- Sciatica Self-care: 5 At-home Remedies for Low Back and Leg Pain
- Sciatica Treatments and Home Remedies
- Pain Management Strategies for Sciatica
- How to Stretch Safely With Sciatica
- Using Over-the-Counter (OTC) Pain Medication Safely
- Steroid Injections
- Surgery for Sciatica
- Complementary Approaches to Sciatica
- The Alexander Technique
- 6 Sciatic Pain Relief Methods
- Nonsurgical Options
- Top 5 Home Remedies That Can Relieve Sciatica
- Sciatica pain vanishes after the sufferer takes rest for a stipulated time period. However, you can try some simple home remedies to get rid of the pain in no time.
- What Is Sciatica?
- Sciatica Remedy #1: Chiropractic Spinal Adjustment
- Sciatic Remedy #2: Acupuncture and Massage Therapy
- Sciatica Remedy #3: Stay Active
- Sciatica Remedy #7: Stem Cell Therapy
Sciatica Self-care: 5 At-home Remedies for Low Back and Leg Pain
People avoid the doctor for a variety of reasons. Maybe you’re unsure about how to use your health insurance or you don’t have any. Or perhaps you simply don’t like visiting the doctor and prefer an “ignorance-is-bliss” approach.
Whatever the reason, some sciatica symptoms truly warrant medical attention. In rare cases, delaying medical care could lead to or cause permanent nerve damage.
If you experience any of the following, please see your doctor as soon as possible:
- You have severe pain in your low back and legs
- You experience nerve-related symptoms, such as weakness, numbness, tingling, or electric shock-like pain
- Your pain doesn’t improve after 2 weeks
- Your pain gets worse, even when using at-home therapies
- You have loss of bowel and/or bladder control
Easing the extreme pain of sciatica doesn’t always require an extreme treatment approach. Relieving sciatic nerve pain at home with gentle exercise, ice and heat therapy, proper posture, and medication may go along way to speed your recovery. But the most important thing you can do for your low back and leg pain is to take it seriously—always call your doctor if you aren’t experiencing relief.
Sciatica Treatments and Home Remedies
Gentle stretching with the help of a physical therapist can help to alleviate sciatic pain. Getty Images
Treatment for sciatica — pain that occurs along the sciatic nerve because of compression — generally starts with home remedies such as stretching, and, if it doesn’t clear up on its own, progresses to other approaches, such as physical therapy, steroid injections, and, as a last resort, surgical interventions.
According to Shideh Chinichian, MD, a family medicine physician with Mercy Medical Group based in El Dorado Hills, California, some doctors prefer that you wait a few weeks before making an appointment to see if the pain of sciatica goes away on its own, because it will in many cases.
“The time to see an MD is after two or more weeks of severe pain,” says Loren Fishman, MD, an assistant clinical professor at Columbia Medical School and medical director of Manhattan Physical Medicine and Rehabilitation in New York City.
But you should seek immediate care “when weakness or intractable pain develops, or the numbness begins to ascend from the feet to the ankles toward the knees, or when there is a loss of bowel or bladder control,” says Dr. Fishman.
When you see a doctor for symptoms suggesting sciatica, you will be asked about the nature of your symptoms, when and how they started, and whether anything worsens or improves them. Your doctor will also assess your back, legs, and neurological function with some simple tests.
Arriving at a diagnosis of sciatica may require no more than that, but in some cases your doctor will also want you to have an imaging study, such as an X-ray, or test the functioning of your muscles and nerves using electromyography.
Pain Management Strategies for Sciatica
Once it’s determined you most likely have sciatica, you and your doctor will decide together how to treat it.
Initial treatment can include the following:
- Applying ice or warmth to the areas that hurt
- Stretching your hips and legs, particularly your hamstrings, the muscles on the backs of your thighs
- Avoiding sitting for long periods
- Seeing a physical therapist for assistance with stretching, heat or ice therapy, and exercises to strengthen the core muscles that support the spine
- Taking anti-inflammatory or analgesic medication, as recommended by your doctor
- Trying complementary therapies, such acupuncture or a method like the Alexander technique, which can improve overall body alignment
If these interventions do not help the pain, and imaging tests were not done earlier, Dr. Chinichian says a physician will likely consider ordering an X-ray to look for bone spurs that could be pressing on the nerve root, or an MRI to see if there is a herniated disk potentially causing the symptoms.
How to Stretch Safely With Sciatica
When stretching to help with sciatica, stretch only until you feel a gentle tension in your limb or other body part. Hold the stretch for at least 10 seconds initially, and build up to holding the stretch for at least 30 seconds. Don’t bounce as you stretch, and don’t hold your breath; breathe normally. (1)
An easy hamstring stretch for people with sciatica is to lie on your back, raise one leg in the air, wrap a towel or strap around the raised thigh or foot, and support your leg with the towel while gently straightening your knee. The leg on the floor can be bent or straight, whichever is more comfortable. You should feel a stretch along the back of your leg.
Another option is to sit on the edge of a chair with both feet firmly on the floor. Extend one leg and flex the foot, so the weight of your leg is resting on your heel. Keeping your back “straight,” gently rock forward on your sit bones so your navel moves slightly toward your leg. You should feel a stretch along the back of your leg.
When you stretch, do it with the goal of feeling better, not becoming more flexible or increasing your range of motion. Over time you may become more flexible and increase your range of motion, but these gains tend to happen slowly, with regular practice.
Pushing (or pulling) too hard in a stretch can cause tiny tears in your muscles, tendons, and ligaments, which will hurt and can cause you to become less flexible, not more.
Using Over-the-Counter (OTC) Pain Medication Safely
Over-the-counter anti-inflammatory drugs, such as Advil (ibuprofen) and Aleve(naproxen), can help ease the pain of sciatica, but overusing these medicines — taking too much at once or using them for prolonged periods — can have dangerous side effects, including damage to the lining of the stomach and even stomach ulcers. (2)
The pain reliever Tylenol (acetaminophen) can cause liver damage if you take more than 4,000 milligrams per day. When calculating your total daily intake, it’s important to read the labels of all the prescription and nonprescription drugs you take to determine which, if any, contain acetaminophen. If you’re not sure if a product contains acetaminophen, ask your doctor or pharmacist. (3)
The risk of liver damage from acetaminophen is also higher in people who drink three or more alcoholic drinks per day or have pre-existing liver disease. (4)
If you find yourself relying on OTC pain medication to relieve sciatica pain for weeks on end, see your doctor for an alternative plan to controlling pain.
For severe sciatica pain, a physician may recommend an epidural steroid injection, in which a corticosteroid medicine is injected near the spinal nerve roots. The relief from an epidural steroid injection can last for a few months or longer.
Surgery for Sciatica
Surgery can be highly effective for severe cases of sciatica. The type of surgery depends on what is causing the pain.
If it appears a herniated disk is pressing on the sciatic nerve, all or part of the disk can be surgically removed.
Another option to relieve pressure on the spinal cord or nerves is a laminectomy. This type of surgery removes the back section of a vertebra to enlarge the spinal canal.
“Referral for surgery can become an option when conservative methods have failed to improve symptoms affecting quality of life,” Chinichian says.
Complementary Approaches to Sciatica
Many Americans look to complementary approaches to relieve the symptoms of sciatica. Among the more popular modalities tried for musculoskeletal pain, including sciatica, are:
- A mind-body approach, such as hypnosis or yoga
- Practitioner-based approaches, such as the Alexander technique or chiropractic
- Whole medical system approaches, such as acupuncture (5)
Some of these approaches have been studied for the treatment of sciatica. A systematic review and meta-analysis of studies of acupuncture for treating sciatica, published in October 2015 in the journal Evidence-Based Complementary and Alternative Medicine, concluded that acupuncture may be more effective at decreasing leg and lower back pain than NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen. Acupuncture combined with pain medication also appeared more effective than medication used alone. And acupuncture also appears to be associated with fewer side effects than NSAIDs. Still, the number of studies in the analysis was small. (6)
Even approaches that have not been studied in any systematic way for sciatica may be worth a try, as long as there’s no reason to believe they might worsen your sciatica.
That being said, any complementary therapy must be approached with caution, with the costs of the treatment and potential risks clearly understood.
Supplements, in particular, can be risky if they interact with any prescription or nonprescription drugs you take.
Even normally safe activities, such as yoga — for which there is evidence of a positive effect on low back pain (7) — or Pilates, can worsen sciatica if pursued too vigorously or if poses that exacerbate the underlying cause of the sciatica are done. Speaking to a class instructor or physical therapist can help you to identify moves that shouldn’t hurt and may help. And as always, listening to your body is paramount during exercise. If something causes acute pain, stop doing it.
If you’re uncertain about the risks of a therapy, speak to your primary care doctor before giving it a try.
The Alexander Technique
The Alexander technique teaches people how to release unnecessary muscle tension so they can sit, stand, and move more comfortably.
Judith C. Stern, who became an Alexander technique teacher after working as a physical therapist for many years, says that physical therapy helped her clients with sciatica, but it wasn’t a long-term solution.
She says the Alexander technique addresses an individual’s body-use patterns, which include posture and tension habits. It teaches the pain sufferer strategies for using their mind-body connection in a positive way, Stern says.
The Alexander technique involves hands-on instruction, with the teacher gently moving or guiding various body parts while you are sitting, standing, walking, or lying on a table.
A study published in The BMJ looked at the effectiveness of the Alexander technique for long-term relief of chronic or recurrent back pain, and found that a series of 24 lessons in the Alexander technique taught by registered teachers continued to provide pain-reduction benefits a year later. A comparison group that had six Alexander lessons followed by an exercise prescription did almost as well as the group that had 24 lessons. The underlying cause of participants’ back pain is not specified, so it’s unknown how many had sciatica. (8)
Regardless, unlearning old habits of movement and learning new ones takes time and repetition. A typical rule of thumb is that it takes 10 to 30 Alexander lessons to achieve lasting change, and some people continue to take lessons beyond that.
“I think it’s the best-kept secret in the treatment of sciatica,” Stern says.
The sciatic nerve is the largest single nerve in the body. It is made up of individual nerve roots that branch out from the spine in the lower back and combine to form the nerve. When the large sciatic nerve is irritated or compressed at or near its point of origin, the area becomes inflamed, which can cause pain, weakness and numbness in the legs, buttocks and feet. Sciatic pain can vary from infrequent and irritating to constant and incapacitating.
Although regularly seeing a chiropractor for chiropractic care is the best way to treat sciatica, there are a few ways you can relieve the pain at home in the days leading up to your appointment, and/or when the pain flares up unexpectedly.
6 Sciatic Pain Relief Methods
1.Apply Heat or Ice
Heating pads and ice packs are a popular form of sciatic pain relief as they are relatively inexpensive and easy to transport. You may want to alternate between heat and ice treatments to see which brings you the most relief.
How to Apply Cold Therapy:
When you begin to feel the pain, wrap some ice in a towel and place it on your lower back for 15 minutes. The cold reduces local inflammation, and therefore, eases the sharp pain. If your skin begins to feel numb, remove the ice pack immediately.
How to Apply Heat Therapy:
Position an electric heating pad or hot water bottle against your lower back, buttock, or the back of your leg for 10 to 20 minutes. The heat dilates blood vessels, which increases the blood flow to the area and helps relax your muscles. Heat therapy helps relieve the pain and makes it easier to stretch or exercise after the treatment.
2.Stretch your Hamstrings
Simply resting for a day or two once your sciatica starts to flare-up does not make the pain go away. In fact, you should be doing the opposite and exercise to relieve the pain. Similar to applying heat therapy, stretching and exercising can increase blood circulation to the injured areas and help lessen your pain.
One of the best muscles to stretch to relieve sciatic pain is your hamstrings. When you do not stretch your hamstrings, they can become tight and inflexible, aggravating sciatic pain. An easy exercise to loosen up these muscles is called a seated hamstring stretch. Begin by sitting on the edge of a chair with one foot flat on the floor and the other leg straightened out in front of you, with the heel of the foot on the floor. Once in the position, lean forward, keeping your shoulders and head upright, until you feel a gentle stretch behind your leg. For a complete stretch, hold the position for 30 seconds.
3.Do Low-Impact Aerobic Exercises
Low-impact aerobic exercise can release endorphins and reduce the inflammation around your sciatic nerve roots. Simple low-impact aerobic exercise includes walking around your neighborhood or on a treadmill. Take short strides and keep an upright posture for the full benefit of the exercise.
4.Take Over-The-Counter Pain Medications
Over-the-counter anti-inflammatory medications that contain ibuprofen and naproxen can help reduce the inflammation of the nerve and lessen the pain. You should always speak to a healthcare professional about which over-the-counter medications you should take for your pain. It is also always best to follow the instructions on the label.
5.Give Yourself a Massage
Since it is most likely you won’t be able to get an immediate massage or chiropractic appointment, you can use DIY massage techniques to relieve the pain. One easy technique is to use a tennis ball. Simply lie on the floor and place the tennis ball under your buttock or upper thigh. Slowly roll your leg or buttocks over the ball until you find a tender spot to focus on. The gentle pressure from the tennis ball may provide relief similar to what you would get from a typical pressure-point massage. Stop the massage immediately if you feel sudden, sharp pain.
6.Try Mind-Body Techniques
Mind-body techniques, such as deep breathing exercises, meditation, guided imagery, and cognitive behavioral therapy, can help relax your muscles and possibly increase your sense of control over the pain.
Depending on what triggers your pain, all of these methods may or may not work for you. However, these methods are only meant to provide temporary relief to control the pain. For greater sciatic nerve pain management, speak to your doctor about chiropractic manipulation or read more about its benefits here.
Most people with sciatica get better in a few weeks with at-home remedies. If your pain is fairly mild and it isn’t stopping you from doing your daily activities, your doctor will first recommend trying some combination of these basic solutions.
Physical therapy. A physical therapist can develop a stretching and exercise routine for you, and also help improve your posture to take pressure off the sciatic nerve.
Stretching. You can help relieve your sciatica pain with lower-back stretches.
Exercise. Inflammation can improve when you’re in motion, so short walks can be a good idea. Your physical therapist can make sure your form is correct so you don’t injure yourself any further.
Limited bed rest. Three days off your feet usually does the trick, and it’s important to be on a firm mattress or the floor. After that, it’s best to return to your normal activities.
Hot and cold packs. Apply each for several minutes on your lower back, a few times a day. Cold packs first for a few days, then heat packs.
Alternative therapies. Many people believe that alternative therapies like yoga, massage, biofeedback, and acupuncture help with sciatica.
Medicines. Your first option should be over-the-counter pain relievers. Acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs) like aspirin, ibuprofen, and naproxen are very helpful, but you shouldn’t use them for extended periods without talking to your doctor.
If the over-the-counter options don’t help, your doctor might prescribe stronger muscle relaxants or anti-inflammatories. Tricyclic antidepressants such as amitriptyline (Elavil) and anti-seizure medications sometimes work, too. Steroid injections directly into the irritated nerve can also provide you with limited relief.
Top 5 Home Remedies That Can Relieve Sciatica
- Sciatica pain occurs due to irritation and compression of sciatic nerve
- Hot and cold compresses are a great way to get relief from pain
- Fenugreek seeds can do wonders in relieving sciatica pain
Sciatica pain occurs due to irritation and compression of the sciatic nerve. This condition is characterized by pain in the lower back which further extends to the legs. Pain in this condition can be extremely distressing, affecting the sufferers’ mobility in some cases. Remember that sciatica is not a medical condition in itself; it is symptomatic of an underlying health condition. There are other symptoms of sciatica, besides just pain in the lower back like slow reflexes, weak muscles and tingling sensations.
Sciatica pain vanishes after the sufferer takes rest for a stipulated time period. However, you can try some simple home remedies to get rid of the pain in no time.
1. Epsom salt
Healthy nerve function requires magnesium and one of the best ways to get access to it safely is with the help of Epsom salt. A combination of magnesium and sulphate, Epsom salt is easily absorbed by the skin pores. All you need to do is take a warm, soothing bath. Soak yourself in a bath tub, hot water with 2 cups of Epsom salt added to it. Keep your legs and lower back submerged in water for 20 minutes. Repeat this three times a week to see the difference.
Photo Credit: iStock
2. Hot and cold compresses
Hot and cold compresses are a great way to get relief from pain and inflammation caused by this condition. Heat will help by relaxing the tight muscles pushing the sciatic nerve. Cold compress, on the other hand, will help in reducing the swelling and numbing the affected area to reduce pain. You could use any one technique or alternate between the two to get relief.
Photo Credit: iStock
The perfect way of adding flavor to food and getting relief from pain is ginger. This home remedy is one of the most powerful natural nerve pain relievers. Ginger is one home remedy that works wonders for all sciatica sufferers. It is a great way of adding potassium to your diet (potassium deficiencies are known to worsen sciatica pain). You can have ginger tea, ginger juice or simply chew a few slices of ginger daily to get rid of sciatica pain.
Photo Credit: iStock
Turmeric’s anti-inflammatory properties make it a powerful home remedy for reducing sciatica pain. You can prepare a healthy drink by adding haldi to a cup of milk and also add a cinnamon stick to it. Sweeten it with a spoonful of honey. Drink this once or twice a day to see the difference. It is not recommended for people who are on blood thinning and diabetes medicines.
Photo Credit: iStock
5. Fenugreek (methi) seeds
Fenugreek seeds are loaded with anti-inflammatory properties and can do wonders in relieving sciatica pain if used correctly. Prepare a poultice of these seeds and apply on the affected area. Grind the seeds and add to milk, enough in quantity to make a thick paste when boiled. Apply on the affected area and leave it on for a few hours before washing it off. Repeat this daily till you feel the difference in pain.
Photo Credit: iStock
What Is Sciatica?
Natural Remedies for Sciatica Pain
The hallmark of sciatica is the throbbing sciatic nerve pain you experience in your lower back and/or legs. The sciatic pain can be constant or come and go. You’re likely to get sciatica pain when the spinal cord gets pinched or injured.
The sciatic nerves themselves are two nerves that arise in the lower back. One runs the entire length of each leg, which explains why you can experience sciatic nerve pain all the way down the length of a leg. The sciatic nerves are actually the longest nerves in the body.
The risk factors for sciatica include the following:
- Taller than average
- Sitting too much
- Work that subjects the worker to a lot of shaking or vibration
A sciatica attack is often excruciatingly painful, and accordingly people are often quick to seek the most drastic forms of sciatic pain treatment to get rid of their distress. Such measures include powerful (and sometimes addictive) sciatic pain medicine and surgery. But it’s worth knowing that there are less extreme forms of therapy that can provide sciatic pain relief, improve spinal health in general, and make future injury less likely. These medication-free holistic measures provide natural muscle relaxation and often produce an increased range of motion, lower stress, boost the immune system, and make re-injury or a new injury less likely.
Sciatica Remedy #1: Chiropractic Spinal Adjustment
There are different kinds of injury to the spinal column including herniated or ruptured discs and prolapse disc bulges. This damage can cause disc and/or spinal material to spill out beyond the vertebrae that should protect it. Similarly, tissue can separate from a disc completely, or disc material can be forced into the spinal canal. All these effects can produce sciatica and severe sciatic nerve pain.
A thorough medical examination possibly including X-rays and an MRI can determine exactly what kind of injury the patient has sustained. Knowing that, a chiropractor can work to realign discs to eliminate or prevent protrusions into the spinal canal.
Sciatic Remedy #2: Acupuncture and Massage Therapy
Although the mechanism by which acupuncture works is not fully understood by Western medicine, it sometimes works well to help sciatica and sciatic nerve pain. Some patients may worry that the needles employed in acupuncture will prove painful in themselves, but this is typically not the case.
Various types of massage therapy including deep tissue manipulation (AKA Rolfing) can also provide sciatica pain relief. They improve blood circulation and muscle tone, reduce inflammation, and release the endorphins that alleviate pain and improve a person’s mood.
Sciatica Remedy #3: Stay Active
Sitting for too long strains your back and leaves you vulnerable to sciatica. So get up and move around.
Regular exercise of any kind is good for you. But certain exercises and practices are especially beneficial for sciatica sufferers, so beneficial, in fact, that physical therapists treating patients with sciatic nerve pain often assign them. These may include the following:
- Light isometric exercises to relieve pain and improve strength in the patient’s spine and legs.
- Taking frequent breaks from standing or sitting.
- Specific stretches.
As a side benefits, these practices have a good chance of making you more aware of your body. If sciatic pain starts coming back, you’ll realize it sooner, know why, and know what you should do to avert the imminent attack.
Just remember not to overtax yourself lest you do more harm than good. Start any exercise program at a reasonable level and work up.
Sciatica Remedy #4: Stretching and Yoga
We’ve already alluded to stretching, and even when not specifically assigned by a physical therapist, stretching and yoga can work against sciatica pain. Slow, measured movement that lengthens the spine, stretches that gently curve the spine backward, and lying on the stomach can all be sources of sciatica pain relief.
Yoga can be especially effective for combatting sciatic nerve pain. It’s gentle, low-impact, and does a particularly good job of strengthening the core and spine while reducing inflammation and stiffness.
Sciatica Remedy #5: Heating pads
Some sufferers find that heating pads are useful for reducing sciatica pain. You can get them from many sources including pharmacies and online. For best results, follow these steps:
- Set the heating paid to low or minimum.
- Put the heating pad on your lower back and leave it there for 15 to 20 minutes.
- Allow at least two to three hours between uses.
Heating pads aren’t for everyone. For some people, cold therapy works better. If that’s you, use an icepack and otherwise follow the guidelines above.
Sciatica Remedy #6: Fight Inflammation
Inflammation makes sciatica pain worse and makes it more difficult for injuries to heal. You can fight inflammation by adopting these healthy habits:
- Don’t smoke.
- Make sure your diet includes plenty of the nutrients that promote healing.
- Get moderate regular exercise.
- Get several hours of quality sleep every night.
Sciatica Remedy #7: Stem Cell Therapy
For those for whom the remedies listed above prove insufficient by themselves, there’s stem cell therapy. Stem cell therapy is regenerative medicine that directly addresses the damage responsible for sciatica. It can relieve pain, reduce inflammation, and grow new healthy tissue.
As a bonus, it’s minimally invasive, and recovery time and the time spent in rehabilitation can be remarkably short.
Sciatica is leg pain caused by a pinched nerve in the lower back. Although the pangs begin in nerve roots located on either side of the lower spine, they then course through the sciatic nerve, which runs the length of each leg from the buttock down to the foot. The leg agony, called radiculopathy, “is often worse than the back pain,” says William A. Abdu, MD, medical director of the Spine Center at Dartmouth-Hitchcock Medical Center. Usually felt in one leg, the sensation “can be intolerable,” says Birgit Ruppert, a physical therapist at the Spine Center. “Some people liken it to the nerve pain you experience if you have a toothache.”
The most common cause of sciatica is a herniated disk: When a disk develops a tear or crack and bulges into the spinal canal, it can pinch the sciatic nerve. Usually, symptoms clear up within about six weeks, but for some people, the pain can last far longer.
Ready to start feeling better? Here are a few treatments worth trying.
Sixty percent of people with sciatica who didn’t get relief from other therapies and then tried spinal manipulation experienced the same degree of pain relief as patients who eventually had surgery, found a 2010 study in the Journal of Manipulative and Physiological Therapeutics. The 120 people in the study saw a chiropractor about 3 times a week for 4 weeks and then continued weekly visits, tapering off treatment as they felt better. In people who responded to chiropractic care, benefits lasted up to a year. “Spinal manipulation may create a response in the nervous system that relieves pain and restores normal mobility to the injured area,” says study researcher Gordon McMorland, DC, of National Spine Care in Calgary, Alberta. “It also reduces inflammation, creating an environment that promotes the body’s natural healing mechanisms.”
“You can get relief as soon as the first session, though it takes about 12 sessions to see improvement,” says Jingduan Yang, MD, assistant professor at the Jefferson Myrna Brind Center of Integrative Medicine at Thomas Jefferson University. A small study in the Journal of Traditional Chinese Medicine found that of 30 people with sciatica, 17 got complete relief and 10 saw symptoms improve with warming acupuncture, in which the needles are heated.
A study in the journal Pain reported that people with chronic back pain who practiced Iyengar yoga for 16 weeks saw pain reduced by 64% and disability by 77%. Although yoga’s effects on sciatica are less clear, gentle forms may be beneficial. By strengthening muscles and improving flexibility, a yoga practice can help sciatica sufferers “move and function better so they don’t fall into a posture that aggravates the sciatica,” says James W. Carson, PhD, a psychologist at the Comprehensive Pain Center at Oregon Health & Science University. For extra grip and stability, try these Natural Fitness Grip Socks ($13, bedbathandbeyond.com ).
Trigger Point Massage
Don’t expect a chilled-out spa massage if you have sciatica. In this instance, trigger-point therapy is best, says Jeff Smoot, vice president of the American Massage Therapy Association. The sciatic nerve sits underneath a muscle called the piriformis, which is located beneath the glutes. “When the piriformis muscle gets tight, it pinches the sciatic nerve, causing tingling and numbness down into the leg,” says Smoot. He applies pressure to irritated and inflamed areas, or trigger points, in the piriformis muscle, as well as in muscles in the lower back and glutes. Typically, Smoot schedules treatments 7 to 10 days apart. If patients don’t see progress by the fourth visit, “they need to try another form of therapy,” he says.
MORE: This Is The Pain-Relief Pillow Amazon Users Swear By For Better Sleep
St. John’s wort oil ($10, amazon.com), a liniment, is “one of my favorites for nerve pain,” says Tieraona Low Dog, MD, director of the fellowship at the Arizona Center for Integrative Medicine. Apply the anti-inflammatory oil two or three times a day where there’s pain. Another option: an OTC cayenne pepper cream ($17, amazon.com); capsaicin, found in chiles, hinders the release of pain-causing compounds from nerves. For severe cases, Low Dog uses the prescription chile patch Qutenza, designed for shingles pain. “One application is effective for weeks,” says Low Dog.
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Ice or Heat
Because the sciatic nerve is buried deep within the buttock and leg, ice or heat on the surface of the body won’t ease that inner inflammation. But the time-honored treatments can act as counterirritants—that is, “they give your body other input in the painful area, and that brings the pain down a notch,” says Ruppert. Apply an ice pack or a heating pad ($28, amazon.com) as needed for 15 minutes.
Dorling Kindersley/Getty Images
The herbal medication devil’s claw is “quite a potent anti-inflammatory, working like ibuprofen and similar drugs to inhibit substances that drive inflammation,” says Low Dog. She generally starts patients on 1,500 to 2,000 mg twice a day. Look for a brand that has a standardized extract of roughly 50 mg of harpagoside, the active compound. Safety reviews show that the supplement is well tolerated by most people but should be avoided by patients with peptic ulcers or on blood-thinning medications. (Find supplements you can trust here.)
Pain Relievers and Muscle Relaxants
Taking a nonsteroidal anti-inflammatory drug, either OTC (like ibuprofen) or Rx, can ease the distress. Because painful muscle spasms may also accompany a disk herniation, doctors sometimes prescribe muscle relaxants or pain-reducing tricyclic antidepressants. (Just don’t make any of these 13 common mistakes you’re making with your pain meds!)A caveat: “These won’t help with the pain caused by pressure on the sciatic nerve,” says A. Nick Shamie, MD, a spokesperson for the American Academy of Orthopaedic Surgeons.
Epidural Steroid Injections
People whose pain doesn’t lessen within about a month and who aren’t helped by other therapies may find their pain remedied by an x-ray-guided injection of steroid into the lower back near the sciatic nerve, says Raj Rao, MD, a spokesperson for the AAOS. “The hope is to reduce inflammation within that nerve branch,” explains Rao. Because of concerns about side effects, such as loss of bone density, the epidural shots are limited to three a year.
Exercise and Physical Therapy
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Moving is usually the last thing people dogged by sciatica want to do, but it’s important to be physically active. “Lying in bed makes it more likely that the pain will last longer,” says Ruppert. “Exercise increases blood flow to the disk and the nerve, helping to get rid of the chemicals causing the inflammation.” Take 15- to 20-minute walks. If that hurts too much, give swimming or water aerobics a try; there’s not as much pressure on the back when you’re in the water, says Ruppert. It may also be worth seeing a physical therapist, who can prescribe stretching exercises to restore flexibility to the back or moves that strengthen core muscles, helping to stabilize the spine and reduce the likelihood of a similar injury.
After 4 to 6 weeks of unremitting symptoms, patients may qualify for surgery. The Spine Patient Outcomes Research Trial found that those who had surgery for a herniated disk had greater decreases in pain and disability 3 months afterward than patients who did not. The benefits lasted up to 4 years.
Catherine Winters Catherine Winters has been an editor at numerous magazines, including Parents, Health and Good Housekeeping.