• Dr. Mark Freund

Treatments for Severe Lower Back Pain and Sciatica


Severe Lower Back Pain and Sciatica

Waking up with back pain and a sharp tingling sensation down your legs is incredibly uncomfortable and one that nobody should have to endure. This sharp electric jolt type of pain, numbness, burning, or tingling along the line from your lower back to your feet may very well be sciatica. As many as 40% of people will experience sciatica at some point in their life. If you've been scouring the interwebs looking for lower back pain and sciatica treatment, you've come to the right place. In this article, we'll cover the common causes symptoms along with methods for sciatic pain relief and management.


What is Sciatica?

Sciatica is nerve pain that is caused by irritation or injury to the sciatic nerve, which originates in the gluteal and buttocks area. The sciatic nerve is a very long and thick nerve in the body. It's made up of five nerve roots; three from the sacrum (base of the spine) and two from the lumbar (the lower back).


The five nerve roots are joined together to form a left and right sciatic nerve. On both sides of the body, the sciatic nerve runs through your hips, buttocks, and down your legs, ending below the knees. The sciatic nerve branches into other nerves in your body, which continue done your leg and into your feet and toes.


Although true injury to the sciatic nerve is quite uncommon, the term sciatic is usually used to categorize any pain that stems in the lower back and radiates down to your legs. When sciatic occurs, most people feel some sort of inflammation, irritation, compression, or pinching of a nerve in the lower back. This may cause muscle weakness in the leg and foot, numbness in the legs, and unpleasant tingling pins-and-needles sensations in the feet, legs, and toes.



Causes, Symptoms, and Risk Factors

Here are the causes, symptoms, and risk factors you should be aware of.


Causes

It can be difficult to pinpoint causes for lower back pain and sciatica. In many cases, low back pain is caused by poor posture, muscle strain, repetitive strain, improper heavy lifting, and strenuous activity. Low back pain can also be a common symptom of osteoarthritis, herniated disk, or spondylitis.


Let's cover these causes more in-depth:


Herniated disc: Otherwise called slipped disc, this causes pressure on the nerve root and is the most common cause of sciatica. A herniated disc is usually found in 5 to 20 cases per 1,000 adults every year. These discs act as cushioning pads between the vertebrae of the spine. Pressure placed on the vertebrae will cause this gel-like center of the disc to bulger throughout weakness in the outer walls. When a herniated disc occurs to the lower back, this can press on the sciatic nerve.

Degenerative disc disease: This disease is the natural wear down of the discs between the vertebrae of the spine. As the discs wear down, this can shorten a person's height and cause nerve passageways to become narrower, which pinch the nerve roots.


Spinal stenosis: This is an abnormal occurrence of the spinal canal becoming more narrow. As the spine narrows, it decreases the available space for the nerves and spinal cord, causing a lot of compression and pressure.


Spondylolisthesis: A spondylolisthesis occurs when there is a slippage of vertebrae so that it's out of position with the one above it, thus narrowing the opening where the nerve exits. The extended spinal bone thus pinches the sciatic nerve.


Osteoarthritis: Bone spurs form as the spine ages and compress the lower back nerves.


Trauma: Any trauma injury to the sciatic nerve or lumbar spine can lead to sciatica.


Tumors: Tumors that are present within the lumbar spinal canal can compress the sciatic nerve.


Piriformis syndrome: This condition develops in the piriformis muscle, a tiny muscle that is deep in the buttocks which can experience spasms or tightness. As a result, pressure and irritation are placed within the sciatic nerve.


Cauda equina syndrome: This is an uncommon but serious condition that affects an array of nerves at the end of the spinal cord. This syndrome leads to pain leg, weakness and numbness around the anus, and a loss of bladder and bowel control.


Risk Factors

Some of the risk factors for sciatica are:


  • Diabetes: This condition will affect how your body uses blood sugar, which increases the odds of nerve damage

  • Prolonged sitting: People who sit all day and live sedentary lifestyles are more prone to develop sciatica than active people are.

  • Occupation: A demanding job that requires you to carry heavy loads, twist your back, drive a vehicle for extended periods may play a role in sciatica, but there isn't conclusive evidence for this.

  • Obesity: Extra weight on the body can place additional strain on the spine, leading to spinal changes that trigger sciatica.

  • Age: As your body ages, the spine changes, which can lead to bone spurs and herniated discs.

  • Current or previous injury: An injury to the spine or lower back puts you at a greater risk of sciatica

  • Lack of a strong core: Your core at the muscles of your abdomen and back. The stronger your core is, the more support you'll have to keep your lower back upright. Unlike your chest, where the rib cage offers support, the only support for your lower back is the core.

  • Have osteoarthritis: Osteoarthritis can damage your spine significantly and place the nerves at risk of injury.

  • Smoking: The nicotine found in tobacco weakens the bones, damages the spinal tissue, and wears down the vertebral disks faster.

  • Pregnancy: The additional weight and hormones of pregnancy can put you at greater risk of sciatica. That's because these hormones can loosen the ligaments that hold the vertebrae together, which keep the spine stable and protect the disks.


Symptoms

There is a myriad of symptoms of severe lower back and sciatica pain. However, it's important to consult with your doctor and chiropractor before coming to a conclusion yourself. Many conditions may have the same causes and symptoms; therefore, it's crucial to see a doctor for proper diagnosis.

sciatica symptoms

These symptoms of sciatic include:


  • Mild to severe pain in the buttocks, lower back, and down your leg

  • Weakness or numbness in the lower back, legs, feet, and buttocks

  • Loss of movement or pain that worsens with movement

  • A pins-and-needles sensation that runs down your legs, feet, and toes

  • Loss of bladder and bowel control


What is the Best Treatment for Sciatica?

Before selecting the right treatment, make sure to consult with your health care provider and medical practitioner to see which are the best treatments for sciatica for your situation. Depending on the severity of the situation, there may or may not always be an immediate relief for sciatica pain.


Non-surgical Treatment Options for Sciatica Pain

If you're experiencing sciatica, most medical experts recommend using conservative care first. This means using a form of chiropractic and physical therapy to treat sciatic pain before any invasive procedures. Additionally, current guidelines recommend that pain medications should be used only for very short periods and at very low doses. Medications and opioids tend to have little effectiveness in actually reducing the sciatica symptoms and don't address the cause of the pain or symptoms.


Chiropractic treatment:

Chiropractic treatment has been shown to be one of the most effective methods of treatment for sciatica due to the diverse toolkit that chiropractors have for dealing with the different symptoms the patient is experiencing. Chiropractors are highly trained to diagnose the sciatic nerve, skeletal problems, and muscle along with reading x-rays.


Chiropractic treatment realigns the positioning of the spine and normal motion through spinal manipulation. In addition, it decreases the pressure on the intervertebral discs and opens the spaces where the roots of the nerve exit. Often performing spinal manipulation and soft tissue physical therapy techniques can strengthen weak muscles, ease spasms and improve the long-term stability of the spine.


In fact, clinical trials have proven that as little as six treatments performed by a chico[practor can be almost as affecting sciatica symptoms as microdiscectomy or spinal compressor surgery. One study had 40 sciatic patients who had symptoms that hadn't improved for at least three months. 60% of the group that received spinal manipulation reported that they had sciatica pain relief from their symptoms.


Physical therapy:

Physical therapy for sciatica is perhaps one of the best treatment options a patient can choose. It's non-invasive and helps to improve the root cause of the issue. A physical therapist will create rehabilitation produce to eliminate or reduce the pain while also normalizing the body's mechanics to improve the strength of your core muscles, relieve nerve compression and improve the nerve and muscle flexibility.


At-Home Remedies

There are many home remedies and lower back pain treatments you can do to perform some relief before you see your doctor, chiropractor, or physical therapist.


Stretching:

Stretching is useful to target muscles that cause pain when rigid and tight. Nerve stretching is also vital. By improving flexibility in the nerves and muscles, the sciatica nerve can glide freely between the fascia, muscles, and other structures in the body.


Exercise:

Low impact aerobic exercises like swimming and walking can help with sciatica. That's because aerobic activity promotes the exchange of nutrients and fluids to help with recovery. Also, aerobic conditioning can help to release endorphins which are the natural painkillers of the body.


Medicine:

Over-the-counter pain relievers like NSAIDs (nonsteroidal anti-inflammatory drugs) and acetaminophen can help. These include medications like aspirin, naproxen, and ibuprofen. However, it's important not to use them for an extended period of time.


Hot and cold packs:

Using hot and cold therapy alternatively can be a great way to reduce symptoms of sciatica. Cold packs are designed to soothe acute inflammation. Hot packs offer a myriad of benefits, such as alleviating chronic pain like tightness, stiffness, and muscles aches. It also helps to release muscle spasms or knots.

lower back pain relief with an ice pack or hor pack

Bed rest:

The more you rest, the more your body releases hormones to help release natural painkillers and restore the body's healing process. If the pain is chronic or severe, make sure to take a few days off to allow your body to heal and reduce some of the symptoms.


Alternative medicine:

It's helpful to consider alternative natural remedies in conjunction with other non-surgical options such as a massage, acupuncture, and yoga to help relax the muscles and relieve the pain from sciatica.


Diagnosis & Treatment

Your medical provider will first go through your medical history and ask about your existing symptoms. During the physical exam, they will ask you to walk, so they can examine how your spine carries your weight. Your chiropractor may ask you to walk on your heels and toes to check the strength of your calf muscles. Your healthcare provider may perform a straight leg raises test as well, which requires you to lie flat with your legs straight up. They will slowly raise each leg until they identify the point and which the pain occurs. This test allows the provider to pinpoint the precise location of the nerves and determine whether there are problems with the spinal discs. They'll likely ask you to perform other motions and stretches to check muscle flexibility and strength and pinpoint other areas of pain.


Depending on what your physician or chiropractor discovers during the physical examination, they will perform imaging and other tests. This includes:


  • Spinal x-rays to look for disc problems, spinal fractures, bone spurs, and tumors.

  • Myelogram to see if the disc or vertebrae is causing pain

  • Nerve conduction velocity studies to see how the electrical impulses are traveling through the sciatic nerve and how the muscle responds.

  • Computed tomography (CT) or magnetic resonance imaging (MRI) scans to view detailed images of the soft tissues of the back and the images of the bone. An MRI will reveal the disc herniation, the pressure on the nerves, and any arthritic conditions that could be pressing on the nerve. MRIs are typically used to confirm the diagnosis of the sciatica condition.


Afterward, the chiropractor will recommend their treatment plan for you, which may consist of regular visits that may include spinal manipulation and physical therapy. They may also ask for you to do at-home remedies like stretching, hot and cold therapy, and light exercise.


Prevention Tips

Once you've treated sciatica, it's important to understand how to prevent it so that it doesn't come back to bite you again. Here are some prevention tips you can consider to prevent severe lower back pain and sciatica:


  • Keep moving - Exercise helps to preserve the back's range of motion, improves circulation, and strengthens your muscles.

  • Maintain a healthy weight - Being obese or overweight puts a lot of pressure on your spine. Carrying extra pounds in your belly will also throw off the center of gravity which can lead to lumbar disc herniation.

  • Preserve your posture - Good posture will allow your spine to remain healthy. Bad posture such as slouching or slumping places stress in your lower back or other areas of your body such as tight hips and buttocks pain.

  • Do yoga - Yoga teaches you how to be in touch with sensations and how your body moves. This activity promotes a healthy spine and keeps your body in shape.

  • Sleep on a good mattress - Sleep supports good health, and having a quality mattress helps you maintain natural spinal alignment. We recommend a memory foam mattress or one that has good foam padding.


Sciatic can be miserable, but that doesn't mean you should have to bear through the pain and suffer from it. At Natural Care Chiropractic, we aim to offer safe, proven, and effective methods of treating sciatica. If you believe you may be experiencing sciatica, it's important to seek help right away. We can analyze your symptoms and diagnose whether sciatica is present. Book an appointment today, and let us help you recover and restore your health.

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