Sciatic Nerve Pain Treatment

Sciatic Nerve Pain Treatment – Part 3

Sciatic Nerve Pain Stretches and Treatment – Part 3

Sciatic Nerve Pain Treatment – Part 2 introduced a couple of basic stretches to help ease your sciatic nerve pain and take the pressure off the sciatic nerve.  However, there are other sciatic nerve stretches that you should do to release your sciatic nerve pain.  These will be described in this section.  As usual, only do what you can and it is better to consult with your physiotherapist to be sure that you are doing the right sciatic nerve stretches for you.

You may notice decreased mobility or stiffness in your lower back with onset of sciatic nerve pain.  I often prescribe this lower back stretch for my patients in order to improve or maintain lumbar mobility.  To perform this stretch, lie on your back (supine position) and place your hands behind your knees.  Slowly pull your knees in towards your chest.  You may want to do one leg at a time first.  You should feel a very mild and gentle stretch across your low back.  Many of my patients do this one first thing in the morning to loosen up, whether they suffer from sciatica or just low back pain.

Sciatic Nerve Pain - Low Back Stretch

Another important stretch that I usually prescribe is a lumbar extension stretch.  This one is especially important if the cause of your sciatic nerve pain is due to a lumbar disc protrusion or pinched nerve in the spine at the level of your low back.  If this is the case, your sciatic nerve pain symptoms usually increase with flexion or any bending forward movements.  For this stretch, lie on your stomach and use your arms to lift your upper body up by pressing up on your hands.  Keep your hips on the floor and your buttocks relaxed.  This is like the cobra move in yoga where your arch your back.  This stretch is helpful because it helps to “pump” the disc back in place (relatively speaking) and opens up the spaces where the nerves exit your lumbar spine.  In this case our target is the sciatic nerve, which originates from lumbar nerve roots.

Sciatic Nerve Pain - Lumbar Extension Stretch

If you can’t extend all the way due to sciatic nerve pain, low back pain, or stiffness, that’s okay.  Just go as far as you can even if you can only manage to push yourself up onto your elbows.  In severe cases or cases that clearly involve a disc bulge, I recommend that you do this stretch 5-10 times every hour or so.  Otherwise, just follow the same stretching guidelines as for the rest of your sciatic nerve stretches: Hold for at least 15-20 seconds, at least 2 reps, a minimum of 2 times per day.  This should get easier the more your do it and as your sciatic nerve pain settles down.  If you cannot lie down for whatever reason, for example at work, you can do a modified version of this sciatic nerve stretch by just standing up, putting your hands on your hips, and leaning backwards (arching your back).  This is especially useful at the office after sitting at a desk for prolonged periods, which would typically flare up your sciatic nerve pain.

Sciatic Nerve Pain Treatment

Sciatic Nerve Treatment – Part 2

Sciatic Nerve Pain Treatment – Part 2

Your physiotherapist will teach you proper positioning techniques to help take the stress off your low back and ease your sciatic nerve pain symptoms.  When your pain starts to settle down, stretches will help to loosen up your muscles and release the tension that has built up.  Some stretches will also help to  increase the mobility of your sciatic nerve, and help restore flexibility. Hopefully at this point you are moving past the acute phase of sciatic nerve pain, or sciatica.  This section will describe appropriate stretching that is commonly prescribed in the treatment of sciatic nerve pain.

It is important to stretch your hamstring muscles.  Your hamstrings are the large muscle group in the back of your thigh, running from your buttocks to behind the knee.  A safe and easy way to stretch this muscle to avoid further injuring your back is to do so from a lying down position.  You will need a long towel or belt.  Wrap the towel or belt around the bottom of your foot or heel, and raise your leg up towards the ceiling, with your knee straight until you feel a pull or stretch behind the knee or back of the thigh.  Hold this for 15-20 seconds and repeat 2x on each leg.

Sciatic Nerve Pain Hamstring Stretch

The sciatic nerve follows the path of the hamstring along the back of the thigh, and for this reason you may not be able to fully raise your leg.  Depending on the severity or cause of your sciatic never pain, you may feel a pull that goes into your low back, numbness down the leg, or a burning sensation in the leg.  If this occurs just go as far as you feel comfortable.  It is important to do this stretch to maintain mobility and flexibility both in your muscles and your nerve for sciatic nerve treatment.  The hamstrings pull on the pelvis which consequently causes a pull on the low back, so if this muscle is tight it could further aggravate your low back pain and/or sciatica.

With sciatic nerve pain and sciatic nerve treatment, another important muscle to stretch is your glute muscle, or your buttocks.  Again, this muscle follows along the sciatic nerve, and when tight, pulls on the pelvis which consequently pulls on the lower back.  This stretch may be a bit more difficult, and is most easily done lying down.  Lie down on your back, and bend both of your knees.  Cross one foot on the opposite knee.  Grab the thigh of the leg that is still touching the floor, and pull that knee toward your chest.  You should feel a pull in the side of the buttocks of the crossed leg.

Sciatic Nerve Pain Glute Stretch

You may notice an asymmetry between sides, as the affected side with sciatic nerve pain will likely feel tighter.  However, it is still a good idea to stretch both sides.  Again, for sciatic nerve treatment stretches, (or any other stretches) hold for 15 seconds, do 2 repetitions on each side, at least two times per day.

Treatment of Sciatic Nerve Pain

Sciatic Nerve Treatment – Part 1

Treatment of Sciatic Nerve Pain – Part 1

Sciatic nerve pain is treatable both at home and by trained health care professionals.   If you are unsure about what to do, please consult with your local physiotherapist.

It is never to early to seek medical help for sciatic nerve pain.  Most importantly, do not let your condition turn chronic.  If your pain is not improving on its own, or if  your sciatic nerve pain is severe, it is advisable that you go see your doctor and/or physiotherapist.

Your doctor may prescribe nonsteroidal anti-inflammatory pain medications (NSAIDs).  These anti-inflammatories will work to decrease the inflammation and swelling of the sciatic nerve itself, and decrease the overall inflammatory response.  They are commonly prescribed for orthopedic conditions.  NSAIDs are available over the counter as well.  Common ones include Ibuprofen, Motrin, Advil, and Aleve.  NSAIDs are effective at relieving pain and reducing swelling.  Ideally, you want something that will address both the pain and inflammation.  Medications such as Tylenol are also good for pain relief, but lack the anti-inflammatory action.  Taking NSAIDs will help make your sciatic nerve pain more manageable and may help you get through the exercises your physiotherapist will recommend.

Physiotherapy treatment of sciatic nerve pain will vary based on the cause and presentation of your symptoms, and will be individualized to your own case.  However, there are a few general principles that we follow in terms of treatment.  The first step is to address the pain,inflammation, and acute phase of sciatica.  Modalities such as TENS, IFC, ultrasound, and laser may be used.  You may also be advised to apply ice to the affected area (usually the low back or buttocks) every few hours for 15-20 minutes at a time.  This will help with pain and swelling.  Your physiotherapist may also show you various positioning techniques that will help to take the stress off of your low back, or help to take the pressure and strain off of your sciatic nerve.  For example, lying on your back with your hips and knees bent at 90 degrees and your legs resting on a chair or stool will help to take the pressure off and should be a relatively pain free position.

Sciatic Nerve Pain and Low Back Relief Position

You may also be advised to put a large pillow under your knees if sleeping on your back, and to put the pillow between your knees if lying on your side.  This helps to take the strain off your low back and pelvis, areas where the sciatic nerve often gets compressed.  It is important to find a comfortable position, or one that is most comfortable, so that you can allow the affected area to rest and settle down.

Your physiotherapist will assess and evaluate the cause of your sciatic nerve pain and prescribe exercises and stretches accordingly.  As a general rule though, we want to maintain/increase range of motion (ROM), decrease muscle tension, reduce pain, and finally restore strength, stabilization, and function.