Sciatica Pain Relief: Exercises, Stretches, and Surgical Options

If you’ve been diagnosed with the annoyance and discomfort of sciatica nerve pain, you may be wondering, “How can I get relief?” Treating sciatica pain can take several different forms, depending on the root cause of your sciatica problem and the severity of your symptoms.

What Sciatica Pain Feels Like

First—how do you first realize you may have sciatica? What does sciatica pain feel like, and why is it happening to you?

Because the symptoms of sciatica usually appear in the buttocks and leg (often below the knee), many people mistakenly believe they’ve sustained a leg injury. Actually, sciatica pain is a lower back issue. It originates in the largest nerve in the human body, the sciatic nerve. Also called the ischiadic nerve, the sciatic nerve begins in the lower back and runs behind the thigh to the knee, where it splits into the tibial and common peroneal nerves that continue down into the feet.

So when you feel a shooting pain or tingling, burning sensation somewhere in your leg, the actual source of these symptoms is some part of the sciatic nerve in the lower back or buttocks being pinched, damaged, or inflamed. For example, a vertebral disc may slide out of alignment, putting pressure on the nerve. Likewise, a back muscle may be swollen or inflamed from overexertion or injury, which can crowd the area around the spine and apply pressure.

The causes of sciatica pain can vary. Sports or accidents may contribute, as can degenerative spinal conditions. Pregnancy is also a very common cause.

Before treating your pain, your doctor will need to examine you and to determine the reason you’re experiencing symptoms. Often, treating the underlying cause takes the pressure off the nerve and makes the symptoms disappear.

What are these symptoms, exactly?

Sciatica nerve pain symptoms:

• Numbness, pain, or tingling that travels down the leg—sometimes reaching the feet and toes

• An “electric” sensation that runs along the length of the leg (Some people say it feels like a toothache—but in the leg.)

• Radiating (spreading) pain originating in the lower back

• Pain anywhere along the leg (often on the outside of the leg, or along the back of the hamstrings and calves)

• Pain that is dull or sharp, stabbing or aching—or any combination of these

• Pain that jumps or spikes when you sneeze

• Weakness in one or both legs

• Inability to find a comfortable position when sitting or driving

Sciatica discomfort levels can vary. For many people, sciatica pain isn’t excruciating—but it can be distracting and annoying. If you sit in a chair all day at work but can’t get comfortable, for example, you may find it difficult to concentrate on the task at hand. Sciatica sufferers may also have trouble sleeping for the same reason; they toss and turn trying to find a position that relieves the pain.

Sciatica can be distressing because its symptoms can continue for a long period of time. Most often, sciatica pain will resolve on its own within a month. But four weeks of nonstop, distracting discomfort can feel like an eternity. And for some people, sciatica can be chronic, with symptoms lasting longer than 8 weeks—maybe even up to a year.

Pain Relief for Sciatica: Non-surgical Options

Most patients (and most doctors) prefer to start treating sciatica pain with conservative, nonsurgical treatments. After confirming your diagnosis and the underlying cause through testing (which may include MRIs, X-rays, and physical examinations), your physician may prescribe four to six weeks of noninvasive medical treatment.

Non-surgical methods to treat sciatica nerve pain can include:

• Heat and cold therapy. These therapeutic modalities can help manage swelling, inflammation, or spasms that put pressure on the nerve. Most sciatica sufferers are advised to use one or both at home or as part of a physical therapy prescription.

• NSAIDs (non-steroidal anti-inflammatory drugs). If the cause of your sciatica pain is inflammation, over-the-counter drugs can help reduce the swelling and subsequent pain.

• Deep-tissue massage. If tight muscles and tissue are pressing on the sciatic nerve, releasing tension may provide some relief.

• Ultrasound Therapy. This physical therapy treatment involves sending sound waves far into the body to heat muscles from within. The approach achieves similar results to hot therapy and massage, but it’s deeper-reaching.

• Chiropractic Treatment. Spinal adjustments and manipulations may help to improve alignment of your vertebrae—just enough to relieve pressure on the sciatic nerve.

• Corticosteroid injections.Epidural injections can flood the roots of the spinal nerves with a corticosteroid, which reduces inflammation and eases pain. A successful treatment may last for months.

• Prescription Medication. Muscle relaxants may help with lower back spasms; antidepressant drugs, in some cases, can block nerve signals for pain.

• Alternative Treatments. Some patients find some pain relief in non-traditional Western medicine approaches like acupuncture, acupressure, and biofeedback.

• Exercises and stretches. One of the most popular courses of treatment for sciatica is simple movement and activity—described in greater detail below.

Exercises and Stretches for Sciatica Pain Relief

Sciatica discomfort caused by physical issues in soft tissues—including muscles, tendons, and ligaments—may be improved through exercise and stretching. Your physician may prescribe specific movements to help train your core muscles and improve your posture. Others can help to stretch and relax the lower back. These moves may help to strengthen your core and lower back area, relieving pressure on the sciatic nerve. Stretching can also help to subdue spasms.

Five commonly-recommended exercises for relieving sciatica pain include:

1. Knees-to-chest. Lie flat on your back, on the floor or on a mat. Slowly bring your knees to your chest, then wrap your arms around your knees. Relax your lower back. Hold this position for 30 seconds. When you release your legs, bring them back to the floor slowly. Repeat three times. For a variation, you can do one leg at a time, holding onto the thigh to bring the knee closer to your face. This move stretches your hamstrings and the lower back. Keep your head flat on the floor to avoid straining your neck.                                                                                                                                                                  
2. Lower back twist. Lie flat on your back with your legs straight. Bend one leg at the knee, keeping the other foot on the floor. Gently let your bent leg fall across your outstretched leg. Keep your opposite foot, your back, and your hips flat against the floor. This move stretches both the lower and middle back. Hold the move for 30 seconds, then switch sides. Repeat 3 times.                                                                                                                                                                                                  
3. Quadriceps stretch. Lying on your stomach, bend one knee behind you. Reach back with your hand on that side, gently grasp your ankle, and pull. This stretch relaxes the hips and the fronts of your thighs. Hold for 30 seconds, then switch to the other side. Repeat 3 times.                                                                                                                                                                             
4. Buttocks and hip stretch. Lying down on the floor, bend both knees. Place the ankle of your right leg in front of the knee of your left leg. Gently pull your left thigh toward your face. This move stretches the outside of the buttocks and the hip obliques—muscles that are difficult to stretch and often overlooked in most stretching routines. Hold for 30 seconds and repeat 3 times.                                                                                                                                                                                                     
5. Groin stretch. Lying flat on your back, bring your feet together, pressing the soles and letting the knees drop toward the floor (gently) until you feel the stretch. Some call this a “butterfly” position. This move stretches the thigh adductors and groin. Hold for 30 seconds and repeat 3 times.

Remember: before beginning any exercise plan, see a doctor or physical therapist. Customizing your exercises to your health history and current condition will help to ensure you’re moving in a way that relieves your symptoms safely. (For example, some exercises may not advisable for pregnant women or for people with pre-existing injuries.)

An orthopedic physician can also advise you about activities to avoid—because these moves may compress your spine or aggravate nerve inflammation. For example, you may need to skip:

• certain yoga moves

• stretches that force you to bend at the waist

• abdominal crunches

• running (especially if your form is poor)

Surgical Options for Sciatica Pain Relief

For some patients, exercise and other non-surgical options will be ineffective at relieving chronic sciatica pain.

Also, in a minority of cases, symptoms can worsen to include neurologic problems like severely weakened legs or issues with the lower GI tract. In these scenarios, surgery may be the only means of resolving the problem.

If your orthopedist determines that you’re a good candidate for surgery, your options include:

• Laminectomy/Laminotomy. If your spinal nerves are being compressed or pinched by contact with the lamina (the spiny part of the vertebra), removal of this piece of bone can relieve the pressure and resolve the sciatica. This procedure is most commonly used in cases where the sciatica is being caused by spinal stenosis, in which the spinal column has been narrowed by injury, repeated overuse, and/or genetic predisposition.

• Between each vertebral bone is protective tissue known as a disc. Each disc has a hole for the spinal cord to pass through it. A “slipped," “pinched,” or “herniated” disc has become misaligned with the spine, causing this hole to press directly on the sciatic nerve. A discectomy removes part or all of the damaged disc to relieve the pressure. The disc may also be replaced with an artificial disc.

Recovery from surgery to treat sciatic nerve pain is fairly speedy: a successful procedure should have you on your feet in one day. However, your doctor may advise pain medications and rest for a few days or weeks while you recover. After sciatica surgery, follow your surgeon’s exact instructions to prevent damaging your spine while it heals. Move slowly and carefully and eliminate as much spinal motion as possible.

After surgery, avoid lifting or twisting motions or abrupt movements for at least two to four weeks. No participation in sports, either.

Summary

Most people experiencing sciatica pain will not require surgery. However, those that do can look forward to a complete recovery: up to 80% of patients experience relief from their pain.

If you or a loved one is struggling with back pain and want to learn more about your treatment options, call Coastal Orthopedics in Corpus Chrisit, Texas today (361) 994-1166

Article written by: Rob Williams, MD