural steroids, are used in selected cases.

As pain permits, physical therapy is introduced into the treatment regime. Stretching exercises that focus on the lower back, buttocks, and hamstring muscles are suggested. The exercises may also include identifying and practicing comfortable, pain-reducing positions.

If the pain is chronic and conservative treatment fails—suggesting that a disk fragment has lodged in the spinal canal and is pressing on the nerve (and perhaps causing a loss of function—surgery may be required. A procedure to repair a herniated disk or excise part, or all of the piriformis muscle, may be suggested, particularly if there is neurologic evidence of nerve or nerve-root damage (radiculopathy).

Massage is a recommended form of therapy, especially when the sciatic pain arises from muscle spasm. Patients may be able to relieve symptoms by icing the painful area as soon as pain occurs. The physical therapist or nurse may instruct the patient to place ice on the affected area for 20 minutes, several times a day. After two to three days, a hot water bottle or heating pad can replace the ice. Chiropractic or osteopathic therapy may offer solutions for relieving pressure on the sciatic nerve and the accompanying pain. Acupuncture and biofeedback may also be useful as pain control methods. There are additional natural cures and Home Remedies for Back Pain that can assist you in sciatica recovery process.

Prognosis

Most sciatica is a long-term, chronic condition that comes and goes. Specific movements or activities may trigger pain in some people, and in other people the pain appears without apparent provocation. Most cases of sciatica are treatable with pain medication and physical therapy. After four to ten weeks of treatment, the patient should be able to resume normal activities.