The sciatic nerve is the largest and longest nerve in the body. The sciatic nerve begins in the lumbo-sacral region (L-4 through S-3) of the spine, as five nerve roots from L-4 through S-3 leave the spine and merge into one large nerve that travels across the buttocks (the gluteal muscles) and down the back of the thigh and then into the lower leg, branching off just above the knee, at the back of the lower thigh, into the peroneal and tibial nerves, and finally giving rise to nerves traveling down into the ankle, feet, and toes. Consequently, sciatic nerve pain or sciatica may be felt at any point along the nerve route, expressing as lower back pain, pain in and/or across the buttocks, leg pain, particularly pain at the back of the leg, pain behind the knee, and even pain, tingling, and/or numbness into the feet and toes. Interestingly, sciatica is not a specific condition but a symptom of a problem at some point along the nerve route, usually but not always at the nerve root itself.
The ultimate sciatica pain relief strategy is ice. Ice is by far the most effective method for immediate and lasting sciatic nerve pain relief. Unfortunately, many people, including many medical experts advise heat for sciatica, in fact for almost all back pain, and that is generally the worst thing you can do. Inflammation and swelling is exacerbated by heat and reduced with ice. Most nerve irritation is the result of inflammation and/or swelling at some point along the nerve route, ice is the recommended treatment. Ice, using an ice compression brace is best but a plain old ice pack will also do just fine. Keep the ice on for as long as you can stand it, providing you have a sheet or thin towel between the ice and your skin to avoid frostbite. This is, of course, anecdotal and based on my experience over 15 major surgeries, 14 on my back…ice works best!
I am not going to get into why people recommend heat, beyond mentioning that proponents argue that heat helps with blood flow to the affected area, specifically nutrition and oxygen, and healing is enhanced, as a result. As you know too well if you experience sciatic nerve pain, when you are in pain the most important thing is relieving the pain! The healing will come later, let’s deal with the sciatica first!
The second sciatic nerve pain relief strategy is stretching. The piriformis muscle, and in particular what is called piriformis syndrome, may be the culprit when it comes to sciatica, or it may be at least partially to blame. The anatomy, where the sciatic nerve is located, along with a muscle imbalance, as the sciatic nerve is located in close proximity to the piriformis, may create the piriformis syndrome. A muscle imbalance may create pressure on the sciatic nerve, creating sciatica. A simple and easy to do stretch can help alleviate discomfort almost immediately.
The sciatica stretch is easy to do while seated in any chair. While seated in a chair, cross your left leg over your right leg so that your left ankle is resting on your right knee, bend forward at the waist pulling the left leg to the chest while continuing to bend forward. You will feel stretching outside of the left leg, as well as in the buttocks, stretching and leaning forward as much as any pain will allow. This stretch may be done to both sides, both legs, but the emphasis should be on the side where you are experiencing the sciatica. If the sciatic nerve pain is due to a muscle imbalance or piriformis syndrome you will feel immediate pain relief, if the pain is the result of a bulging or herniated disc, you may need to rely on other treatment strategies.
The third method is to change your footwear. Often people suffering from back pain in general, and sciatic nerve pain specifically, are wearing the wrong shoes. The importance of proper shoes cannot be overstated! Fashion? Forget about fashion! The only thing that matters when it comes to footwear is pain relief when you are in pain; and, when experiencing sciatica in particular. I recommend New Balance walking shoes because they are rated very high when it comes to heel cushioning; and, because they allow for varying degrees of width and a greater array of sizing alternatives, thus improving fit which translates into a better walking experience. The better fit and cushioning means less impact on the spine and that means less back pain generally and less sciatica specifically.
New Balance shoes are also rated very high for dealing with pronation, another factor to consider when it comes to sciatica. For more information, Runner’s World Magazine has a great website that deals extensively with the proper shoes, as well as pronation and supination. Keep in mind their target audience is a bit different but they still have excellent explanations for both of these conditions and they make recommendations concerning walking shoes, as well as what shoes are ranked highly and for what. The only other shoe worth considering is the Asics Gel-Nimbus 11. This is a runner’s shoe but took the editor’s award for Runner’s World, a huge accomplishment. The shoe mainly won for the “fit and feel” of the shoe. It has memory foam throughout for a great overall fit. I have just ordered a pair, I so will let you know what I think. They are comparably priced to the best New Balance walking shoes.
The fourth sciatic nerve pain relief strategy is water walking. No, I don’t mean swimming, I mean getting into a pool and walking and moving with slow and deliberate movements. I have used this strategy and it is one of the best I have ever found. Not only is the water soothing, even if the water temperature is on the cold side (so much the better, actually!), but the motion itself is therapeutic. I realize not everyone has access to a pool but most communities in the states have a YMCAs or YWCAs. And price shouldn’t be an issue because they have membership rates tailored for any socio-economic bracket. So, there is no reason not to get in the pool at least a couple of times a week. If you use this strategy for a month or two, you will never do without it again, it is that good.
Finally, the fifth sciatic nerve pain relief strategy is rest. This is a short-term pain relief strategy and should not become a permanent method of dealing with sciatica or any other form of back pain…or pain of any sort for that matter. In fact, the reason I left it until last is because it is usually the worst thing you can do as a regular method of dealing with pain. While being active and even exercising may seem counter-intuitive, it is usually the best back pain and sciatic nerve pain relief strategy, period! The more you sit around, the less you do, the more pain you will have, guaranteed! However, there are times when you may need to put your knees up, put the ice pack on your back, and rest. As long as it is short-term and incident specific, fine, rest. But please, do not become a couch-potato as a means of treating sciatica or any other form of back pain, it is the absolutely kiss of death when it comes to overcoming your back pain and/or sciatica.
So there you have them, my five ultimate bad back strategies…or in this case, my five sciatica relief strategies. The best for immediate relief from sciatica is ice. The next-best treatment strategy for sciatic nerve pain relief is stretching, particularly the piriformis/sciatica stretch. The third technique is to switch your shoes, slip into something more comfortable, so to speak. The fourth pain relief strategy is to start walking, water walking that is. By the way, walking, as a rule, is also one of the best long-term strategies and will be dealt with extensively in an upcoming article series. Finally, number five is last for a reason, it should not be abused…rest. Rest, while at times necessary, is not a long-term treatment strategy. In fact, rest is a terrible long-term strategy leading to muscle weakness, muscle atrophy, weight gain, and other negative effects that actually contribute to, instead of alleviating, back pain and sciatica. So, get off the couch or out of the recliner, and certainly out of bed, and start walking…more to follow!