What is sciatica?

Sciatica is a painful condition that can be excruciating. The pain shoots straight through the center of your body and is difficult to ignore. Although sciatica causes pain, it is a symptom of a deeper problem in the spine. Sciatica is a term used to describe nerve pain in the legs caused by irritation and/or compression of the sciatic nerve root. It originates in the lower back, penetrates deep into the buttocks, and travels down the leg. The pain may be accompanied by numbness and/or weakness.

Non-surgical treatments for sciatica

1. Physical therapy

Physical therapy includes strength and aerobic conditioning and stretching exercises. Physical therapists tailor an exercise and conditioning program to each patient's fitness level and medical condition. Your daily exercise routine should avoid aggravating sciatica while working specific muscles to help you overcome the pain.

For sciatica, physical therapy programs typically focus on:

Strengthening the spine and abdominal, buttocks, hip, and lower back muscles.

Increasing core strength.

Stretching tight, inflexible muscles, such as the hamstrings or piriformis muscles in the buttocks.

Promote blood circulation and the exchange of fluids and nutrients through light aerobic exercise

Physical therapy includes walking, swimming, pool therapy, resistance training, and range of motion exercises.

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2. Hot and cold therapy

Alternating hot and cold therapy can promote healing and relieve pain. When you alternate between heat and ice, ice reduces inflammation, while heat promotes blood circulation. Reduced inflammation relieves pain, while increased blood circulation promotes healing.

Cold therapy

You can use ice packs for cold therapy for 15 to 20 minutes at a time. Avoid using ice again because you may suffer nerve damage from frostbite.

Heat therapy

Heat therapy has the opposite effect on sciatica. The benefits of heat therapy are more about healing than pain relief. Therefore, you should use heat therapy after cold therapy relieves pain. Heat therapy promotes healing by:

Reducing muscle tension and spasm

Increasing joint mobility

Improving nerve tissue function

Increasing tissue metabolism

You can use hot water bottles, heat packs, hot towels, or electric heating pads to apply heat therapy. You should also avoid using a heat pad on your skin for too long to prevent skin damage.

3. Physical Activity and Exercise

Staying physically active can help relieve inflammation and promote healthy blood circulation. The amount of physical activity and exercise you can do depends on your condition and pain level.

Physical therapists recommend the following exercises for people with sciatica:

Core strength

Proper posture

Hamstring and lumbar flexibility

Proper lifting technique

While some resistance and mild discomfort are normal, stop exercising or stretching if sciatica becomes worse.

4. Medication

Some common medications doctors prescribe for sciatica include:

Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications include ibuprofen (Advil), acetylsalicylic acid (aspirin), and naproxen (Aleve).

Opioid pain relievers, such as oxycodone or tramadol

Oral steroids, including prednisone or methylprednisolone

5. Epidural steroid injections

Epidural steroid injections (ESIs)

ESIs help relieve sciatica by:

Reducing inflammation

Corticosteroids interrupt the subsequent production of inflammatory enzymes, known as the inflammatory cascade. In short, they limit inflammation in the irritated sciatic nerve.

Pain Relief

Using ESIs for pain relief minimizes your need for NSAIDs or opioid pain medications. Opioids can be addictive if you become overly dependent on them.

Continue Exercise

Because ESIs provide long-lasting pain relief, they allow you to continue physical therapy without relying too much on pain medications. Exercise and physical therapy can strengthen the muscles around the sciatic nerve and increase blood flow to the area to help it heal.

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