Sciatica pain - Physiotherapy

Sciatica is painful. It starts in the lower back and runs down the leg. Sometimes, it’s mild, but it can be unbearable. It happens when the sciatic nerve is irritated or compressed. In India, many people suffer from it, especially those with sitting jobs, heavy lifting work, or aging-related issues.
 

What causes sciatica?

There are many reasons. The most common one is a herniated disc. When a disc in your spine slips out, it presses on the nerve, causing pain. Sometimes, bone spurs or spinal stenosis (spine narrowing) can also press on the nerve.

• Lousy posture is another reason. Sitting for long hours in the wrong position can trigger sciatica. Office workers, drivers, and even homemakers who sit in one place for too long can get it. Lifting heavy objects incorrectly can also strain the lower back.
• Obesity is also a significant factor. Extra weight puts pressure on the spine. This can lead to nerve compression. Here are some fast weight loss secrets that can help.
• Pregnant women sometimes get sciatica, too. As the belly grows, it shifts the body’s center of gravity, putting pressure on the sciatic nerve.
• In India, sitting on the floor for a long time, using heavy mattresses, or carrying heavy loads daily can also increase the risk.

Symptoms of sciatica

• sharp pain in the lower back, buttock, or leg
• tingling or numbness in the leg or foot
• difficulty standing up or walking
• weakness in the affected leg
• pain that gets worse while sitting or bending

Sometimes the pain is mild and disappears. But if it stays for weeks, it needs attention.

How physiotherapy helps

Physiotherapy is the best way to manage sciatica. It helps reduce pain, improve mobility, and prevent future episodes. It also strengthens the muscles, improves posture, and relieves nerve pressure.

Physiotherapy works in three stages:

1. Pain relief—In the beginning, the focus is on reducing pain. Hot and cold therapy helps. Ultrasound therapy or electrical stimulation may also be used. Gentle stretching exercises start at this stage.
2. Stretching and mobility—Once the pain reduces, stretching and mobility exercises begin. They help loosen tight muscles and improve flexibility. The physiotherapist will guide you on how to do them safely.
3. In the final stage, exercises are introduced to strengthen the core and lower back muscles. This prevents future problems and helps maintain good posture.

Physiotherapy also includes techniques like manual therapy, nerve mobilisation, and hydrotherapy. These help relieve stiffness and improve blood circulation. Posture correction is also an important part of physiotherapy. Many people unknowingly sit or stand in a way that puts pressure on their lower back. Learning the right posture from a physiotherapist can prevent sciatica from returning.

What are the complications associated with sciatica?  

Most individuals recover completely from sciatica. However, one potential complication is chronic pain that can persist over the long term. If a nerve is significantly damaged, it might result in chronic muscle weakness, such as a condition known as “foot drop.” In this case, nerve damage can lead to numbness in the foot, making regular walking challenging or even impossible. Sciatica may also lead to permanent nerve damage, causing a loss of sensation in the affected legs.

The best sciatica relief exercises are always to consult a physiotherapist before starting exercises. Here are some that help:

1. Pelvic tilt: lie on your back, bend your knees, tighten your stomach, and push your lower back to the floor. Hold for a few seconds, release, and repeat.
2. Knee-to-chest stretch: lie on your back. Bend your knees. Pull one knee to your chest. Hold for 20 seconds. Switch legs.
3. Cat-cow stretch - get on all fours. Arch your back like a cat, then drop your stomach like a cow. Repeat slowly.
4. Cobra stretch: lie on your stomach. Place hands under your shoulders. Push up, lifting your upper body while keeping your hips on the ground. Hold for 10 seconds.
5. For a seated spinal twist, sit on the floor with your legs straight for a seated spinal twist. Bend one knee over the other. Twist your torso towards the bent knee. Hold for 20 seconds. Switch sides.
6. For a hamstring stretch, sit on the floor, stretch one leg out, reach towards your toes, hold for 20 seconds, and switch legs.
7. Bridge exercise - lie on your back, bend your knees, and lift your hips. This strengthens the lower back and core.
8. Wall sits: Lean against a wall and slide down until your knees are at a 90-degree angle. Hold for a few seconds, then stand up. This exercise strengthens back and leg muscles.

These exercises help relieve nerve pressure and improve flexibility.

Lifestyle changes to prevent sciatica,

• Maintain good posture. Always sit with your back straight. Use a chair with proper back support. Avoid slouching.
• Avoid prolonged sitting. Take breaks every 30 minutes. Walk around, stretch, or stand for a while.
• Lift properly—never bend from the waist to lift heavy objects. Bend your knees, keep your back straight, and lift.
• Sleep on a good mattress - a medium-firm mattress is best. Avoid soft beds that sink in too much.
• Stay active - walking, yoga, and swimming help keep the spine healthy.
• Control weight - extra weight puts stress on the spine. Eat a balanced diet and stay active. Join TruePal’s weight loss program to manage your weight effectively.

Physiotherapy with TruePal at home

Getting regular physiotherapy can be challenging. Visiting a clinic takes time, and sometimes pain makes travel difficult. That’s why TruePal offers physiotherapy at home.

With TruePal, you can:

• get expert physiotherapists to guide you at home
• have personalised treatment plans
• do safe and effective exercises under specialist supervision
• avoid unnecessary travel and discomfort

Our physiotherapists help with:

• posture correction
• pain relief techniques
• customised exercise routines
• long-term management plans

Whether you have mild pain or severe sciatica, TruePal helps you recover in the comfort of your home. You get one-on-one attention, better results, and a faster recovery.

Surgical options for sciatica  

Surgery might be the most suitable choice when sciatica becomes severe. Typically, healthcare providers will not suggest surgery unless there are signs that nerve damage is occurring or likely to occur soon. They may also recommend surgery if you experience intense pain that inhibits your ability to work or perform daily activities, or if your symptoms do not show improvement after six to eight weeks of conservative treatment.

Surgical procedures to alleviate sciatica include:

1. Diskectomy. This procedure involves removing fragments or small pieces of a herniated disk that are compressing a nerve.  

2. Laminectomy. Each vertebra has a back segment known as the lamina (located on the side of the vertebra directly beneath the skin of your back). A laminectomy entails the removal of a portion of the lamina that is exerting pressure on spinal nerves.

When you see a doctor

Sometimes, sciatica becomes serious. See a doctor if:

• The pain lasts more than six weeks
• You feel weakness in your leg
• You lose bladder or bowel control
• Pain is unbearable

Ayurvedic and home remedies for sciatica

In India, many people try Ayurvedic treatments for sciatica. Some remedies include:

• Hot oil massage - massaging the lower back with warm sesame or coconut oil helps reduce pain.
• Herbal supplements - ashwagandha, guggul, and triphala may help reduce inflammation.
• Turmeric milk - Drinking warm milk with turmeric helps relieve pain.
• Fenugreek paste - applying a paste of fenugreek seeds on the affected area can provide relief.
• Panchakarma therapy - Ayurvedic detox treatments like basti (medicated enema) help in chronic sciatica cases.

Can sciatica be prevented?  

Some sciatica triggers can be prevented, while others may occur unexpectedly or for unknown reasons. Even for those causes that are not preventable, it is possible to lower your risk of developing them.

The following strategies can aid in preventing sciatica or lowering the likelihood of it occurring: 

• Maintain proper posture. Adhere to good posture practices while sitting, standing, lifting, and sleeping.  
• Cease (or avoid starting) the use of tobacco products. Nicotine from any source (including vaping) diminishes blood flow to your bones, which can weaken your spine and its components.  
• Achieve and maintain a weight that’s suitable for you. Your primary care provider can assist you in establishing a healthy eating plan and physical activity routine. Ensure you receive adequate calcium and vitamin D to maintain bone health.  
• Stay active. Physical activity can range from stretching to strength training. Enhancing core strength and flexibility can alleviate back pain. Other forms of exercise, like aerobic workouts, can also contribute to achieving and maintaining a healthy weight.  
• Safeguard yourself against falls. Wear properly fitting shoes and keep areas such as stairs and walkways free from clutter to decrease fall risk. Ensure that rooms are well-lit and that there are grab bars in bathrooms and railings on stairways.  
• Allow yourself time to recover when necessary. Avoid pushing through back pain, as this may result in more severe injuries. Back pain doesn’t have to prevent you from staying active; you can still engage in low-impact activities like swimming, walking, yoga, or tai chi.

Conclusion

Sciatica can be painful, but it is manageable. Physiotherapy is the best way to treat it naturally. Simple exercises, good posture, and a healthy lifestyle can prevent it. If pain persists, seeking medical help is essential.

With TruePal’s physiotherapy, you don’t have to suffer alone. Expert care comes to you, helping you recover faster and live pain-free. Listen to your body, take care of your back, and stay active. A pain-free life is possible with the right approach!

FAQs

1. Can sciatica happen abruptly, or can it develop gradually over time?

Sciatica can develop either suddenly or gradually, depending on its cause. A herniated disk or injury may lead to immediate pain, whereas issues like spinal arthritis or degenerative conditions typically progress slowly over time. 

2. Should I avoid activity if I'm experiencing sciatica?

Resting can be beneficial in the initial two days of experiencing sciatica. However, complete rest is often ineffective, as lack of movement can exacerbate pain and hinder recovery. The aim should be to strike a balance that allows for enough activity to keep you flexible and maintain strength while avoiding exacerbation of sciatica or risking injury. Consulting a healthcare provider can help you determine the right balance for recovery. 

3. What distinguishes sciatica from radiculopathy?

Radiculopathy is a more general term for symptoms resulting from a compressed nerve in the spine. Sciatica is the most prevalent form of radiculopathy.

4. How can I differentiate whether my hip pain is due to a hip problem or sciatica?

To differentiate between hip pain and sciatica, consider that hip issues, like hip arthritis, typically cause discomfort in the groin area or when bearing weight on the leg or moving it. If your pain originates in your back and travels toward your hip or leg, or if you experience numbness, tingling, or weakness, it is more likely due to sciatica.

5. When is it necessary to visit the emergency room?

Seek emergency medical care if you notice any muscle weakness, experience loss of bowel or bladder control, have severe pain that disrupts your normal activities and lasts more than a few hours, or if you suddenly experience intense pain, numbness, or any sciatica-related symptoms following a fall, car accident, or any significant injury.