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Can Sciatica be Treated Without Drugs?

by Dr. Elizabeth Langer

Sciatica is form of peripheral neuropathy caused by irritation along the sciatic nerve. Pain may travel from the low back, into the gluteal region, and down past the knee. It is often described as sharp, burning, tingling, or numbness. Depending on the cause of sciatica, treatment and prognosis may vary.

The sciatic nerve is the longest nerve in the body. It begins between the fourth and fifth vertebra in the lumbar spine, travels through the gluteal muscles and down the back of the thigh. After passing the knee, it divides into two nerves: the tibial and peroneal nerve. The tibial nerve travels down to the feet to the heel and sole of the foot. The peroneal nerve travels along the side of the leg to the upper surface of the foot.

Anything that compresses or irritates the sciatic nerve can create pain. Common causes of sciatica include herniated discs, degenerative joint disease, spinal stenosis, and osteoarthritis. Joint restrictions or misalignment of the lumbar vertebra or sacrum may also irritate the sciatic nerve. The sciatic nerve may become entrapped by a muscle, such as the piriformis. Serious conditions which may cause sciatia may include spondylolisthesis, fracture, or inflammation due to an underlying pathology. Hormonal changes, such as with pregnancy, may also create irritation of the sciatic nerve.

In addition to the pain, sciatica may create weakness in the muscles supplied by the nerve. The pain usually occurs in one leg and is irritated by prolonged sitting or standing. Pain may be relieved by lying down and light exercise, such as walking. Pain may increase after coughing, sneezing, or having a bowel movement.

To ensure an accurate diagnosis, an MRI, CT scan, or a bone scan may be recommended. Blood work and urinalysis may also be administered to rule out potential inflammatory conditions or kidney pathology.

Common Treatments

Depending on the cause of sciatica, treatment will vary. Common allopathic remedies include rest, non-steroidal anti-inflammatory drugs, steroid injections, painkillers. Surgery may even be prescribed.

Though these remedies are fine for short-term use, for long-term management, problems may ensue. Rest is necessary for many ailments. It promotes healing and allows the body to recover. However, too much rest can create stiff joints and muscles, contribute to poor posture, weight gain, and decrease energy - making sciatica symptoms worse. Pain medication can help to make it through the day and ensure a better nights rest. However, pain medications should only be used temporarily. NSAIDS can create digestive problems, gastrointestinal bleeding, difficulty breathing, and may be linked to stroke. Pain killers can cause symptoms such as nausea, constipation, and may facilitate addictions.

Surgery is only effective 50% of the time and should only be used as a last resort. The problem with surgery is that it can sometimes make the symptoms of sciatica even worse. Too often, patients come for acupuncture or chiropractic care expecting to be relieved from surgical complications, but it can be very difficult to repair damage after bones have been cut, ligaments and tendons torn, and metal objects have been implanted.

Other remedies may include exercise, physical therapy, acupuncture, and chiropractic care.

Acupuncture for Sciatica

Acupuncture is a gentle and powerful method for resolving sciatica. It stimulates the nervous system and helps to heal and repair damaged nerves. Acupuncture is especially effective to relieve the burning, sharp, and shooting pain associated with sciatica.

There are many different treatment options available when treating any type of nerve pain. Some practitioners find success when applying needles along the affected nerve, while others have better results when using points which are more distally located. It all depends on the practitioner and patient.

Some practitioners may use adjunct therapies in addition to needles such as electrical stimulation, moxabustion, Tui Na, and cupping.

Chiropractic and Sciatica

Chiropractic care mobilizes joints, loosens muscles, and takes pressure off of the sciatic nerve.  Not only does it help to correct improper posture and misalignments, it stimulates the nervous system, fights inflammation, and helps to ensure proper circulation.

Depending on the cause of sciatica, symptoms usually resolved within a few weeks. Often, a chiropractor will recommend other modalities such as ultrasound, exercise, or electrical stimulation. It is important that patients follow their treatment plans and stay active in order to ensure that their pain is resolved and their symptoms do not return.

Exercise and Physical Therapy for Sciatica

In many cases of sciatica, stretching and strengthening the muscles in the back and hamstrings can take the pressure off of the sciatica nerve. Practicing yoga can be a wonderful form of sciatica relief.  Yoga poses, or asanas, facilitate motion in the joints of the spine and loosen tight hips, hamstrings, gluteal, and piriformis muscles. 

Sometimes people need a little extra help and physical therapy can be the solution for people suffering with sciatica.  A good physical therapist can help to monitor the progress of the patient, show different exercises, and ensure proper alignment.  Some physical therapists may offer soothing modalities such as ultrasound, electrical stimulation, ice and heat.  A good physical therapist can help patients with their exercises on a regular basis and prevent injury from reoccurring. 


Complications and Warnings

Treatment for sciatica is affected by the existence of pre-existing conditions such as diabetes, cancer, and autoimmune disorders. Sometimes health care practitioners forget to take these matters into consideration and may be too quick to recommend surgery or addictive pain medication.

Though usually not dangerous, there are instances when the pain due to sciatica warrants immediate care. Inform your health care provider immediately if there is complete loss of sensation or the if the pain is unremitting. If pain is experienced after a fall or injury, or occurs with a a fever, go to the emergency room. A complete loss of bladder and bowel control may indicate cauda equina syndrome and should be evaluated immediately.

Sciatica is often treatable and conservative methods should always be attempted before using more invasive procedures. Acupuncture and chiropractic care are both powerful methods in resolving sciatica, but there are many natural options available.