Natural treatments for sciatica

• DEFINITION: Treatment of irritation of the major nerve that extends from the lower spine to the lower buttocks, legs, and feet.
• PRINCIPAL PROPOSED NATURAL TREATMENTS: None
• OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, Alexander technique, biofeedback, chiropractic, Feldenkrais method, massage, Pilates, prolotherapy, Tai Chi, yoga, anti-inflammatory herbs, supplements targeting nerve health, hydrotherapy, topical herbal preparations, Transcutaneous Electrical Nerve Stimulation

Introduction

Sciatica is the irritation of the sciatic nerve, a major nerve that passes down the back of each thigh. The sciatic nerve originates in the lower spine and travels deep into the pelvis to the lower buttocks. From there, it passes along the back of each upper leg and divides at the knee into branches that go to the feet. Sciatica typically causes pain that shoots down the back of one thigh or buttock.

Anything that causes irritation or puts pressure on the sciatic nerve can cause sciatica. The most common cause is a sprain or strain of muscles or ligaments in the area, and for this reason, sciatica is often associated with low back pain. The cushions between the spine's bones (the disks) can also cause sciatica when they bulge out of place or degenerate. Other causes of sciatica include spinal stenosis (narrowing of the spinal canal in the lumbar area), spondylolisthesis (slippage of a bone in the lower back), and, rarely, benign or malignant tumors. Pregnancy, certain infections, diabetic neuropathy, endometriosis, and bone spurs have also been identified as risk factors for sciatica nerve pain. Sitting in one position for long periods of time may also aggravate the sciatic nerve.

Diagnosis of sciatica is made by discussing symptoms, neurologic evaluation, and tests, such as a nerve conduction study, X-rays, and a magnetic resonance imaging (MRI) scan. Common symptoms include burning, tingling, or shooting pain down the back of one leg; pain in one leg or buttock worse with sitting, standing up, coughing, sneezing, or straining; and weakness or numbness in one leg or foot. More serious symptoms that sometimes occur in sciatica include difficulty walking, standing, or moving; increasing weakness or numbness in the leg or foot; and loss of bowel or bladder control.

In most cases, sciatic pain resolves on its own without specific treatment. Bed rest, although sometimes recommended, is probably not helpful. However, physical therapy techniques and steroid injections have shown promise. If permanent nerve damage is threatened, surgery may be necessary.

Attacks of sciatica tend to recur. Certain common-sense steps may help prevent recurrences—when lifting, one should hold objects close to the chest, maintain a straight back, and use the leg muscles to slowly rise; practice good posture to reduce pressure on the spine; if possible, avoid sitting or standing in one position for prolonged periods; use low-back support during prolonged sitting; rest one foot on a low stool if standing for long periods; sleep on a firm mattress; exercise regularly a minimum of thirty minutes most days of the week (good exercise choices include walking, swimming, or exercises recommended by a doctor or physical therapist); and consider job retraining if working requires a lot of heavy lifting or sitting.

Other Proposed Natural Treatments

Acupuncture has shown promise for sciatica, but the research evidence supporting its use remains preliminary, although it does show acupuncture can increase blood flow and reduce symptoms. Similarly, biofeedback, chiropractic, massage, and prolotherapy, while sometimes advocated for sciatic pain, need additional study. Soaking in a warm tub during hydrotherapy can ease sciatic pain. Transcutaneous Electrical Nerve Stimulation (TENS) may reduce pain related to sciatic by administering electrical pulses to sore muscles.

The Alexander technique, Feldenkrais, Pilates, Tai Chi, and yoga are thought to improve posture and movement habits. Based on this, these methods are advocated for preventing or treating sciatica, but again, proof of effectiveness is lacking. Medical professionals recommend movement along with cold and hot compresses.

Several anti-inflammatory herbs have been suggested for the relief of sciatica pain. However, many of these recommended supplements are based on traditional uses and require additional scientific study. Turmeric, devil's claw, willow bark, and boswellia are herbs that have traditionally been used to relieve pain and inflammation and, therefore, may be helpful in treating sciatica pain. Vitamin B complex, alpha-lipoic acid, and magnesium have been studied for their ability to affect nerve health and, for this reason, are sometimes recommended for sciatic nerve pain. Finally, topical creams containing capsaicin and arnica may also be beneficial.

Bibliography

Andriano, Matt. Sciatica: A Comprehensive Guide to Sciatica Causes Exercises & Home Treatment. CreateSpace Independent Publishing Platform, 2015.

Cherkin, D. C., Sherman, K. J., et al. "A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain." Archives of Internal Medicine, vol. 169, 2009, pp. 858-866.

Dagenais, S., et al. "Evidence-Informed Management of Chronic Low Back Pain with Prolotherapy." Spine Journal, vol. 8, 2008, pp. 203-212.

Dugdale, David C., Brenda Conaway, and C. Benjamin Ma. "Sciatica – Symptoms and Causes." Penn Medicine, 20 Sept. 2022, www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/sciatica. Accessed 7 Oct. 2024.

Furlan, A. D., et al. "Massage for Low-Back Pain." Spine, vol. 34, no. 16, July 2009, pp. 1669–84. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=43503525&site=ehost-live. Accessed 7 Oct. 2024.

Vasey, Christopher, and Jon E. Graham. Natural Remedies for Inflammation. Healing Arts, 2015.

"Sciatica Home Remedies and Self-Care." Harvard Health Publishing, 22 July 2024, www.health.harvard.edu/pain/sciatica-home-remedies-and-self-care. Accessed 7 Oct. 2024.