How to Relieve Sciatic Nerve Pain?

Sciatica is defined as pain caused by irritation or compression of the sciatic nerve. The sciatic nerve is the largest nerve in the human body. It starts at the back of your pelvis and runs down your buttocks, legs and feet.

There are many causes of sciatica. The main ones are either referred pain or compression. Symptoms include pain, numbness, burning and tingling in the upper back radiating down to the back of the legs. It can cause pain in these specific areas. In this article, we will focus on the treatment and prevention of sciatica.

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Treatment

However, most cases of mild sciatica often get better after six to eight weeks without treatment or surgery. Initial treatment is often a combination of painkillers and exercises to help relieve the pain. In severe cases, surgery may be needed. The first step in treating sciatica is to diagnose the cause of the pain. Tests such as computed tomography (CT) scan of the spine and/or magnetic resonance imaging (MRI) scan of the spine may be done.

Medical treatment

This includes several groups of medications that should be prescribed according to individual factors and patient preferences. The overall goal of medical treatment is to relieve pain and improve activities of daily living. In addition, when starting a new medication, you should be aware of all possible risk factors and side effects.

• NSAIDS (Non-steroidal anti-inflammatory drugs)

This group includes both analgesic and anti-inflammatory properties. Many clinical trials have shown their short-term benefits in relieving pain, but long-term use is not recommended due to many adverse effects. They should only be used under medical supervision.

• Muscle relaxants

Muscle relaxants such as diazepam and phenobarbital have been shown to help with sciatica. However, they have side effects such as dizziness and sedation compared with NSAIDS.

• Anti-depressants

Antidepressants such as TCA (tri-cyclic acid) are used to eliminate and suppress chronic pain. TCA is also said to have local anaesthetic effects and the ability to reduce the intensity of pain. However, the antidepressant family has many side effects so should be administered carefully.

• Opioids

Opioids such as morphine are used to treat acute pain under strict medical supervision. They should not be used for chronic pain (NICE guidelines).

• Topical applications

One such commonly used topical therapy is the 5% lidocaine patch. This is a local application that delivers the drug directly to the site of pain through the skin. It has no side effects and has been shown to be effective.

• Steroid injections

A corticosteroid injection can relieve pain when injected into the nerve roots. It can reduce inflammation in the area and limit irritation of the nerve. However, they cannot be used frequently because of the serious side effects of steroids.

Surgical treatment

There are many surgical treatment options, depending on the cause and severity of the sciatica. Surgical treatment of sciatica has been shown to be successful when it is secondary to a herniated disc. Several clinical trials have shown that surgical treatment improves sciatic nerve pain more quickly than medical treatment. Choosing surgery over medical treatment may also depend on the patient's ability to afford surgery and psychological status. Delayed recovery may also affect the patient's socio-economic status, family life and emotional status.

Physical therapy

Physiotherapy can be divided into passive and active therapies. Passive therapies include ultrasound, heat and ice, manual therapy such as massage, and electrical muscle stimulation. Corsets and braces are now used for patients with chronic lower back pain.

Active therapeutic measures may include a range of exercises under the supervision of a physiotherapist. These may include modalities such as strengthening the muscles of the lower back (lumbar region), postural correction, stabilisation exercises, and flexibility exercises such as yoga. These exercises should be selected according to the patient's specific needs, abilities and preferences. Exercise may be combined with cognitive behavioural therapy.

When to see your doctor

If you have neuropathy, talk to your doctor or a neuropathy specialist if the pain and other symptoms get worse over time and increase in severity.

Prevention of sciatic nerve pain

Lower back pain can gradually develop into sciatica. It is therefore important to know how to prevent it. Correct posture when sitting, lifting weights and walking is essential. It is also important to warm up before and cool down after exercise. Regular exercise also helps prevent back pain and sciatica. Try to keep your spine straight when you sleep by using a firm mattress. Your neck should not be at a steep angle when you sleep.

Summary

Sciatica is caused by irritation or compression of the sciatic nerve. It is usually associated with back pain. There are many treatment options available, ranging from simple pain-relieving medication to complex surgery. A combination of exercises along with various medical treatments is aimed at increasing activities of daily living and improving the physical, mental and socio-economic wellbeing of the patient.