Sciatic pain, often referred to as Sciatica is a real pain in the bottom! Up to 40% of people could experience sciatic pain at some point in their lives. Due to this being a nerve based pain, it can be very severe and make walking, sitting and even lying intolerable.
So what causes this and how do we get the pain to stop.
What causes Sciatic Pain?
Sciatic pain refers to pain coming from the Sciatic nerve. This very large nerve starts in your lower back, runs through the glute muscle in your bottom and then travels on down the leg. Nerve pain can be tricky to treat and can last far longer than muscle based pains.
Anything that irritates the nerve can create sciatic nerve pain and the pain can be felt anywhere down the nerve line making it challenging to work out a cause. Let’s take a look at a few of the causes.
Lower back and Sciatic Pain
One of the most common reasons for Sciatic pain is disk issues in the spine. The pain may be felt in the leg, but the nerve originates in the spine and so the first place to look is in the spine. If the disks of your spine are being compressed for any reason, often due to weak spinal stabilisers, the disk can bulge and compress the nerve root within the spinal area.
This compression will irritate the nerve and create the symptoms of sciatica. To solve this we need to improve the disk health. Gentle back bends will often help the disk bulge, along with ice and spinal stabiliser exercises. The long term solution here is to strengthen the core and spinal stabilisers so the disk stays healthy.
Piriformus Syndrome and Sciatic Pain
Deep in your bottom is a muscle called the piriformis. This is an external rotator of your hip and works alongside other muscles such as your large gluteus muscles. However if there is imbalance in these hip muscles, the piriformis can become overworked, get larger (hypertrophy), or get tighter. The sciatic nerve runs directly under this muscle, in some unfortunate people it actually runs through this muscle. This makes it possible for the sciatic nerve to literally become squashed, creating pain.
A different approach is needed for this cause, and we would assess the firing patterns of the hip muscles to find the cause of the overworking piriformis. Once the muscles are working correctly again the sciatic pain will pass, though ice, sometimes heat, and stretching can help in the short term.
Does walking help Sciatic Pain?
This depends on the cause of the pain. The gluteal muscles are used in walking, so if the piriformis is the cause of the issue, walking may not help at all. If it is a spinal issue, walking can help as the spinal muscles tend to switch on when you walk, giving the vertebrae more support and allowing the disk to bulge in a different direction, offloading the nerve.
How do you get instant relief from severe Sciatic Pain?
As most sciatic pain is caused by disk issues, icing the lower back and performing gentle back bends or lying on your tummy and gently lifting your chest will often work wonders over a few days. If this makes it worse there is likely to be some level of degeneration going on in the spine and an MRI scan would be the best place to start.
What are the do’s and don’ts for sciatica nerve pain?
Generally sciatic pain is caused by inflammation, so as a rule, don’t use heat on it as this is likely to make inflammation worse. If you can try to ice for 10 minutes every hour. Try icing the lower back first and see whether that helps the symptoms. If you suspect your piriformis may be overworking and is too tight, you may find a heat pack helps in this area, but try ice on the bottom first to rule out any inflammatory reasons for the pain.
Also, as a general rule try not to lean forwards too much. As Sciatic pain is often caused by disk issues, leaning forward can make it worse. Try gentle back bends lying or standing and see whether that helps to relieve things.
Lying on your tummy can often give relief to sciatic pain as this helps to decompress the spine and relax the glute muscles.
If you are not getting any relief from the above ideas, it is time to seek advice. As mentioned above there are several causes of sciatic pain and each one has a specific need in terms of treatment. If you are unsure book on in and we can assess you to work out why you are getting this pain.
For more information on sciatic pains, take a look at the NHS website here. To understand how we treat back problems, take a look here
