Sciatica Nerve Pain: Overview
It is a health condition that is characterized by an intense or mild pain that discharges from the sciatica nerves channels. The nerve branches at your lower back and it passes through each of your hips down along your legs. Despite the nerve being on each leg, the pain which is agonizing at times and only affects one of your body sides.
It arises commonly when the spine disk is worn out with time; it, therefore, ends up applying pressure on the sciatic nerve and thus causing intense pain. This usually occurs due to intense use of the back, age or even injury.
Sciatica Nerve Pain: Causes
The bones that form the spines are usually cushioned for protection from friction and also shock absorption. The cushioning is done by disks which are small and flat in shape. They also have an added outer layer (annulus) which is tough for sustaining pressure applied to it. The discs are situated between each of the spinal cord bones and absorb any shock transmitted through the spine.
Therefore, a herniated disc is a fragment that has ruptured from the main disc. The fragment is then pushed into the spinal canal from the ruptured annulus. When such a process occurs on a disc, this means it’s in the early degeneration stage. Considering the canal of the spine has a limited space, which is not enough to fit the fragment and the spinal cord, the pressure is applied to it. As a result of the pressure exerted on the spinal nerves, it creates a pain which may be mild or severe.
Herniated discs are prone to happen on any section of the spine. The most common is the lower spine. Other regions include the cervical region. The impact of the pain relies on the part of the spine which is damaged.
The herniated discs are formed as a result of injury, excessive strain on the back, or naturally as a result of aging.
Degenerative disc disease is a medical condition in which due to changes in the anatomy of the discs that cushion the spine, they degenerate and also loses their role. The degenerated disc results in intense pressure applied to the spine due to the loosen spine. At times the fragments get into the spinal canal. When the spine loses support it becomes weak and exerts pressure on the spine, in the process, the fragments of the degenerated discs are forced into the spine causing intense pain.
This condition is prevalent in the cervical and lumbar region of the spine. It’s characterized by narrowing of the cavities that houses the spinal nerves. As a result of squeezed cavities, the pressure is exerted on the nerves. The symptoms differ across different people with diseases. Some will feel pain, others numbness, muscle weakness, and also tingling. But despite the symptoms, the conditions become worse with time to all the individuals having it. It’s caused due to wear and tear of the spine.
SI joint problems
This condition is characterized by pain in the lumbar and sacral region of the spine. The main cause is the spine and hip joint injury. The joint received the whole body weight and provides support to basic body motions such as walking. The SI joint has nerve endings; hence degeneration or injury on the joint causes intense pain when it moves abnormally. The sciatic nerve also passes through the joint, thus an impact on the joint causes a negative impact on the sciatic nerves.
This is a neuromuscular disorder which is very rare. It’s caused when the muscle exerts pressure on the sciatic nerves. Piriformis is a form of muscles which are based in the buttocks close to the hip joint upper section. The Piriformis is the main source of stability and flexibility of the legs. The sciatica nerves pass through it or close to the muscles. The Piriformis syndrome is as a result of the muscle applying stress or pressure on sciatica resulting in pain.
The condition creates an impact on one given side of the lower body, with the pain characterized according to which part of the sciatic nerve has been affected. In most cases, the pain starts from the lumbar region as it extends to one of the foot and its toes. At times the pain may be too severe to restrict body movement. This makes it hard to continue with your regular activities. The symptoms may be short or long-lasting depending on how long the individual has been suffering from the condition.
The pain from the condition can either be mild or sharp. It creates a sort of burning sensation and sometimes an excruciating pain. Other times it may feel like an electric shock on one side of your body. With the symptoms worsening with every cough you take. Taking a sit may seem like a good alternative to relieve you of the pain but instead, it usually aggravates the pain. In most cases, its only one section of your body that is affected.
Some common symptoms are:
- The feeling of a burning sensation down your foot with excruciating pain.
- Mild or intense pain in your lower back.
- You receive a paint that is constantly exerted on one side of your sacral region.
- The pain concentrated on your foot makes it hard to move a muscle leave alone walking.
- General traits include numbness, weakness of the muscles making it hard to shift your body.
Sciatica Nerve Pain: Diagnosis
Diagnosis involves different steps. The specialist will begin by asking you about your current and initial symptoms. The various methods that you’ve tried in the treatment of the condition and some other typical questions.
After the questions, the specialist will carry out physical and neurological tests. The physical exams include study your posture, physical condition, range of motion, and noting which movement is the source of your pain.
Other physical examinations done by the specialists include feeling your spine in general, noting the curvature it’s having, the alignment and also the muscle spasm. For the neurological examination, the strength of your muscles, reflexes and other changes occurring in the nerve are examined.
There are six main causes of sciatica; each of the causes affects a different part of the body. Therefore a more detailed examination has to be done, in order to avoid confusion and to be certain about which type of sciatica is being treated.
For accuracy of the main cause of sciatica, imaging tests will be required. This includes an x-ray or a CT scan or CAT scan. If the causes of sciatica may be spinal stenosis or herniated disc, your specialist may order an MRI test done to be certain.
MRI Scan on Lumbar
The scan utilizes magnetic waves and radio waves to take an internal caption of your body through your skin without uses of surgical technique. Apart from the bone structure image, the scan displays the internal soft tissues such as organs and muscles.
Why it’s done on the lumbar?
Through the scan, the doctor or specialist will be able to diagnose what it’s affecting the patient’s back. It can either be an injury, infection, disease or other related factors.
Unlike other techniques such as X-rays, CT scan and ultrasound, an MRI scan gives a detailed image of the spine. The image includes disks, cavities and spinal cord where the cavities where nerves channel through.
Are there risks associated with lumbar MRI?
MRI scan is considered the safest among the other methods of scans. This is because it’s free from ionization. Therefore it can be utilized on children who are growing and even pregnant women who are susceptible to ionizing energy. Up to date, no documentation is there to prove or show the side effects of this technique.
The only risk that may arise due to using this technique is on individuals who have metallic implants. The magnet in the machine may cause a shift of the metal in the body.
Allergic reaction due to the dye used. The dye is introduced in the body through blood. This gives contrasts when the image is taken thus it appears more clear. The allergies due to the dye are usually mild and often treated with medication. It’s only a few instances where the dye causes anaphylactic reactions.
Preparation for the MRI
Before the scan, the specialist will inquire if you have a pacemaker. In case you have, an alternative safer method will be applied. This is because the MRI can reprogram the device due to its magnetic waves.
You will also be required to remove all the pieces of jewelry on your body. This also includes removal of any metallic object you are wearing. The MRI at times attracts the metals. The doctor has to be notified in case of any presence of a metal implant or metal fragments that may have been left in your body for any reasons.
Mention if you have any allergies. Claustrophobic or feeling of being uncomfortable in enclosed areas has to be mentioned to the doctor.
How the MRI works
- After you have gone through the preparation method for the MRI, you will be given the clinic gown to put on.
- The MRI machines where you will be taken in looks like a giant doughnut and a bed at the center.
- You will be told to get on the sliding bed which will glide you into the machine.
- The process takes about 30 minutes after which it will slide you out by itself.
- The image caption will be imprinted on a film or sent to radiology for interpretation. Thereafter you will be given the diagnosis.
Treatment of sciatica through exercises
If you read on the main causes and symptoms of sciatica, it may seem counteractive to pick exercise as a form of treatment. But actually it’s not, among the various form of treatment, it’s the most effective and quick to relieving pain when experiencing the symptoms. But don’t get this wrong, not every exercise will be effective. Some are enough to reap you apart with excruciating paining when you apply. But in this article, we will highlight the major exercises that will come in handy at the time of need and also in the treatment of the condition. Also included, is the specific exercises for the various causes of sciatica apart from the Herniated Disc.
Thus, the exercises will serve the following key roles:
- Relieve you of the sciatic pain in case it occurs.
- Through the exercises, future recurrence of sciatica symptoms is prevented.
- Best alternative treatment of the condition.
Before selecting the category of exercise that best fits you, it’s best to go for diagnostic. Most of the exercise techniques that will be highlighted are going to be based on the source of pain. Thus a diagnosis from a health professional will enable you to know what the main cause of the pain is. For example- exercises for sciatica caused by Piriformis Syndrome or exercises for sciatica caused by Herniated Disc.
Exercises for sciatica caused by Herniated Disc.
This particular form of sciatica is caused when intense pressure is applied to the disc by the spine. When the limit of the disc is exceeded, it becomes compressed. Rather than being compressed uniformly to spread the pressure, it bulges backward. And through this, the protruding end exerts pressure on the Sciatica causing an intense pain that is channel down to the foot. The pain is usually felt on one side of the body.
In this case, there are specific exercises which are commended to relieve the symptoms from the herniated disc. The prescription of the exercises is sometimes based on the best position to shift the symptoms felt on the legs back to the lumbar region. This particular method is known as Centralization exercise.
To accomplish the impact of this exercise, the patient has to lie flat on the stomach, then lift the body using the elbow and set it in a backward bending posture. It is also referred to as the press-ups or extension exercise:
The lumbar region (lower back) is set into the extended position through lying on your belly, after which use your elbows to gently and slowly prop your upper body. Meanwhile, as you prop the upper body, maintain your waist flat touching the ground. The gently and steady movement is meant to adjust the body slowly as it bends. During that, you may experience some pain, but it gets better as you attain the position.
After attaining the prone posture, hold on there for the next 5 second, and then relax by lying flat. Repeat the process up to 10 times for it to be effective. Meanwhile, as you add more reps, also add up to 30 seconds for the prop position.
After getting through with this exercise position, you may be encouraged by the physical therapist or spine specialist to try more extension exercises.
After the prone posture, it’s time to apply for a new position.
Maintain the same lying position for the next exercise. But this time, rather than propping your upper body with your elbow, uses your whole hand. Place the palm of your hands flat on the floor then lift your upper body through extending stretching your hands till they are straight. Meanwhile, maintain your wait region and your butt flat on the floor.
In this position, you only need to maintain your upper body raised for only 1 second and repeat it for up to 10reps.
Lying can be quite a challenge for certain people due to pain or unavoidable reasons. But the good thing is that the same exercise is possible through a standing posture:
- Stand at an upright position, then using your hands, hold your waist.
- Slowly and gently lean back while you feel you’re back stretching. Go as far as you are comfortable. But also ensure you will not be in a risk of falling backward.
- While stretching backward, hold there for 5 seconds while resting a bit during each rep.
- You can go for up to 10 reps also.
Despite the standing position being a good alternative for prone posture, the best one is always the prone posture. Although it’s advised that the best way to start the extension exercises is, to begin with, the standing posture. It works as the foundation for your back as you proceed to the more intense (the prone posture).
The exercise works best when done on a regular basis for about 2 hours each. As a recommendation from the specialist, avoid the forward bends. Bending forward counteracts all the effort you had placed earlier. If done accidentally, an immediate extension exercise has to be done.
Exercises for sciatica caused by Spinal Stenosis
As explained earlier, it’s a condition that occurs when the cavity that houses Sciatica shrinks and begins to press the nerves. Thus result in intense pain. The symptom includes a sharp and excruciating pain which is radiating on the sciatic nerve down the leg. This can be experienced while walking with the immediate solution are leaning forward or sitting down.
Exercises needed and the impact they have
For the treatment of this condition, flexion exercises are best commended by the specialists. Through leaning forward while bending our lower back, it opens up the passage cavities of the sciatica nerves. It opens up at the exit point of the nerves from the spine, thereby relieving the pressure which was exerted on the nerve causing the pain. And it’s for this reason why the spinal stenosis symptoms are always relieved through bending forward. Or you can make it even more effective by leaning on a support which is at your waist region.
Exercising your back focuses on alleviating sciatica symptoms. It includes strengthening and stretching exercises combination that focuses on:
- Stretching & strengthening extension muscles.
- Stretching & strengthening flexion muscles.
Through applying these exercises on a daily basis, the spine attains a position that gives passage to the branching sciatica nerves. And through this, the pain in the leg is reduced.
Sciatica Spinal Stenosis exercises:
Pelvic tilt- for this exercise, lie on your back while facing up. Bend your knees and place your foot in a stepping position. Try to lift your upper body a bit by tightening your stomach muscle which will, in turn, exert pressure which is needed on your back muscle. Just to be sure you are doing it the right way while tightening the muscles of your stomach; your navel should be moving towards your sternum. Hold every stretch for up to 10 seconds. And your target should be on 8 – 10 reps.
Curl – ups- for these, lie on your back facing up, bend your knees and place your foot in a stepping position. Then fold your arms and place them across your chest. Then simultaneously, raise both the shoulder and your head from the floor. Do this for up to 10 reps, each rep should be 2 – 4 seconds.
Hook lying march- lie on a pelvic tilt posture, then move your legs on a marching manner. You’re legs when raised while marching ensures they are 3 – 4 inch off the ground. Do this for up to 2 sets, and a 30s time interval per every set.
Exercises for sciatica caused by Piriformis Syndrome
Piriformis muscle is based deep in the butt, but very close to sciatic nerves. The condition is caused as a result of the muscle exerting pressure on the sciatic muscle. This pressure on the sciatic nerves results to pain which is very severe and accompanied with symptoms such as numbness, and sharp pains that cut through your butt and extends up to your foot and toes.
Muscle stretches for Piriformis
Through stretching these muscles, you get to relieve the pressure on sciatica, and thus reducing the pain. The stretches have diverse ways which are all effective. Here you get to choose what favors you.
Below are the best-commended exercises methods which will work effectively for you:
Lie on your back while facing up with your legs flat on the ground. Then bend both your knees. Using one of your hands, hold the affected leg at the knees and pull it towards your chest. Using the other hand, hold the foot by the ankle, then pull the leg at the ankle towards the other knees. Through this, you will experience the stretch occurring. Also, do not overstretch or force your ankle above its limit. While pulled, hold it in place for 30seconds, after which, get it back to the initial posture. Up to 3 stretches are good enough.
Lie on your back while facing up with your legs flat on the ground. Bend the leg which is affected by placing the foot close to the unaffected knee. Then through using the hand which is opposite to the leg, pull the affected knee across tour body. This should be done until a stretch is felt. Meanwhile, hold the knee in place for 30 seconds, after which you can lay it straight on the floor. Your target here should be at least 3 stretches.
Knee-to chest stretch
Lie on your back while facing up with your legs flat on the ground. Then bend your legs. Pick the affected foot by the ankle and place it on the other leg thighs, but close to the knee. Through the use of both hands, pull the unaffected foot by the thighs while feeling the stretch progressively. Hold the foot at the position where the full stretch is felt on the butt which is affected. This is done for 30 seconds with relaxation time after each stretch. Up to 3 stretches is sufficient enough to be effective on your affected foot and butt.
4- Point stretch
Pull the unaffected leg while bent close to your chest; ensure it’s in a position that is parallel to your shoulders. While the other leg should be lowered flat on the floor with the lower thighs touching the floor directly ensuring the stretch on your foot that is affected is felt. Also, hold the foot whole feeling the stretch for 30 seconds. This is done for up to 3 stretches until the effect is felt on the foot that is affected.
Exercises for sciatica caused by SI joint problems
Exercises that focus on the sacroiliac joint stability are great for minimizing pains which are caused by micro motions which exerts pressure on the sciatic nerve causing irritation. Also, exercises that also concentrate on the sacroiliac joints reducing tension are best in restoring the full flexibility potential of the joint muscle, thereby alleviating them and thus reducing the tension the sciatica nerves doing away with the pain in your leg and butt.
Applying various exercises for motion which directs their impact on the sacroiliac joint, has the capacity to restore the normal flexibility of the joint and in the process, it also alleviates the pressure exerted on the sciatic nerves that cause the pain. Below are exercises that are commended for this particular sciatica:
Begins by lying on your back facing straight up, while your legs are bent and parallel to each other. While maintaining both feet touching the floor, pull both of them simultaneously towards one side, during this, your back and shoulder should remain on a flat posture. Maintain the legs on that position for 5 – 10 seconds after which shift it to the opposite side and do the same.
For effectiveness, the exercises should not be based on the days when you are getting condition symptoms. They should be on a regular basis. This not only alleviates the pain from the condition but it also reduces the likelihood of it occurring in the future.
Lie straight on the floor on your stomach then raise your upper body with your elbows. Meanwhile, ensure your pelvis is pressed on the floor. While doing the stretch, it should be gentle and with the butt and lumbar region relaxed. Maintain the press-up posture made before for up to 5 seconds. As you progress with various sets, gradually build up on the holdup duration of time, from 5 up to 30 second is good enough.
Single knee stretched to chest- lay on your back facing straight up. Bend one of your knees, then grab it by lower thighs and pull it towards your chest using both hands. Maintain the foot at the chest position for 5 to 10-second duration. After which do the same with the opposite leg to balance the exercise.
Exercises to strengthen the SI joint for relieving Sciatica
Below are exercises that are handy in strengthening the muscles of the pelvic as well as stabilization of SI joint. These exercises inhibit excessive motions that trigger this condition by irritating the sciatica nerve.
Start with all your limbs on the floor like a standing dog. Then raise one of your hands as well as the foot opposite to that hand and place them in parallel positing to the floor. Maintain the pose for the next 5 seconds. Then do exactly the same with the other hand and foot. Do these on both sides for up to 3 – 5 reps which are complete.
Lie on your back facing up, and then bend both your knees. At the same time spread your arms in either direction. Then begin gently by raising your lower back off the ground until it reaches a point where your body runs straight from the shoulders to your knees. After achieving this pos, maintain it for 5 seconds, after which you can gently lay it back on the floor. For effectiveness do 8 – reps.
Exercises for sciatica caused by Degenerative Disc Disease
This disease eats away the disc causing it to reduce in size. This reduces the cavity of the nerves with time. Therefore, when they are too small, they exert pressure on the sciatic nerves resulting in pain.
Sciatica which arises as a result of the Degenerative Disc Disease is treated through a dynamic lumbar stabilization exercise program.
Exercises for lumbar stabilization
For these particular exercises to be effective, you need to understand fully the instruction. Yes, they may look simple and fast to do, but incorrect pos will be least beneficial. Due to their complexity and accuracy requirement, they are done progressively. You begin first with the simple as you advance to the intricate techniques.
The key feature for engaging in these exercises is to be able to master your spine control and sensation. Once you’ve got everything on your fingertips, you can proceed with less concentration as compared to the first time.
The exercises involving lying on your back
Begin by lying on your back; spread your hands straight to the sides and your knees bend. Gently, raise your lower back from the floor. Proceed until your knees and your shoulders align on a straight line. Maintain the bridge posture for 8 – 10 seconds then lower your waist gently and relax. Target at least the range of 2 – 10 reps.
Hook-lying March combination
You start by lying on your back; bend your knees and place your feet on the ground; then raise one of your hand while lowering the foot opposite to it. Do the same with the other hand.
Hook lying March
You begin with lying on your back, and your arms straightened at your sides. Using your stomach muscles, gently lift you alternate legs in a marching pattern and aim at 30 seconds per every rep. Also, have breaks of 30 seconds to relax.
The exercises involving lying on your stomach
Below are exercises that aim at strengthening the lower back muscles. When doing, ensure your back is straight, no arch formation and should be rigid.
Prone-arms and leg-lift
Lie face down on the floor; stretch your hands above your head and the elbows should be straight. Then raise one hand and the opposite leg for up to 2 or 3 inches above the floor. Maintain it there for 4 -6 seconds. Then gently relax them, and do the same with the other hand and leg. As stamina builds, aim up to 2 sets with several reps.
Prone leg lift
Lie on the floor flat while maintaining both hands below your shoulder level. Lift one of your legs with a slight bend permitted and with no arch on the back. Maintain the pos for 4 – 6 seconds then lower your leg. Do the same with the other leg. Complete two sets with up to 10 reps of leg raises are good enough.
Bird dog exercise
Begin by standing on your knees and hands at once. Then raise one of your legs parallel to the floor. A slight bend at the knees is allowed. While maintaining the leg at a loft, raise the hand opposite to the leg. It should also be parallel to the floor. Therefore maintain both at the raised position for the duration of 4 to 6 seconds. Meanwhile, your back should be flat with no arch formation. Do the same with the other hand and leg. You can do up to 10 complete sets.
4- Point leg lifts
Start by standing on your knees and hands at the same time. Lift one of your legs with a slight bend on the knees. Meanwhile, your back should remain flat with no arch formation. Maintain it at the position for 4 – 6 seconds then gently lower it. Do the same with the other legs. As your leg stamina builds aim at many reps of leg raises.
Other Treatment options
Due to the intense and excruciating pain, a person gets from the condition; most of the medications are usually painkillers. The condition usually responds well, too personal care measures when they are put in place. Some of the medicines which sciatica responds well to include:
Use of pain relievers from over the counter such as: Nonsteroidal anti-inflammatory drugs (NSAIDs) and Acetaminophen. Some of the NSAIDs are Asprin, naproxen, and ibuprofen. These drugs are effective in easing the pain but should not be over-relied upon without the doctor’s advice.
When the drugs from over the counter are mild in easing the pain, through seeking the doctor’s advice, you will be given a prescription of stronger medicine. Such as: Amitriptyline which is an antidepressant. But also medications of anti- seizures work in curing the pain. When it’s very severe, steroid injections are prescribed. They are injected directly into the nerves which are irritated, but they provide relief which is limited.
When every other type of treatment fails to work on the patient, surgery is the last option for trial. About 5 – 10% of patients with sciatica go through this form of treatment. The other 90% relies on other methods which usually work for them.
When you experience a mild symptom of the condition for about 3 months of even after trying other methods of treatment, then you are only left with surgery as the only option. In some cases which is rare, sciatica can cause some loss of physiological functions such as not being able to control your bladder and bowel. When you have such a symptom, it’s a direct ticket to surgery.
There are diverse types of massage with each serving a different role in our body. The effectiveness of this method of treatment relies upon the right choice of the technique. The pain from the condition originates within deep tissues in our back as well as another part where it occurs. Therefore a deep tissue massage is what you will need. It will be able to penetrate your tissue and offer the relieving sensation from the pain. Apart from the treatment of the condition, the massage will also give you relaxation. It’s enough to shift your mind away from the pain caused by sciatica.
Deep tissue massage works best on the troubling spots in our body that are hard to reach. The therapist applies deliberate, gentle and slow strokes on our body. These strokes focus pressure on tendons, muscles, and other layers of tissue which are deep within our body. Despite having a low rhythmic pattern when compared to another form of massage it can be therapeutic. Has the potential to relieve stiffness, pain, injuries and back pain.
Sciatic heat treatment method works by dilating the blood vessels, this increases the rate of blood flow, thus increases the supply of oxygen and other nutrients which are beneficial to the part which is in pain. Through these, the healing process commences. The heat application stimulates thermo-receptors on the skin, through this; the focus on the pain is shifted thus become less intense. It is a method which is suitable after the disappearance of acute symptoms. If heat alone is not enough, ice can also be used in an alternating way together.
During the application, care has to be taken to avoid burns on the body. The heating instruments that will be used should be warm and not hot. Also, the heat should be applied directly on the skin. Use something like a cloth in between to prevent burns.