Sciatica can be a pain in the butt - literally. Here's how to separate fact from fiction when it comes to this common form of nerve pain.
If you haven't felt the pain of sciatica, chances are you know someone who has. At least 40 percent of adults will experience sciatica at some point, according to the Cleveland Clinic.
Sciatica refers to a shooting or burning pain or numbness that can go from the lower back down the back of one leg, sometimes all the way down to the foot. The pain is a sign that there is pressure somewhere along your sciatic nerve, the largest nerve in your body.
Sciatica can be a real pain in the butt - literally. And it can keep you from doing things you love, so it's understandable to want a quick fix. Here are some myths and truths you'll want to know as you work on healing.
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Myth #1: Sciatica Is a Diagnosis
“Sciatica is actually a descriptor of symptoms rather than a diagnosis,” says David Woznica, M.D., M.S., director of clinical medicine at Vori Health, a virtual holistic health provider that offers an integrated approach to treating muscle and joint pain. “The origin of the problem can vary.”
Herniated discs and bone spurs are often to blame. Arthritis or spinal stenosis, a narrowing of the spinal canal, can also cause sciatica pain. It can also come from problems in the sacroiliac joint on the back of your hip.
Sometimes, there is no obvious cause of sciatica pain.
Myth #2: You Always Need to See a Doctor for Sciatica Pain
The truth? It depends.
If the pain is moderate and it’s not constant, Dr. Woznica says you can first try self-care measures like over-the-counter anti-inflammatory medicine, light exercise, and time. “The vast majority of cases resolve on their own in about three months or so,” he says.
If your pain is getting worse after a week or two of self-care, you may need more help.
“If you’re having severe, debilitating pain 24/7 and zero positions resolve it, then you’re probably going to have to see a physician or a good physical therapist for intervention,” Dr. Woznica says.
Myth #3: You Should Rest if You Have a Sciatica Flare-Up
You may think it's best to take it easy when you're in pain. But bedrest is not typically recommended for sciatica pain, Dr. Woznica says. Too much bedrest can weaken muscles and cause other problems, like constipation or blood clots.
“You want to find ways to still move while keeping your irritation to a minimum and not aggravating it,” he says.
These four daily stretches can help ease and prevent pain:
Clinical trials suggest the best course of action is to keep to normal activity as much as possible, according to a report from Harvard Medical School. But if something makes the pain worse, back off.
Myth #4: Surgery Is Often Necessary
For patients with moderate sciatica pain, seeing a surgical specialist isn’t usually necessary.
"If you go to a surgeon, you might get a steroid injection and surgery right away," Dr. Woznica says. But in many cases, the condition will improve without those measures.
An experienced physical therapist or musculoskeletal specialist can help you explore nonsurgical options first. Dr. Woznica says he typically prescribes a short course of an oral steroid followed by an anti-inflammatory medication to reduce inflammation.
"At the same time, I would recommend physical therapy," he says. "Because we want to get the tissue stronger around whatever's irritating you."
If your condition doesn’t improve with the combination of those measures, your doctor may recommend steroid injections.
When should you consider surgery for sciatica pain? If you are having unrelenting pain or numbness, if the pain is getting worse, or if one leg is getting weaker or smaller, these could be signs of more serious nerve damage. Surgery might be necessary to keep the nerve damage from becoming permanent.
Myth #5: Sciatica Pain Is an Unavoidable Part of Getting Older
It's true that your risk of sciatica pain goes up as you age. Other risk factors include obesity and jobs where you're lifting heavy things - or driving or sitting for long periods of time. Diabetes also increases the risk of nerve damage.
But sciatica is not inevitable, and there are measures you can take to help ward it off, says Dr. Woznica. For example, a physical therapist can help you strengthen weak areas that might make you more vulnerable to sciatica pain.
If you sit a lot, Dr. Woznica recommends doing this quick exercise every 30 minutes:
- Stand tall and put your hands on your lower back.
- Brace your core to support your spine and do a gentle backbend. (The movement is similar to a Cobra stretch for those who are familiar with the yoga pose.)
- Hold for a count of five.
- Release and repeat 10 times.
- Next, keeping your hands on your lower back, gently bend to your left 10 times, then bend to the right 10 times.
To protect your back when lifting objects, avoid twisting your body — and lift with your legs, not your back, Dr. Woznica says.
Myth #6: Sciatica Pain May Fade, But It’s Forever
When sciatica pain is severe, you might find it hard to imagine your life without it. Luckily, sciatica pain usually resolves itself, says Dr. Woznica.
"If you were stuck on a desert island with no doctors and nothing around, there's a good chance you would be fine in three months," Dr. Woznica says. "It's like the old saying: Time is the medicine, and the doctor keeps you busy until time takes care of it."
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