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How to cure sciatic nerve pain

In order to cure the inflammation of the sciatic nerve, which can also be called sciatica, an orthopedist or physiotherapist can recommend treatments and remedies such as exercise and sometimes physiotherapy.

The sciatic nerve is the largest nerve in the human body, being formed by several nerve roots that come from the spine. The sciatic nerve begins at the end of the spine, passing through the buttocks and back of the thigh, and when it reaches the knee it divides between the common tibial and fibular nerve and reaches the feet. The pain that emerges is felt along this path and can present itself in the form of a tingling sensation, stinging or electric shock.

When there is compression or inflammation of this nerve, sciatica arises and causes symptoms such as intense pain in the back, glutes or legs, difficulty in keeping the spine erect and pain when walking. In these cases it is important to seek an orthopedic doctor or physiotherapist so that he can recommend the most appropriate treatment.

Symptoms of sciatic nerve inflammation

If you think you may have an inflammation of the sciatic nerve, select your symptoms and find out what your chances are:

  1. 1. Tingling pain, numbness or spinal shock, gluteal, leg or sole of the foot.
    Yes
    No
  2. 2. Burning sensation, cracked or tired leg.
    Yes
    No
  3. 3. Weakness in one or both legs.
    Yes
    No
  4. 4. Pain that gets worse by standing too long.
    Yes
    No
  5. 5. Difficulty walking or staying too long in the same position.
    Yes
    No
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These symptoms are often associated with changes to the spine, such as herniated disc, spondylolisthesis or even arthrosis. This is why, when the first symptoms appear it is very important to see an orthopedist or a physiotherapist so that tests are performed and X-ray examinations of the spine are done to assess if there are changes and if so if there is nerve compression.

When the person exhibits other symptoms such as pinching or burning sensation and feels their legs tired and heavy, these types symptoms have no relation to the sciatic nerve, but is characteristic of the myofascial pain syndrome, which is often confused with sciatic nerve changes.

How to know if it is sciatica

The diagnosis of sciatica can be done by an orthopedist or physiotherapist based on the signs and symptoms presented. The test that identifies changes to the sciatic nerve can be done in a clinic and consists of: lying on your stomach and lifting one of your legs of the marquise in a stretched position, if there is pain or tingling, the test indicates sciatic compression. If there is pain in the other leg, this indicates a severe alteration of the spine, such as a herniated disc, for example.

Imaging tests such as X-rays and MRIs may be helpful in evaluating the spine, helping to identify what is compressing the nerve. If the results show that the spine is healthy and doesn't present changes the cause of sciatica can be muscular or fascia, and the treatment is relatively simpler.

When there is suspicion of nerve damage, which is very rare and usually only happens in the event of a serious accident, it may be necessary to perform an electroneuromyogram, which is an examination that evaluates the nerve function itself.

Treatments for sciatic nerve pain

How to cure sciatic nerve pain

Treatment for sore or inflamed sciatic nerve can be done with the use of painkillers, anti-inflammatory pills, ointments, use of heat patches and physiotherapy with specific exercises. The options are:

1. Medication

The medications most indicated to fight sciatic pain are Paracetamol, Ibuprofen or if you need something stronger the orthopedist may indicate Tramadol, which derives from morphine and Diazepan and is a muscle relaxant. But a more natural way of fighting pain is to take a vitamin B complex, as it improves the health of the body's nerves.

2. Massage

One of the best home treatments for inflamed sciatic nerve is a massage with moisturizing cream or essential oils because it can help to relieve pain and improve movement because it relaxes the muscles of the back, legs and buttocks, thereby decreasing nerve compression. The massage should be performed by a masseur or physiotherapist and does not exclude the need for treatment in a clinic.

3. Exercising

Resting worsens the pain as well as staying too long in the same position and so light workouts are welcome. Initially the most recommended exercises are stretching exercises that consist on lying with you belly up and hugging your legs, for example.

When the pain diminishes in intensity, after the first week of physical therapy, muscle strengthening exercises can be performed, such as: lying down on your belly, flexing the knees and tightening a cushion between your legs and working the back and spine, lying with your belly up, flex the knees and raise your hip and butt of the floor. These Clinical Pilates exercises are excellent options for curing sciatica because they can help to strengthen the abdomen and spine. Strengthening the abdomen is a great trick to protect the spine.

4. Physiotherapy

In most cases, the treatment of inflammation or sciatic nerve compression involves physical therapy sessions with devices that reduce pain and inflammation and are performed strengthening exercises and stretches and techniques to mobilize and stretch the affected leg, improving the blood supply to the sciatic nerve itself and normalizing the muscle tone of the glutes and leg.

It is also recommended to apply heat over the region that needs treatment and perform stretching exercises so as to relieve nerve compression. See other cautions and home treatment options to treat the sciatic nerve in Home remedy for sciatica.

Sometimes when these problems are associated with poor posture, the physiotherapist may also recommend performing a treatment called Global Postural Reeducation - RPG, in which the posture is corrected and the muscles responsible for postural changes are also stretched.

5. Diet

During a sciatic crisis one should prefer anti-inflammatory foods like salmon, garlic, onion, flaxseed, chia seeds and sesame seeds. But it is also important to reduce the consumption of foods that increase inflammation in the body, which are mainly processed meats such as sausage and bacon.

6. Alternative treatment

In addition, there are other options that can also complete the treatment, which include performing Acupuncture and Reflexology sessions for pain relief and discomfort. Another possibility is osteopathy, which consists of techniques that stretch the muscles, pulling in a way that pops the joints, being a good option to treat scoliosis, hyperlordosis and herniated discs that are usually involved in the cause of sciatica.

7. Spine surgery

It is only recommended in the most severe cases. For example, in cases of herniated discs that do not improve with all the treatments mentioned above. In these cases the surgeon may decide to remove the intervertebral disc and glue one vertebra to the other.

How to avoid sciatica

To prevent a new crisis of sciatica, you should:

  • Stretch the leg muscles and spine regularly;
  • Avoid sedentariness and regularly practice activities such as walking, Pilates or Hydrogymnastics that strengthen and lengthen muscles;
  • Try to keep your back posture correct even when sitting;
  • Always be within your ideal weight;
  • Keep your abdomen strong so as to protect the spine.

What causes sciatic nerve pain

Sciatic nerve pain occurs when the nerve undergoes compression, which is common when a person has lumbar disc herniation, especially between L4 or L5, a tightening of the canal where the spinal cord passes, a misalignment of a vertebra or when there is an increase of the tone and firmness of the gluteus, for example.

Women who practice physical activity in the gym and have a well-worked buttocks can have sciatica because there has been an increase in tone or even a gluteal contracture, specifically in the piriformis muscle.

About 8% of the world population suffers from sciatic pain. This is because in these cases the fibers of the nerve pass through the piriformis muscle, and when it is very tense or contracted, it compresses the nerve, leading to the appearance of pain in the form of numbness, shock or tingling sensation. 

Sciatica in pregnancy

During pregnancy it is common for the sciatic nerve to be affected due to rapid weight gain, belly growth and changes in women's gravity center, which can lead to compression of this nerve. When this happens, the pregnant woman should seek a doctor or physiotherapist to start treatment and minimize the symptoms. Treatment can be done with stretching exercises, hot patches and anti-inflammatory ointments to apply to the affected area.


Bibliografia

  • KISNER, Carolyn; COLBY Lynn Allen. Exercícios terapêuticos: Fundamentos e Técnicas. 6ª.ed. São Paulo: Manole, 2016. 439-448.
  • Mark Dutton. Fisioterapia ortopédica: exame, avaliação e intervenção. 2ª.ed. Porto Alegre: Artmed, 2010. 1134-1156.
  • SARTORI, Lourraine Simões; BASQUEROTO, Vanessa Penha. Os benefícios do pilates na reabilitação da hérnia de disco lombar. 1-6,
  • Lara, Fernanda Heemann. Efeitos do pilates na hérnia discal lombar. Projeto do Trabalho de Conclusão de Curso apresentado ao curso de graduação em Fisioterapia, 2011. Universidade do Sul de Santa Catarina.
  • NECTOUX, Valquíria Zorzi; LIBERALI, Rafaela. Método Pilates como recurso analgésico em pessoas com diagnóstico de lombalgia/lombociatalgia. Revista Brasileira de Prescrição e Fisiologia do Exercício. Vol.4. 20.ed; 196-202, 2010
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