Sciatica (Pinched Nerve) - FAQ

A: There is some evidence that sciatica may respond to chiropractic treatment. Chiropractic care adjusts the spine to treat spinal mobility and restore alignment, and thus improves function and decreases pain. However, it may not be appropriate for radiating pain.

A: There is mixed evidence that acupuncture is beneficial for back pain. For some people it helps, while in others it does not. Studies indicate that there is potential benefit in using acupuncture to treat pain in general and treatment under a licensed professional is generally effective, safe, and well-tolerated.

A: Although a massage is unlikely to solve the underlying cause of sciatica, studies suggest that it can temporarily relieve symptoms. Getting a massage eases muscles that are tight and putting pressure on your sciatic nerve. A massage also stimulates the release of endorphins, which increases your threshold for pain.

Before starting massage therapy, do speak to your doctor to make sure a massage is safe for you.

A: It is important to maintain appropriate levels of activity if you have sciatica. This includes stretching the lower back by doing:

• Knee-to-chest stretches
• Standing hamstring stretches
• Pelvic tilts
• Bridges
• Lying glute stretches

Not all these exercises are suitable or work for everybody, so it is important to talk to your doctor or physical therapist on which are the best exercises for you.

A: Most episodes of sciatica get better within 6 weeks with rest and medication. See your doctor to assess the severity of your problem and get advice on how best to manage it.

A: Sciatica can occur during pregnancy due to changes in the body as it prepares for childbirth. Muscle changes, the baby’s weight and shifts in the body’s centre of gravity can cause the sciatic nerve to become pinched. The sciatica almost always goes away after pregnancy.

A: Sciatica pain is caused by pressure on the sciatic nerve, which runs from the lower back down through the hips, buttocks and back of the leg. When you run, all the muscles you use are attached to this nerve, which can potentially make sciatica pain worse.

Whether running is suitable or not will depend on your condition and its location, cause and severity. It is best to speak with your doctor or physiotherapist for advice on how best to proceed.

If you do run when you have sciatica, take some precautions to minimise the pain:

• Be sure to warm up and cool down before and after a run.
• Take time to stretch well, giving special attention to the hip flexors and glutes.
• You can also adjust the intensity and duration of your run.
• Consider heat and cold therapy to help relieve pain after running and reduce inflammation.

A: Depending on the cause, most episodes of sciatica typically resolve in a few weeks with simple at-home remedies. This includes some days for rest before moving on to appropriate exercise and stretching. Heat and cold therapy as well as pain medication can also help to ease symptoms.

A: Sciatica pain is caused by pressure on the sciatic nerve, which runs from the lower back down through the hips, buttocks and back of the leg. When you sleep, certain sleeping positions can place the nerve under pressure and tension, causing pain. To reduce the discomfort, try to sleep in a position that maintains the natural alignment of the spine so that the nerve is not pinched.

You can try sleeping on your side. Consider placing a right-sized pillow to fill the space between your waist and mattress or a pillow between the knees to keep the hips and spine in a neutral alignment.

If you sleep on your back, consider using a pillow or rolled-up towel under the knees or back so that the curve of the back and neutral position of the hip are maintained.

When it comes to your mattress, a medium to firm mattress is best to maintain good spinal alignment.

A: For the treatment of sciatica, you may see different types of specialists, depending on the nature of your condition. This may involve orthopaedic doctors, neurologists and physiotherapists.

A: If you have sciatica, you should not sit for long periods of time. Try to stand up and move around every 20 minutes to prevent too much pressure from building on your back, buttocks and legs. You should also ensure that your chair provides good support.

When sitting, be mindful of your ergonomics:

• Ensure your hips and knees are bent at a 90-degree angle.
• Place your feet on the floor.
• Consider supporting the small of your back with a cushion to maintain the normal curvature of the spine.
• Do not cross your legs.

A: A magnetic resonance imaging (MRI) scan is not always necessary to diagnose sciatica, but it can be used to assess the anatomy of the spine. An MRI scan provides detailed 3-dimensional views of spinal bones and tissues, and is particularly good at picking up problems where the nerves are being pinched.

However, no single imaging technique is 100% accurate and each has its limitations. An MRI is done with the patient lying on their back (supine). In this position, the spine is not loaded in the same way as when it is upright. Some nerve impingements only occur in the upright position, and the MRI scan might miss those.

A: Most episodes of sciatica resolve in a few weeks. To ease symptoms, you may consider taking painkillers or muscle relaxants. In some cases, a steroid injection can help reduce the inflammation that is putting pressure on the sciatic nerve.

Other remedies include stretching, massage, or heat and cold therapy.

A: Sciatica pain is caused by pressure on the sciatic nerve, which runs from the lower back down through the hips, buttocks and back of the leg. If the pressure presses on the nerves that are responsible for bowel control, it can lead to incontinence or constipation. This condition is known as cauda equina syndrome.

Cauda equina syndrome is a surgical emergency. If you experience pain, numbness, tingling or weakness in one or both of your legs, and if you lose control of your bowels or bladder, seek medical attention immediately.