Sciatica: What Is It & How to Relieve (with symptoms quiz)

Clinical review: Marcelle Pinheiro
Physiotherapist
September 2022

The sciatic nerve is the longest nerve of the body and it is made up of many nerve roots that come from the spine. The sciatic nerve starts at the end of the spine, passes through the glutes, goes down the back of the thigh, and then splits when it reaches the knee into the tibial and fibular nerves that go to the feet. Pain can be felt anywhere along this path way, and the pain can feel sharp, electric and tingling.

When there is compression or inflammation of this nerve, sciatica, or sciatic nerve pain, occurs. It can cause symptoms like intense pain at the bottom of the back, flutes or legs, difficulty keeping your back straight, and pain with walking. In these cases, it is important to see a doctor, orthopedic surgeon or physiotherapist to indicate the appropriate treatment for you.

To cure an inflamed sciatic nerve, you should follow treatment recommended by the orthopedic surgeon or physiotherapist, which may involve medication, exercises, and sometimes physiotherapy.

Main symptoms

The main symptoms that arise with sciatic nerve inflammation are:

  • Pain at the bottom of the back that radiates to the glutes or one of the legs;
  • Back pain that worsens with sitting;
  • Feeling of electric shocks or burning in the glute or leg;
  • Weakness in the leg on the affected side;
  • Feeling of tingling in the leg.

Many times, these symptoms are associated with abnormalities in the spine, like spondylolisthesis or even arthritis in the vertebrae. For this reason, when symptoms emerge, you should see an orthopedic surgeon or physiotherapist for assessment. They may recommend a spine x-ray to rule out another condition that could be compromising the sciatic nerve.

Online quiz to assess your risk for sciatica

If you think you may have sciatic nerve inflammation, report your symptoms below to assess your risk for sciatica:

  1. 1.Tingling pain, numbness or spinal shock, gluteal, leg or sole of the foot.
  2. 2.Burning sensation, cracked or tired leg.
  3. 3.Weakness in one or both legs.
  4. 4.Pain that gets worse from standing for too long.
  5. 5.Difficulty walking or staying too long in the same position.

How to confirm if it is sciatica

Sciatica diagnosis is confirmed by an orthopedic surgeon or physiotherapist based on the symptoms you are presenting with. The way it is usually confirmed in the office is by laying down on your back (on the floor or exam bed) and lifting one leg straight up. If you feel tingling, this represents compression of the sciatic nerve. If there is pain in the other leg, this means you may have a serious abnormality in the spine, like a herniated disc.

Imaging tests like an x-ray or MRI may be useful to assess the spine, and can help to identify what may be compromising the nerve. If the spine appears to be healthy and within normal limits, the cause of sciatica is usually muscular or tissue-related, and treatment is relatively easier.

When the doctor suspects that the sciatic nerve may be damaged, which rarely occurs (usually only in car accidents), he or she can order an electromyography (EMG), which is a test that evaluates nerve functioning.

How to relieve an inflamed sciatic nerve

The treatment for a painful or inflamed sciatic nerve involves the use of analgesic medication, anti-inflammatories in the form of pills or topical ointments, the use of hot water bottles and physiotherapy with specific exercises. The treatment options, in more detail are:

1. Medication

Medications indicated to treat sciatica are acetaminophen, ibuprofen, or stronger medications that are morphine-based, like Tramadol. Muscle relaxants and diazepam can also be prescribed by the orthopedic surgeon. A more natural way to relieve pain can be the use of Vitamin B, which improves nerve health throughout the body.

2. Massage

Massage with a hydrating cream or essential oils is one of the best home remedies for treating an inflamed sciatic nerve. It helps to relieve pain and improve movement by relaxing back, glute and leg muscles, which reduces any nerve compression. Massage should be completed by a registered massage therapist or physiotherapist, and should not replace other medical treatment. 

3. Exercise

Total rest or staying too long in the same position can worsen pain, therefore light exercise is welcome. Initially, the most recommended exercises is stretching that can be done in a lying position. You can lay on your back and hug your knees to your chest, for example. 

When pain starts to decrease in intensity, after the first week of physiotherapy, you can perform exercises that involve strength training. One example is: lying on your back, bend your knees up and squeeze a pillow between your knees. To work your back and spine, you can lay on your back, bend your knees up, and lift your bum up from the floor or bed. These are Pilates-based exercises to help cure sciatica, as they strengthen the abdomen and spine. Strengthening the abdomen is a great way to protect the spine.  

Check out some stretches for sciatica that you can use throughout the day to manage and prevent pain. 

4. Physiotherapy

In most cases, the treatment of nerve inflammation or compression involves the completion of physiotherapy session with equipment that reduces pain and inflammation. Strengthening and stretching exercises are also completed, as well as manual manipulation to mobilize and stretch the affected leg. This helps promote circulation to the affected sciatic nerve and normalize the leg and glute muscle tone. 

In addition, the application of heat to the affected area is also recommended, as well as stretches to elongate and relieve compression. Learn about other home remedies you can try to relieve your sciatic pain.

Sometimes, when these problems are associated with bad pasture, the physiotherapist can recommend a treatment called global postural reeducation (or GPR), which involves the correcting postures and stretching muscles that cause abnormal posture.

5. Diet

During a sciatica flare-up, you should opt to eat more anti-inflammatory foods, like salmon, farlic, onion, flaxseed, chia seed and sesame. It is also important to reduce intake of foods that increase inflammation in the body, which are mostly processed meats like sausage and bacon.

6. Alternative treatment

In addition, other options are available that can complement your medical treatment, like acupuncture and reflexology. Another option is to consult an osteopath, who uses techniques to stretch the muscles by popping the joints. This is a good way of treating scoliosis, hyperlordosis, and a herniated disc, all which can cause sciatica.

7. Spinal surgery

This approach is reserved for more serious cases, like when a herniated disc does not improve with the above treatments. In this case, the surgeon can opt to remove the disc and fix the vertebra to another.

How to prevent the pain from returning

To prevent a new sciatica flare-up, you should:

  • Perform regular stretches that elongate the leg and back muscles.
  • Avoid a sedentary lifestyle and engage in regular physical activity, like walks, Pilates, and water aerobics, which can help to strengthen and stretch the muscles.
  • Try to use correct posture, even when sitting.
  • Maintain a healthy weight.
  • Keep your abdominal muscles strong to protect your spine.

An anti-inflammatory diet can also help to manage swelling and prevent further flare-ups. Learn more about anti-inflammatory foods to incorporate into your daily diet. 

What causes sciatic nerve pain

Sciatic nerve pain happens when the nerve becomes compressed, which is common when you have a herniated lumbar disc, especially between L4 and L5. It can also happen with spinal stenosis, spinal misalignment, or with increased contraction or firmness of the glute muscles.

Women who work out at the gym and really focus on toning their bum can also experience sciatica, due to increased contraction or over-working of the glutes (specifically of the the piriformis muscle).

About 8% of the global population suffers from sciatica because their nerve fibers pass through the piriformis muscle. When this muscle becomes too tense or contracted, it compromises the nerve, leading to pain, numbness, electric shocks or tingling.

Inflamed sciatic nerve during pregnancy

During pregnancy, it is common for the sciatic nerve to become affected due to the rapid weight gain, belly growth and changes in the center of gravity, all which can lead to nerve compression. When this occurs, you should look for a doctor or a physiotherapist to start treatment and reduce symptoms. Treatment can be done with stretching, warm compresses and topical anti-inflammatories applied to the affected area.

See some safe ways you can relieve back pain during pregnancy

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Atualizado por Tua Saude editing team, em September de 2022. Clinical review por Marcelle Pinheiro - Physiotherapist, em September de 2022.

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Clinical review:
Marcelle Pinheiro
Physiotherapist
Physiotherapist degree provided by the University of Estácio de Sá (Brazil). Licensed to practice under CREFITO #170751.