Sciatica
Sciatica
Soothe Hot Needles of Pain
If you have sciatica pain, it hurts to stand. It hurts to sit. You can't even lift a half-gallon of milk without hot needles of pain shooting down your leg. And you're wondering what started it all.
Sciatica pain actually starts in your spine, says Leena I. Kauppila, M.D., a visiting researcher at Harvard Medical School. "The most common cause of sciatica is compression of one of the nerves in the spine," she explains. The nerve, which normally carries electrical impulses from your spine to your lower limb, has been pinched, squeezed or otherwise irritated. And the pain that you feel is the nerve's humble attempt to get somebody, somewhere, to figure out what's wrong and get the problem fixed. (It rarely affects both buttocks or both legs at the same time.)
Sometimes chemicals naturally produced by your body in response to an injury in your lower back will irritate a nerve, says Carol Hartigan, M.D., a physiatrist who specializes in spine rehabilitation at the Boston Back Center of New England Baptist Hospital and New England Spine Center, also in Boston. Other times, the gel-like contents of one of the circular disks of your spine will leak--frequently as a response to an injury--and press on a nerve.
In women over age 50, normal aging of the spine may cause bony projections to pinch or irritate a nerve, says Dr. Hartigan.
Or arthritis of the spine may pinch or irritate a nerve, says Mary Ann Keenan, M.D., chairman of the Department of Orthopedic Surgery at the Albert Einstein Medical Center in Philadelphia.
STRETCH IT, CINCH IT, ICE IT
Fortunately, sciatica pain usually disappears on its own within a month, says Dr. Hartigan. But a month is a long time to spend in pain. So meanwhile, here's what women doctors say that you can do to ease your discomfort.
Take a shower, then stretch. If a muscle strain, muscle spasm or other lower-back injury is responsible for sciatica, head for the shower, says Dr. Keenan.
Hold on to a grab bar or other sturdy structure so that you don't fall, then let the warm water run down over your body for five to ten minutes, with your back to the spray. As it does, gently lean forward from your waist until you reach a point just before it hurts. Hold that position for several seconds, says Dr. Keenan, then slowly straighten your body. Stand upright for a couple of seconds, then slowly lean back from the waist until you reach a point just before it hurts. Hold the position for several seconds, then slowly straighten once again.
Repeat the same gentle stretching movement to each side, says Dr. Keenan. By the time that you're finished, chances are good that you'll have quelled any muscle spasm that could be responsible for your pain.
Don't linger too long in the shower, and don't soak in a hot tub or bath or use a heating pad for longer than 30 minutes, cautions Dr. Keenan. Too much heat can actually exacerbate your pain by increasing swelling.
Try a gel pack. To help reduce pain and inflammation, Dr. Hartigan recommends applying a cold gel pack every few hours to whatever area hurts--your back, buttock or leg--for 10 to 15 minutes at a time. Gel packs are available at drugstores. (In a pinch, you can susbstitute a cold towel, soaked in ice water.)
Make a natural cushion. Buy a waist-cinching elastic back support from your local drugstore or medical supply house, says Dr. Keenan. The cincher pushes in your abdomen, which makes an internal cushion of air that soothes and protects nerves around your spine.
When To See A Doctor Sciatica pain that lasts longer than four weeks should be checked by a doctor, says Carol Hartigan, M.D., a physiatrist who specializes in spine rehabilitation at the Boston Back Center of New England Baptist Hospital and the New England Spine Center, also in Boston. It's rare, but if the problem turns out to be a herniated disk, your doctor may recommend a trial cortisone injection or even surgery to relieve pressure on a nerve. And by the way, spinal manipulation by a chiropractor or other practitioner should never be performed on someone with sciatica pain, warns Dr. Hartigan. It could make the problem worse. Be wary of massage as well. It can contribute to inflammation, which may intensify symptoms.
You should also check with your doctor if sciatica pain is accompanied by unexpected weight loss, fever, difficulty controlling your bowel or bladder or a feeling of numbness in your buttocks, rectum or vagina or if you are over the age of 50, she says.
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Stretch every 30 minutes. Movement encourages circulation and can reduce the inflammation associated with some damaged areas like disks, says Dr. Hartigan. So don't sit for prolonged periods when you have sciatica.
Take a walk every hour. Taking a three- to five-minute walk every hour will also speed healing, says Dr. Keenan.