Say Goodbye to Sciatica Pain: Myths Exposed and Relief Tips

Aug. 16

Sciatica is a condition that affects millions of people worldwide, causing pain, discomfort, and even disability in severe cases. If you've ever experienced a sharp, shooting pain that radiates from your lower back down to your legs, you may be experiencing sciatica. In this blog post, we'll explore what sciatica is, its common causes, symptoms, and most importantly, how you can find relief.

Understanding Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.

The sciatic nerve is the longest nerve in the body, and it plays a crucial role in connecting the spinal cord with the legs and feet. When this nerve becomes irritated or compressed, it leads to the pain and discomfort associated with sciatica.

SYMPTOMS OF SCIATICA

Sciatica is often characterized by the following symptoms (1):

Lower Back Pain: A dull or sharp pain in the lower back that may radiate down the leg.
Leg Pain: Pain that starts in the buttock and travels down the back of the thigh and calf, and possibly into the foot.
Numbness or Tingling: A "pins and needles" sensation in the leg or foot.
Muscle Weakness: Weakness in the affected leg, which can affect mobility. Often the first muscle that is affected is your calf muscle leading to difficulty performing a calf raise
Movement Specific Pain: Pain that worsens with a specific type of movement, such as bending forward (more common in disc bulges) or prolonged walking (more common in stenosis).

COMMON MYTHS OF SCIATICA

Sciatica is a well-known condition, but it’s often misunderstood, leading to confusion and sometimes ineffective treatments. Understanding these misconceptions can help in properly managing the condition. Here are some common misinterpretations of sciatica:

1. Sciatica Is a Diagnosis

Myth: Many people believe that sciatica itself is a diagnosis.

Reality: Sciatica is actually a symptom of an underlying condition. It indicates irritation or compression of the sciatic nerve, but it doesn’t specify the cause. The actual diagnosis might be a herniated disc, spinal stenosis, or another condition affecting the sciatic nerve.

2. Sciatica Only Affects the Lower Back

Myth: Some think sciatica is just lower back pain.

Reality: While sciatica often starts in the lower back, it typically radiates down the buttock, thigh, and even into the lower leg and foot. The pain is usually felt along the path of the sciatic nerve and can vary in intensity.

3. All Leg Pain Is Sciatica

Myth: Any leg pain is immediately attributed to sciatica.

Reality: Not all leg pain is caused by sciatica. Conditions such as peripheral neuropathy, vascular disease, or even muscular injuries can cause leg pain. Proper diagnosis is crucial to identify sciatica specifically.

4. Rest Is the Best Treatment

Myth: Many believe that bed rest is the best way to recover from sciatica.

Reality: While rest can help in the initial stages, prolonged inactivity can actually worsen sciatica symptoms. Movement, gentle stretching, and physical therapy are often more effective in promoting recovery.

5. Sciatica Requires Surgery

Myth: Some people think surgery is inevitable for sciatica relief.

Reality: Most cases of sciatica can be managed with non-surgical treatments, such as physical therapy, chiropractic care, and lifestyle changes. Surgery is typically considered only when conservative treatments fail, and the pain is severe or disabling. Furthermore, while surgery may provide quicker short term relief, research shows that results are similar between surgery and conservative care (physiotherapy and chiropractic) one-year post operation (2)

6. Sciatica Is a Permanent Condition

Myth: Once you have sciatica, you’ll have it for life.

Reality: Sciatica can be a temporary condition. With proper treatment and self-care, many people experience significant improvement or complete resolution of symptoms. Relapses can occur, but they can often be managed with ongoing care.

7. Sciatica Is Only Caused by a Herniated Disc

Myth: A herniated disc is often assumed to be the sole cause of sciatica.

Reality: While a herniated disc is a common cause, sciatica can also result from spinal stenosis, piriformis syndrome, degenerative disc disease, or even trauma. Identifying the exact cause is essential for effective treatment.

8. A Herniated Disc Cannot Repair

Myth: There's a common belief that once a disc is herniated, it cannot repair itself and will cause permanent pain and disability.

Reality: While herniated discs can cause significant discomfort, they are not necessarily a permanent condition. In fact, most herniated discs can heal over time (3). The body has a natural ability to reabsorb the herniated portion of the disc. This process can reduce the size of the herniation and alleviate pressure on the affected nerves.

Additionally, many people with herniated discs improve with conservative treatments, such as physical therapy, chiropractic care, and proper exercise. These approaches can help strengthen the muscles supporting the spine, improve flexibility, and promote the healing process. In some cases, the symptoms of a herniated disc can resolve within weeks or months, allowing individuals to return to their normal activities without the need for surgery.

9. Chiropractic Care Is Dangerous for Sciatica

Myth: There’s a misconception that chiropractic adjustments can worsen sciatica.

Reality: When performed by a licensed and experienced chiropractor, spinal adjustments can be safe and effective in relieving sciatica pain by realigning the spine and reducing nerve pressure.

10. Over-the-Counter Pain Medications Are Enough

Myth: Some believe that taking painkillers is sufficient to treat sciatica.

Reality: While over-the-counter pain medications can help manage symptoms, they don’t address the underlying cause of sciatica. Long-term relief often requires a combination of treatments, including physical therapy, chiropractic care, and lifestyle modifications.

Common Causes of Sciatica

Several factors can contribute to the development of sciatica, including:

Disc: One of the most common causes, spinal disc becomes irritated or experiences significant trauma, it can cause the neighbouring nerve (in the low back this is generally part of the sciatic nerve) to become irritated.
Spinal Stenosis: This condition commonly seen in older people, involves the narrowing of the spinal canal, which can compress the nerves, including the sciatic nerve.
Piriformis Syndrome:The piriformis muscle, located deep in the buttocks, can sometimes irritate or compress the sciatic nerve, leading to sciatica.
Injury or Trauma: Accidents or injuries to the lower back or pelvis can damage the sciatic nerve.

How to Relieve Sciatica

Fortunately, there are several effective ways to relieve sciatica pain. Here are some approaches that our physiotherapy and chiropractic clinic recommends:

1. Physical Therapy

Physical therapy is a cornerstone of sciatica treatment. A trained physiotherapist can design a customized exercise program to strengthen the muscles supporting your spine, improve flexibility, and reduce nerve sensitivity.

2. Chiropractic Adjustments

Chiropractic care focuses on spinal health with a specialization in spinal manipulations. Manipulation, while not directly influencing the direct cause of the symptoms, can be beneficial in reducing the sensitivity and pain of the affected nerves and muscles. Through gentle spinal manipulations, a chiropractor can help reduce inflammation, improve mobility, and promote natural healing.

3. Hot and Cold Therapy

Alternating between hot and cold packs can provide immediate relief from sciatica pain. Cold packs can reduce inflammation, while heat can increase blood flow and relax tense muscles. Apply cold packs for 15-20 minutes, followed by a warm compress for 15-20 minutes.

4. Medications

Non-prescription pain relievers, such as ibuprofen or acetaminophen, can help manage the pain and inflammation associated with sciatica. If not providing significant pain relief, consider discussing your pain with a doctor as there are pain medications that are more targeted for nerve-related pain.

5. Ergonomic Adjustments

Making adjustments to your daily activities and posture can prevent further irritation of the sciatic nerve. Ensure that your work environment is ergonomically friendly, and avoid sitting for prolonged periods. Use a lumbar cushion for added support, and take frequent breaks to stand and stretch.

6. Mind-Body Techniques

Stress and tension can exacerbate sciatica pain. Techniques such as deep breathing, meditation, and mindfulness can help manage pain by reducing stress levels and promoting relaxation.

7. Consult a Specialist

If your sciatica persists or worsens, it's crucial to consult with a healthcare professional. In some cases, more advanced treatments, such as corticosteroid injections or even surgery, may be necessary.

Conclusion

Sciatica can be a debilitating condition, but with the right approach, relief is within reach. By understanding the causes and symptoms of sciatica and exploring various treatment options, you can take control of your health and alleviate the pain.

At Pursuit, we offer comprehensive physiotherapy and chiropractic care to help you manage sciatica and other musculoskeletal conditions. Our team of experts is dedicated to providing personalized care to help you achieve optimal health and well-being. If you're struggling with sciatica, don't hesitate to reach out and schedule a consultation. Together, we can create a plan that works for you.

References:

1. Jensen R K, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica BMJ 2019; 367 :l6273 doi:10.1136/bmj.l6273

2. Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: Evidence-based practice. Int J Gen Med. 2010 Jul 21;3:209-14

3. Zhong M, Liu JT, Jiang H, et al. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Pain Physician. 2017;20(1):E45-E52.

Dana Tostenson, MPT

With a passion for people and health, physiotherapy has been a natural fit for Dana.

He enjoys working with clients through a holistic approach; incorporating manual therapy, tailored exercise prescription, and evidence informed education to help his patients overcome their pain, improve performance, and enhance their overall health.

Victoria, BC physiotherapist Dana is excited to help people return to the activities they love, approaching any issue, big or small, with enthusiasm and compassion. As a former varsity athlete and now a recreational competitor, his passion for sports and performance optimization makes him a great fit for injured athletes or weekend warriors hoping to return to and excel in the game.

Dana is a graduate of the University of British Columbia (Masters of Physical Therapy), the University of Alberta (Bachelor of Science in Nutrition), and has completed his Transitional Doctorate in Physical Therapy. He has advanced training in Functional Dry Needling, joint manipulation, chronic pain management, nutrition, as well as vestibular and TMJ disorders.

Outside the clinic you can find Dana on the jiu-jitsu mats, taking in the island’s natural beauty, or tending to his admittedly too many house plants (which have now spilled into the clinic).