Sciatica Treatment

By Jay Herrera, DPT
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Young man with back pain

What is Sciatica?

Sciatica is also known as Sciatica Syndrome and is a generalized phrase or term to indicate pain in the buttocks region usually on one side of your body but can affect both sides at once.  The lumbar/sacral nerves exit the spine and travel down the back part of your leg. Shortly after exiting your spine, these nerve bundles form one big nerve and that is called the Sciatic Nerve. It serves to provide control of your muscles and sensation of your leg.

What Can Cause it?

One major cause of sciatica is pressure or inflammation of the sciatic nerve from a herniated lumbar disc, sometimes (erroneously) called a “slipped disc.” It can cause varying degrees of pain or uncomfortable sensations down the leg, at times all the way to the toes.  Most of the time it will get better with treatment, but prolonged and severe pressure can damage the nerve, leading to complications like loss of control of muscles, such as drop foot.

When the sciatic nerve is entrapped or compressed, which is usually by excessive tightness of various muscles of your buttock region, this can cause localized irritation of the sciatic nerve, and then result in pain and even interfere with muscle and sensory function of the leg  Your provider will be able to help you determine if there is disc involvement or if it is more likely from very tight muscles,

What Are Self Treatment Options?

  1. Soft Tissue Massage to the area of pain in your buttock region. You can use your fingers to rub the irritated region. You can also take a tennis ball and perform circular motion with firm pressure to tolerance.
  2. Apply heat in the form of a heating pad, heated water bottle, or moist heat to the affected area for 15-20 minutes to help increase local blood flow to the area and decrease the tension of the tightened muscles that may be compressing on the sciatic nerve.
  3. Gentle muscle lengthening via comfortable stretching of the buttocks (gluteal region).
  4. Electrical stimulation to relax the tight muscles of the buttocks.

What Are The Professional Treatment Options and What Should I Expect?

  1. Manual therapy by a licensed healthcare provider ie (Physical Therapist, Chiropractor, Osteopath) to assist the relaxing of the tight muscles of the effected areas, decrease joint inflammation, improve joint mobility and identify musculoskeletal imbalance and correct any problems of surrounding muscle groups.
  2. Cold laser aka low level laser therapy to the affected region.
  3. Massage device application to perform more intensive soft tissue mobilization.
  4. Ultrasound therapy may also be used to help improve local circulation to the area and therefore promote healing of the surrounding tissue.
  5. Your provider should be able to show you effective stretches, such as piriformis muscle stretches, you can do at home.

With any or all of these therapies, you can expect a period of healing over several days to a couple weeks, assuming your sciatica is not due to a disc herniation or other more serious problem. The important aspect of undergoing professional care is to determine the cause the problem in the first place. The treatment can then be customized to address your specific cause. Typically, it can take 1-2 weeks of daily attention to relieve the symptoms and heal the underlying condition depending on the severity of the condition.

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