Sciatica

Diagnosing Sciatica

Sciatica is a common condition that causes pain along the sciatic nerve, which runs from the lower back through the hips and down each leg. Proper sciatica diagnosis and treatment can significantly improve quality of life. In this article, we’ll explore how to treat sciatica, how to diagnose sciatica, and prevention tips.

Physical Examination

A thorough physical exam is the first step in diagnosing sciatica. A healthcare provider assesses your reflexes, muscle strength, and ability to perform movements like walking on your heels. These tests help pinpoint the source of pain, especially if it radiates along the sciatic nerve [1].

• Walking Assessment: Your doctor evaluates gait, balance, and muscle weakness linked to nerve compression.
• Posture Evaluation: Healthcare professionals identify pain changes with posture adjustments; poor sitting habits may worsen symptoms.
• Leg Raising Test: A straight leg raise test detects sciatic nerve irritation if pain radiates down the leg.
• Strength & Reflex Tests: Standing on toes or heels helps assess muscle weakness and nerve function.

Diagnostic Tests

• X-Ray: Identifies bone-related issues like fractures or spurs that may compress the sciatic nerve.
• MRI: Provides detailed images of discs and nerves, diagnosing herniated discs or spinal stenosis.
• CT Scan: Reveals bone spurs and severe disc degeneration affecting the sciatic nerve.
• EMG: Measures nerve activity, detecting damage and pinpointing affected nerves.

Sciatica Treatment

Medications

Sciatic nerve pain relief is often the first line of treatment. Different types of medications can be used to relieve sciatic nerve pain depending on the severity and underlying cause. These options aim to reduce inflammation, manage nerve pain, and improve overall comfort. Combining medications with other forms of sciatica treatment often produces the best results.

1. Anti-Inflammatory Drugs – Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to reduce inflammation and alleviate sciatica pain relief.[2]
2. Corticosteroids are powerful anti-inflammatory medications.[3]
3. Certain antidepressants are used to manage chronic nerve pain. They alter pain perception pathways, making them effective for sciatic nerve pain treatment.[4]
4. Anticonvulsants stabilize overactive nerve signals, reducing pain and discomfort caused by nerve compression.[5]
5. In severe cases of sciatica, short-term opioid use may be prescribed.[6]
6. Muscle Relaxants can relieve muscle spasms that sometimes accompany sciatica, easing tension in the lower back and legs.[7]
7. Topical Analgesics – Creams or patches may be applied to the skin to provide localized pain relief.[12]
8. Over-the-Counter Pain Relievers – Acetaminophen can be an alternative to NSAIDs for managing pain, especially for individuals who cannot take anti-inflammatory medications.[6]

Neuromuscular Therapy

Neuromuscular therapy is a cornerstone of sciatica pain treatment. Neuromuscular therapy focuses on relieving muscle imbalances, trigger points, and nerve compression that contribute to sciatic pain. A trained therapist designs exercises to strengthen core muscles and improve posture. Specific sciatic nerve exercises include gentle stretches to relieve pressure on the nerve.

Sciatica Treatment at Moore MyoWorx

Moore MyoWorx offers specialized sciatica treatment through its patented TM20 Device [8] and Accelerated Recovery Program (ARP).

• The TM20 Device uses targeted electrical stimulation to reduce muscle tension, improve blood flow, and accelerate healing for lasting relief.
• The ARP is a two-week program combining neuromuscular therapy, targeted exercises, and patient education to address chronic sciatica.

By integrating the TM20 Device with the ARP, Moore MyoWorx provides a comprehensive approach to sciatica treatment, aiming to heal the root cause of pain rather than merely managing symptoms.

Steroid Injections

Corticosteroid injections deliver powerful anti-inflammatory medication directly to the affected area. These injections can provide temporary relief, particularly in cases of severe pain or swelling [11].

Surgical Options

Surgery is considered only when other treatments fail. Common procedures include:

• Microdiscectomy: Removes part of a herniated disc pressing on the nerve.
• Laminectomy: Relieves pressure by removing part of the vertebra.

Surgical intervention is a critical component of sciatic nerve treatment for severe cases, offering long-term relief when other approaches are ineffective. 

Self-Medication and At-Home Treatments

At-home care plays an important role in sciatica treatment at home, especially when combined with professional medical treatment. While home remedies alone may not resolve severe cases, they can complement medications, physical therapy, or other doctor-recommended interventions to enhance recovery and alleviate symptoms.[9]

1. Heat and Cold Therapy

• Cold packs: Reduce pain and swelling in the first 48 hours after a flare-up.
• Heat therapy: Helps relax muscles and improve circulation after the acute phase.

2. Stretching and Sciatic Nerve Exercises

Gentle stretches, like knee-to-chest or seated hamstring stretches, relieve pressure on the sciatic nerve. These exercises complement physical therapy prescribed by your doctor.

3. Posture and Sitting Adjustments

Learning how to sit with sciatica—using ergonomic chairs and maintaining good posture—reduces strain on the lower back. Small changes, like lumbar cushions or standing breaks, can make a big difference.

4. Over-the-Counter Pain Relief

NSAIDs like ibuprofen or acetaminophen can manage mild pain. Used alongside professional treatments, they enhance overall effectiveness.

5. Stay Active

Light activities such as walking improve blood flow and strengthen back muscles. Prolonged inactivity should be avoided as it can worsen symptoms.

Combining Home and Doctor-Guided Treatment

At-home remedies are most effective when combined with a doctor’s care. For example, daily stretches complement professional physical therapy, while heat or cold packs enhance results from prescribed sciatic nerve pain treatment plans. 

A combination of physical therapy, targeted exercises, and at-home remedies often work best[10]. For severe cases, corticosteroid injections or surgery may be necessary. 

Always consult your healthcare provider before trying new remedies or exercises for sciatica pain treatment.

How do I get rid of sciatica ASAP?

Immediate sciatica relief often comes from rest, applying heat or cold, and taking over-the-counter pain relievers. For persistent pain, consult a doctor.

Is walking good for sciatica?

Walking can help by improving circulation and reducing inflammation. Avoid excessive strain by walking at a moderate pace.

Is it better to sit or lie down with sciatica?

Prolonged sitting or lying down can worsen symptoms. Sit with proper support and posture, or lie on your back with a pillow under your knees to reduce pain. Stay active with light stretches.

What is the 1-minute exercise for sciatica?

The “figure-four stretch” is a quick and effective exercise. Cross one ankle over the opposite knee, lean forward gently, and hold for 30 seconds on each side to relieve sciatic nerve pressure. While many people find relief from this stretch, incorrect form or overstretching could worsen symptoms. Always check with a healthcare professional before starting any new exercises for sciatica.

Treatment for Sciatica: Key Takeaways and Next Steps

Treating sciatica often requires a combination of approaches, including physical therapy, medication, self-care strategies, and in some cases, surgical intervention. The goal is to relieve pain, restore function, and prevent recurrence. If symptoms persist or worsen seeking prompt medical advice is crucial to avoid complications and explore advanced treatment options.