How Do I Get My Sciatic Nerve to Stop Hurting?

Picture of Sciatica Symptoms

The sciatic nerve is the largest nerve in the body. It’s rooted in the lower back and extends through the rump, providing nerve endings through the leg.

Sciatica or sciatic nerve pain is centered on the lower back and can radiate down the leg to the foot, and the cause is usually from a ruptured disc in the spinal column that irritates or inflames the nerve. Bone, tumors, muscles, and infections can also cause inflammation of the sciatic nerve and the resulting back and leg pain.

One common cause of sciatica is a pinched nerve in the back, often resulting from a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis), which compresses part of the nerve. This compression leads to inflammation, pain, and often some numbness in the affected leg. Additional symptoms may include tingling or muscle weakness in the leg or foot or even trouble walking. The severity and type of symptoms can vary based on the location and extent of the nerve compression.

Bed rest has been traditionally advocated for the treatment of acute sciatica. But how useful is it?

To study the effectiveness of bed rest in patients with sciatica, a research team in the Netherlands led by Dr. Patrick Vroomen randomly assigned 183 such patients to bed rest or, alternatively, to watchful waiting for this period.

The results, reported in the New England Journal of Medicine, showed that after two weeks, 70% of patients in the bed-rest group reported improvement, as compared with 65% of the patients in the control (watchful-waiting) group. After 12 weeks, 87% of the patients in both groups reported improvement. The results of assessments of the intensity of pain, the aggravation of symptoms, and functional status revealed no significant differences between the two groups. The extent of absenteeism from work and rates of surgical intervention were similar in the two groups.

The researchers concluded that "among patients with symptoms and signs of sciatica, bed rest is not a more effective therapy than watchful waiting."

Other treatment options for sciatica nerve pain relief depend on its cause and include addressing the underlying cause.

• Transcutaneous electrical nerve stimulators (TENS units) are sometimes useful for more chronic forms of sciatica.
• A variety of low back conditioning and stretching exercises are employed to help people recover from sciatica.
• What medications are effective for sciatic nerve pain relief? Sciatica medications used in treatment include pain relievers, muscle relaxants, anti-inflammatories, and antidepressants.
  • Antidepressants actually can help in this setting by reducing pain perception in the brain.
  • Other medications that may be helpful include gabapentin (Neurontin) and duloxetine (Cymbalta).
• Cortisone medications, given orally or by local injection (epidural injection), can sometimes help relieve sciatica.
• Surgical procedures can sometimes be required for persisting sciatica that is caused by nerve compression at the lower spine.
• Sometimes, pain management specialists help with chronic sciatica conditions.

What is sciatica self-care? Keys to the management of acute sciatica include relief of pain and relaxing associated muscle spasms.

How can I relieve sciatic nerve pain at home? Home remedies for sciatica pain relief include:

• heat and cold pack administration,
• over-the-counter pain medications such as acetaminophen (Tylenol), naproxen (Aleve), ibuprofen (Advil, Motrin), and aspirin, and
• gradual exercises and stretching.

Physician specialties that evaluate and treat sciatica range from generalists to subspecialists. These specialties include:

• general medicine,
• family medicine,
• internal medicine
• emergency medicine,
• gynecology,
• orthopedics,
• neurosurgery,
• rheumatology,
• pain management, and
• physiatry.

Other health care providers for low back pain include physical therapists, chiropractors, massage therapists, psychologists, and acupuncturists.

• What are the best exercises for sciatic nerve pain relief? The best exercises for sciatic nerve pain relief include the piriformis stretch, knee-to-chest stretch, seated spinal stretch, cat-cow stretch, hamstring stretch, and pelvic tilts. These exercises help by stretching and strengthening the muscles supporting the lower back and hips.
• What are the best medications for sciatica pain relief? The best medications for sciatica pain relief include over-the-counter pain relievers such as ibuprofen, naproxen, or acetaminophen. Prescription muscle relaxants may help with muscle spasms, while antidepressants can be used for chronic lower back pain. In severe cases, steroid pills or injections might be necessary. Always consult a health care professional before starting any medication.
• How long should you take medication for sciatica? Medication for sciatica is typically taken for a few days to a few weeks, depending on the severity of symptoms and the type of medication. Always follow your doctor's specific recommendations for duration and dosage.
• What are the side effects of sciatica medications? Common side effects of sciatica medications include drowsiness, dizziness, dry mouth, constipation, confusion, leg swelling, nausea, and headaches. It’s important to consult a health care professional for personalized advice on managing such side effects.
• Are muscle relaxants effective for treating sciatica? Muscle relaxants are generally not considered effective for treating sciatica. While they may provide some relief from muscle spasms, they do not address the underlying nerve irritation causing sciatica. They only provide temporary relief by relaxing the tight muscles that are contributing to sciatic pain.
• Can chiropractic treatment provide sciatic nerve pain relief? Yes, chiropractic treatment can effectively relieve sciatic nerve pain by addressing the underlying causes. Chiropractors use spinal adjustments, soft tissue therapy, and stretches to realign the spine, reduce inflammation, and improve flexibility. Research shows chiropractic care provides lasting relief for many patients by taking a holistic approach to treating the root cause of sciatica. However, its effectiveness can vary widely depending on the individual and the specific cause of sciatica.
• Are there any over-the-counter treatments for sciatic nerve pain relief? Yes, there are several over-the-counter options for managing sciatic nerve pain, including:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to reduce inflammation
  • Acetaminophen for pain relief
  • Topical creams containing menthol or capsaicin
  • Lidocaine patches for targeted numbness relief
  • Applying heat or ice packs to the affected area

           However, if the pain persists or worsens, it's important to consult a doctor for proper diagnosis and treatment.

• Can massage therapy help with sciatic nerve pain relief? Yes, massage therapy can provide temporary relief for sciatic nerve pain. It can soothe tense muscles, which may reduce pressure on the sciatic nerve. Additionally, it can stimulate the release of endorphins, potentially increasing your pain threshold. However, it won’t treat the underlying cause of sciatica.