Five tips for managing sciatica
By Dr. Joshua Kiely, DC
If you’ve ever felt hot lightning zip down the back of either leg, you might have felt sciatica. Between 13 - 40% of people will deal with sciatica at some point in time. As a chiropractor who sees patients suffering from sciatica every week, I’ve provided my top 5 tips that might help when dealing with sciatica.
Sciatica refers to the symptom of leg pain specifically in the distribution of the sciatic nerve. The sciatic nerve is one of the biggest nerves in the body and starts in the lower back and travels all the way down the back of the leg. Sciatica is often described as a one-sided sharp or shooting pain that can travel all the way to the toes or may stop anywhere between the back and the ankle.
Sometimes sciatica pain is accompanied by weakness, numbness, or tingling. In the most severe cases there can be changes in bowel and bladder function or numbness through the groin area. If you ever experience either of these symptoms it is best to seek emergency care as quickly as possible because these can be signs of a rare but serious condition called Cauda Equina Syndrome.
There are many causes for sciatica.
My first experience with sciatica pain actually came after getting a case of the Shingles during a particularly stressful period of my school life. I had lingering leg nerve pain and strange skin sensations for a few weeks after going through a cycle of antivirals for Shingles. This is a rather unusual cause of sciatica - my chiropractic patients typically describe an episode of low back pain or hip pain that slowly progresses to sciatica symptoms and becomes more intense over the course of a week or two.
Sciatica can be mild and transient, other times it can be absolutely hellish and feel like it’s never going to go away. Before trying out any of these tips, I recommend that anyone suffering from sciatica symptoms get checked out by a professional who can assess and investigate the causes and severity of the sciatica issue. Professionals well-qualified to investigate sciatica include chiropractors (pssst… I know a guy), physiotherapists, and family doctors.
The five tips.
Tip 1: Sometimes rest is necessary.
If you’ve ever seen me in person in Ottawa, you know I am a huge advocate of movement playing a huge role in reducing pain and improving function. Sciatica is one of the conditions that I occasionally recommend some rest instead of pushing through pain.
When the sciatic nerve is irritated, the pain can be nearly unbearable, and sometimes it is better to use short bouts of rest to reduce the pain before trying to continue in our normal activities.
Tip 2: As soon as we can, let’s get moving again.
The research is clear that movement and exercise can provide enormous physical and mental health benefits. Sciatica may change the activities that are comfortable to perform, but making modifications to ensure we keep moving can drastically improve how we feel and our overall health.
I’ve had chiropractic patients comfortably walk, bike, and swim despite ongoing sciatica issues. The key is paying attention to our body, modifying activity to not increase pain, and managing the activity dosage so we don’t leave ourselves bedridden the following day. To learn more about exercising with pain check out this article.
I found walking to be very uncomfortable when dealing with my sciatica symptoms but I actually found that I had less pain for several hours after only 30 minutes of cycling. Eventually my symptoms improved and went away, but it was great to know that I could still keep moving and get temporary relief through cycling.
Tip 3: Time is on your side.
When something hurts like hell, it can be easy to think the pain will never go away. Thankfully, the research tells us a different story: time is on our side when dealing with a sciatica issue.
Most patients improve over the course of several weeks regardless of the treatment intervention they use. This does not mean that nothing works, instead it’s an optimistic view that there are different treatment options available for different people, all with the understanding that we are managing pain and modifying activity so that time can play it’s crucial role in helping us overcome pain.
Tip 4: Do whatever it takes to get some sleep.
By far, the biggest issue (after terrible pain of course) that my chiropractic patients describe during an episode of sciatica is the lack of sleep. When their leg is throbbing at two in the morning, it can be hard to be optimistic that recovery is on the way.
Some simple solutions I’ve had Ottawa patients use with success include:
Engaging in light physical activity shortly before bed that reduces pain. For example, if walking usually provides some relief, try a 20 minute walk close to bedtime so that you can go to sleep more comfortably.
Try a mattress-topper or sleeping on a harder bed. Trying a different mattress or even sleeping on the floor can occasionally be a modification that provides some relief during the night.
If sleeping on your side, place a pillow between the knees. If sleeping on your back, place a pillow under the knees.
Talk to your family doctor about medication options for managing pain so that your sleep isn’t as negatively affected.
Tip 5: Hands-on pain management options.
Hands-on pain management options otherwise known as “conservative care” encompasses a broad array of options, some of which include:
Spinal-manipulation therapy
Deep-tissue or relaxation massage
Acupuncture
Guided exercise program
Heat or cold therapy - including warm baths or ice packs.
After an assessment and discussion with your chiropractor or physiotherapist, you can often find a combination of pain management options that will keep you comfortable while you heal.
Hands-on conservative options can be a great tool to help avoid stronger medications or more invasive interventions such as injections or surgery (these things absolutely have their place in the management of certain sciatica issues but are rarely our first line of treatment).
Final thoughts.
As a chiropractor in Ottawa I see many people suffering from sciatica looking for help on their journey to full health and function. There’s nothing better than watching patients competing in their sport again, picking up their kids again, or making it through the workday comfortably without worrying about their sciatica issues.
Regardless of what you’ve tried in the past, there are almost always options to help manage pain and improve sciatica symptoms. I’ve even been to mobile chiropractic visits in Kanata, Carp, and Stittsville to help patients who were in so much pain they could hardly leave their house, and we’ve found ways to get them up and moving again, well on their way to full function.
