Information and tips from a fellow sufferer.

As someone who has suffered MASSIVE sciatic pain due to a SLIGHTLY herniated disk, I offer this page to help those who've also become afflicted in whatever way I can. If you are familiar with sciatica, many of these tips may seem familiar to you. But perhaps there may yet be some nugget of information you were unaware of. If you are new to the sciatic condition, rest assured, you can find help here.

Below will be found a description of the problem, a list of causes, treatment options, stretches and exercises that will benefit you, and finally a list of general tips to help ease the pain and speed recovery. Please read the page thoroughly, as there is much information throughout that can be of use to you NOW.

PLEASE NOTE: I am not a doctor or health care professional. I'm simply a person who has suffered this miserable condition, and wish to share what I have learned with others in the hopes that I can help them. For expert advice, please see a doctor or other health care professional.

Symptoms:

The symptoms of sciatica can be variable. Not everyone experiences deep unrelenting agony. For many, it starts out as aches, light cramps, or numbness in the back, hip, or anywhere along the leg and foot. At this stage, it often isn't considered serious to the patient. However, if it isn't dealt with, it will likely become much worse, which trust me! You want to avoid. Others experience a full blown pain crisis as their first sign. In either case, the general procedures are the same, although if the pain is great, immediate medical attention should be sought for quickest recovery.

- Pain or tightness in the lower back.

- Pain, tightness, tingles, or numbness in the hip, down part of or all of the leg, usually along the rear outermost part of the leg.

- Pain, tightness, tingling, or numbness anywhere in the foot.

- Weakness in the leg, sudden clumsiness, inability to walk in a straight line, or walk at all. Can happen with or without pain.

- Problems going to the bathroom due to back pain, leg pain, or numbness in the groin area. NOTE: If this symptom becomes too severe, and you cannot go to the bathroom at all, SEEK MEDICAL ATTENTION IMMEDIATELY!!! Although this is rare, an over-inflammed sciatic nerve can have the effect of rendering elimination impossible, and due to the backup of materials, can become a very serious and deadly problem. The hospital will be able to treat this before such happens if you go soon enough.

Though not often reported, the pain from an aggravated sciatic nerve can radiate to the unaffected side of your body, or upwards to your chest and back. Take special care of these areas should this happen, to avoid muscular strain, and further weakening of your original sciatic problem.

Causes:

The more common cause of sciatica is disk compression, which causes the disk material to bulge outward, putting pressure on the nerve. This is called a herniated disk (or "bulging disk").

Disk ruptures (breaks) and disk collapse can also be an underlying cause. The verterbrae themselves can sometimes put pressure on the nerve. This is often the case with back injuries or malformations.

Piriformis syndrome is another cause of sciatica. This is when the muscles of the hip place pressure on the nerve. This can happen due to accident, injury, or inflammation. For anatomical reasons, it's more common in women, though men certainly can get it too. A special note must be made about Piriformis syndrome. Doctors often ignore this possibility, opting for the more traditional herniated disk explanation. Herniated disks show up very often in people, including a great number who have no complaints of pain at all. (sciatic or otherwise) It seems that herniated disk is the preferred diagnosis when one is found, but it may not always be the real cause. Pharmaceutically, both conditions are treated the same, with anti-inflammatories, muscle relaxants, and pain killers, but when it comes to physiotherapy, there can be a difference in which methods work best. More information about Piriformis Syndrome can be found here: Piriformis Syndrome | eOrthopod.com

There are other far less common reasons for sciatica, such as tumours, infections, and so on. But these are rare. A doctor will be able to quickly judge whether your pain is due to the typical reasons above, or something more unusual.

First things to do.

If you suspect your nerve has been aggravated, it is best to seek medical attention. The doctor can confirm the diagnosis through manipulation and diagnostic techiniques. He/she will likely order a CT scan or MRI to confirm whether the sciatic inflammation is being caused by an injured disk. Treatment options are listed below.

The next step is to simply take a couple of weeks to rest. No unnecessary movement or activity should be attempted at this time, as it can aggravate the condition.

Once this time has passed, *slowly* small exercises can be attempted. Depending on your pain level, this can be nothing more than stretches and flexes while you are lying down. If you are able, taking a walk from one room to another and back may also help. Walking is the best exercise to get back into form and heal. No matter what activity you are trying, if the pain becomes too much, don't fight it! Go lie down, and rest again. It's better to try several tiny efforts during the day than one or two major ones.

In time, you will be able to stay up longer, and do more. The general rule is to always try to get more activity, but as soon as the pain increases, it's time for a rest.

Treatments:

Pharmaceutical.

For lower grade pain, analgesics can be tired. Acetylsalicylic Acid (Aspirin), Acetominophen (Tylenol), Ibuprophen, and even back medications such as Doan's or Robaxacet can be tried. The back medications usually contain a muscle relaxant as well as an analgesic, both which will help in their own ways. For something stronger than regular pain relievers, you can ask the pharmacist if they sell Acetominophen with codeine. Codeine offers both pain relief and muscle relaxant properties, so is usually a beneficial adjunct to regular analgesics. In all cases, make sure to ask the pharamcist for possible side-effects and/or drug interactions. Do not exceed recommended dosages.

If the pain is more severe, the above suggestions probably won't help much, if at all. A doctor can prescribe you more effective, anti-inflammatories, muscle relaxants, and pain killers.These are much stronger, but have more side-effects, most often causing digestive troubles. Don't be afraid to ask questions.

Medical:

Epidurals can ease the pain tremendously. Cortisone, and likely some other agents, are injected into the spine. It can take a few days for the full effect to reach its' limit. It also helps speed the healing process. It can be a little hit and miss though. I've had this procedure done twice. The first time it allowed me to regain my normal acitivites starting the day after the shot. My second treatment really didn't seem to do much at all. Usually you have to get a referral from another doctor to get the procedure. It will be done in a hospital or pain management clinic.

Another option I have not yet tried is something my doctor called a "Fast Block". Apparently it's an injection given more in the lower back/hip area, that numbs the nerve. I can't speak about it's effectiveness, but I did want to mention it as a possibility.

Finally, there is back surgery. I'm sure several options are out there, but the one most commonly mentioned is the one where they shave disk material away to stop the pressure on the nerve. It's a common enough procedure, but I definitely recommend it being used as a last option only. There are several significant risks to it, and the truth is, for one person it may give them back their lives, while for another person, it can turn into the worst decision they ever made. Surgery is no guarantee that the pain will diminish. In many instances, it can actually get worsened. If your doctor suggests surgery to you, definitely get as many second opinions as you can before pursuing it.

Physiotherary and alternatives.

Heat may be applied to areas that hurt. Make sure the heat source is not too hot, and never sleep with an electic pad on. Some professionals suggest also using ice treatments on the back itself to reduce inflammation. Given my own experiences, I must suggest caution when applying ice. At the suggestion of a chiropractor, I applied ice once to my back, which led to uncontrollable and exceedingly painful muscle cramps. If this happens to you, cease using ice, and only use heat.

Massages can be given by someone you trust, or even by yourself if you are able. Pressure should never be applied directly to the spine, nor should any back massage be overly strong. The purpose of any massage at this point is to loosen muscles and stretch the nerve. Massage should always be started lightly, increasing the pressure slowly over minutes until the "right" pressure is achieved. Any massage that causes pain should be avoided, lest the condition worsen again.

Visiting a chiropractor can relieve pain. It is not a cure however. There's a lot of debate about whether a chiropractor is of any real benefit, or could even be harmful. I have been a few times. The first time, I found this treatment immediately helpful for the pain, and my overall condition seemed to resolve quite quickly. By my last sciatic episode, the treatments were pretty much doing nothing. It's your choice if you'd like to try it. Maybe you'll get lucky and it will help. But it can be expensive, and have little value if it doesn't work. It is best to ask your doctor first if it's something you should consider.

Traction: After a couple of weeks, traction can be performed. This is easily done at home, if you have someone with decent strength or weight to help you. The sufferer should lie down on a pad on the floor. The knee should be bent, and the feet firmly placed on the ground. Now your partner will place a towel under your knees, and using their weight, slowly will start pulling the towel. DO NOT do this quickly or in a jerky fashion. It is normal to feel some stretching in the lower back and in the nerve. If it becomes painful, the method should be stopped, and tried again in a few days. Ultimately, your partner should be pulling on the towel for about 5 minutes, but this depends on your pain and their stamina. The technique can be repeated 3-5 a day.

Inversion table: If you can afford it, or know someone who is handy, it may be very worth it to try using an inversion table. It's a board that you lie on, that can pivot, so that your feet are higher than your head. They can be left free-swinging so you can do exercises on them, or locked into position so that you can release the pressure on your back. I have not yet tried this, but through some experiences I've had, I'm sure this would be a very helpful device, both to help an acute attack, and to prevent future ones. Here's a link to show you a model. Gravity Inversion Table.

Other techniques. I have heard of pressure points and acupuncture being used to help with the pain. I have not tried either of these. I see no danger in acupuncture, though I'm unconvinced it would help during my worse times. Pressure points could be problematic though. I have learned one pressure point on the nerve that can help somewhat, but for a full treatment at a clinic I have no idea how effective it would be. I'd also be worried about them placing too much pressure on some spot. If you would like to try this method, make sure to tell them that you are suffering from sciatica, and don't hesitate to ask any questions about the procedure so you know whether you should try it or not.

Stretches and Exercises:

There are several stretches and exercise that can help speed the recovery time with sciatica. They can also be used to keep you in shape to prevent a recurrance. When you do start doing the stretches, do not push yourself to pain. If you feel pain, you have either gone too far, or are doing a stretch you are not ready for. What you are looking to do is go to where you feel a small tightening of the nerve. The tightening can happen along the whole nerve, or more often in just one place, like the foot or back. Once you feel the tightening, that's where you hold the position for 6 seconds, or whatever the site recommends. Repeat each exercise 3-6 times (on each side if applicable) Breathe well and deeply when you are in the stretched postions. That is what will give you the most benefit. You may feel extra tightening when you breathe, but so long as it isn't actually painful, it's a good thing.

Personally, I liked to do my bunch of stretches at least 3 times a day when I was trying to recover, sometimes more when I felt up to it. But don't push yourself too hard at first. Just attempting to do one set of each recommended stretch is enough at first if you can't handle more. Take long breaks if you need to. And don't do these exercises on a bed. They must be done on the floor or on a mat. It's bad for you on a bed.

Some stretches are better for freshly aggravated nerves, others are better 1/2 way through the healing, others better when you are pretty much over the worst, and wish to regain your strength and prevent a recurrance. Below, I have listed the stretches that helped me most, but gauge for yourself whether you are ready for any of these exercises/stretches. Note: Do not attempt any stretches within the first couple of weeks after the onset of severe sciatica. This time should be spent resting.

Strengthening Exercises and Nerve Stretchers.

Positions to Relax Nerves and Muscles.

Instead of trying to remember all the exercises I can think of, I looked around on the net for a site with some, hopefully with pics. And I did find one.

http://www.spine-health.com/topics/conserv/Sciatica-Exercises/Sciatica-Exercises-Overview.html

On this page, it will say something like "exercises for sciatica from herniated disk", or from spinal stenosis, or other things. The exercises that helped me where the types included under "Exercises for Sciatica caused by Piriformis Syndrome" (despite the fact that they say it's because I have a herniated disk) Check out both the herniated disk and piriformis stretches, as well as the others too, to see what helps you.

Back pain exercises for the spine on video free provided by Back.com

On this page, you will find videos that will show you how to do the stretches.

Other General Tips:

When a person first aggravates their sciatic nerve, it is best to not try to force yourself to recover too quickly. The first 2 weeks or so should really be spent lying down and resting. You'll get enough of a workout going to the bathroom, and doing any other necessary activities like getting food, changing clothes, etc. For now, just try to relax, as that too will help calm the muscles and help your recovery.

When my nerve is aggravated, I find sleeping on my belly, sometimes with a pillow under it, the only way to prevent waking up in agony.

I'm unconvinced of the effectiveness of muscle lotions like A5-35, Bengay, etc, but they nonetheless can be helpful at night when you are trying to sleep. I find that feeling the burning of the cream distracts from the pain I feel under it.

Wear loose clothing, and try not to sleep with a heavy blanket or comforter.I find the weight or constriction can make the pain worse.

Don't let yourself get cold, or your feet either. You really should wear socks/slippers at all times. The cold causes the nerve to tense and the muscles can actually go into spasms from it.

After a couple of weeks, one should slowly start with stretches, and a little walking, but whenever the pain becomes intense, it's time to take a rest again. Walking is the best, and only, exercise you can do at this time. If it hurts as soon as you get up, then just do a quick trip to the kitchen (for example) and go lie down again. If you can last longer, great! But when the pain starts again, go rest immediately. Depending on you, the rest can be as short as a few minutes, or as long as a couple of hours. If you think you are able to walk around the block, then by all means, do it! It's the best thing. When you are able to remain upright for 10 minutes or more, it's a good time to do some light chores, to get your body used to the slightly different movements that they require. Just avoid bending or lifting heavy objects.

Bathing can relieve some of the muscular discomfort of the back and leg, as well as loosen the sciatic nerve itself. However, if this causes you more pain during or after the bath, it would probably be better to avoid until you can handle it better. For some a hot shower works well enough. I had mixed results myself when bathing or showering. The heat certainly helped, but the position aggravated my nerve too much.

At my worst, I used to have sponge baths. My husband would bring me some warm slightly soapy water, with a sponge or wash cloth, which we used to clean me. (He did the areas I couldn't reach.) When done, he would bring me warm pure water for rinsing. I know it sounds kind of primitive, but when you are laying in bed for weeks on end, any kind of cleaning is welcome!

Swimming is also a good exercise once you can handle doing so. Don't go into a pool that is too cold, as this can trigger spasms. Don't actually swim either, as you probably won't be ready for it yet. At first, the best is just to lounger around, allowing yourself to relax in the water. The water will take some of your weight off the back and nerve, to allow it to rest. If you are up to it, some light stretching exercises can be done. But take care not to over-exert yourself.

Avoid sitting in a chair. For most this puts pressure on the nerve, and can lead to a step back in recovery. When you are ready, think of sitting as an exercise in itself. Remember to sit with proper posture. Do it for brief periods. Should pain, tingling or numbness occur, leave the chair, and either walk, do some stretches, or lie down to relax your muscles and nerve. Please note that for many, sitting itself can be damaging enough to cause a full blown episode of sciatica. We simply weren't designed for long term sitting. Always sit with proper posture, take walking or resting breaks frequently, and refrain from sitting if back ache or sciatic pains present themselves.

When walking, sitting, or engaging in other activities during recovery, here's a tip that may be of some use. To maintain proper posture and ease the load on the spine and sciatic nerve, suck in your gut as much as you can. It can be a bit of a trick at first, but once you see the benefits, you will quickly get into the habit of doing it any time you are moving or exerting yourself. This can even be helpful during stretches and exercise. Just remember though that once in position, proper breathing is important, so relax the stomach to be able to breathe deeply.

When you feel you are getting quite a bit better, I have found a trick for bending to lift light objects. Lift one leg in the air when you are bending. It's a bit of a balancing trick, but it eases the load on your back, and limits the potential for over-stretching the nerve.

Always judge for yourself whether an exercise or tip is helpful. If it causes more pain, then don't do it. Ask your doctor or other health care provider for more tips or options if you need them.

Other practical tips: If the nerve is severaly aggravated, and you find you pretty much can't do anything on your own, don't be afraid to ask for help. At the very least, a friend or family member should come to check on you at least 3 times a day, more if possible. It also helps if they can set you up with a cooler filled with drinks and snacks. My husband even put tv dinners or leftovers in the cooler for when he was at work. He also placed the microwave fairly close so I could easily reach it, and heat up meals myself if I needed to. You will not be able to do regular chores during your convalescense. Don't even try to, as it will only make you worse. Have your partner, friend, family member help you with anything that is necessary.

Your mental health is also a priority during a bout of scaitica. The pain, sedentariness, and loneliness can take a great toll on a person. Many people suffer bouts of depression or anxiety during and even after this. I suffered from extreme anxiety brought on by my last and worst bout of sciatica, which required treatment with anti-depression medications to resolve.

To avoid this, do try to keep your mind active, and if possible, your hands. Watch tv shows and movies you like. Do crossword puzzles. If you have a laptop, then surfing the net or playing games can be extremely helpful. Write a novel. Get to that light hobby that you never had time for before. And keep a phone beside you, for contact and for emergency. Anything you can do to positively occupy your time will go a long way to keeping you from becoming emotionally distrought. I'm also a believer in touch therapy, so massages, or even just hand holding, are highly recommended.