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SCIATICA

Causes

Symptoms

Home Remedies

Exercises for Relief from Sciatica

Prevention

Treatment

External Therapy

Yoga

 
 
Sciatica refers to pain, weakness, numbness, or tingling in the leg, that originates in the low back and travels through the buttock and down the large sciatic nerve in the back of the leg It is caused by injury to or compression of the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own.

The sciatica nerve is the largest nerve in the body and is formed from the lower segments of the spinal cord; it is made up from the lumbar and sacral nerve roots from the spine. The sciatic nerve exits the lower part of the spinal cord (lumbosacral region), passes behind the hip joint, and runs down the back of the thigh. It has branches in the thigh muscles, the knee joints, and down into the muscles of the legs and feet. It is more exposed to injury and inflammation than most other nerves.

Sciatica can be brought on by sitting on a hard seat. When your leg goes to sleep, that is also a form of sciatica. Sciatica nerve pain is a relatively common form of low back pain and leg pain.

The term sciatica is often used very broadly to describe any form of pain that radiates into the leg. True sciatica occurs when the sciatic nerve is pinched or irritated and the pain along the sciatic nerve is caused by this nerve (radicular pain) and is called a radiculopathy. When the pain is referred to the leg from a joint problem (called referred pain), using the term sciatica is not technically correct. This type of referred pain (e.g. from arthritis or other joint problems) is quite common.

The disease is known as Griddhasi in Ayurveda. It occurs most frequently in people between 30 to 50 years of age. The vast majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical sciatica treatment. For others, however, sciatic nerve pain can be severe and debilitating
Causes
Sciatica refers to a set of symptoms that are usually caused by a problem in the lower back called a radiculopathy - when a nerve root that connects to the sciatic nerve is compressed or irritated. The six most common problems that can cause sciatica and sciatica-type symptoms include:

Herniated Spinal Disc:
A herniated disc occurs when the soft inner core of the disc leaks out, or “herniates.” When this happens, the normal cushion between the vertebras of your spine ruptures. This causes the disc to push out into areas normally occupied by these nerves. The nerves are compressed and people then experience the symptoms of pain, weakness, and numbness.

In general, it is thought that a sudden twisting motion or injury can lead to an eventual disc herniation and sciatica. However, most discs weaken over time due to repetitive stress and the final result is a herniation. A herniated disc is sometimes referred to as a slipped disk, ruptured disk, bulging disc, protruding disc, or a pinched nerve, and sciatica is the most common symptom of a lumbar herniated disc.

Lumbar Spinal Stenosis: The abnormal narrowing of the spinal column that may occur in any of the regions of the spine is called stenosis and it commonly causes sciatica. Spinal stenosis is relatively common in adults over age 60. Lumbar spinal stenosis is related to natural aging in the spine.

Degenerative Disc Disease: While disc degeneration is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica.

Isthmic Spondylolisthesis: This is when a vertebra is dislocated from its normal position and can start to pinch the sciatic nerve.

Piriformis Syndrome: The sciatic nerve can also get irritated as it runs under the piriformis muscle in the rear. If the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica-type pain.

Sacroiliac Joint Dysfunction: Irritation of the sacroiliac joint at the bottom of the spine can also irritate the L5 nerve, which lies on top of the sacroiliac joint, and can cause sciatica-type pain.

Some less common causes of sciatica include the following:

  • Pregnancy. The changes that the body goes through during pregnancy, including weight gain, a shift on one's centre of gravity, and hormonal changes, can cause sciatica during pregnancy.
  • Scar tissue. If scar tissue is affecting the nerve root, it can cause sciatica.
  • Muscle strain. In some cases, inflammation related to a muscle strain can put pressure on a nerve root and cause sciatica.
  • Spinal tumour. In rare cases, a spinal tumour can impinge on a nerve root in the lower back and cause sciatica symptoms.
  • Infection. While rare, an infection that occurs in the low back can affect the nerve root and cause sciatica.

It is important to know the underlying clinical diagnosis of the cause of sciatica, as treatments will often differ depending on the cause. For example, specific sciatica exercises, which are almost always a part of a sciatica treatment program, will be different depending on underlying cause of the sciatica symptoms.

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Symptoms

Sciatica pain can vary widely. It may feel like a mild tingling, dull ache, or a burning sensation. In some cases, the pain is severe enough to make a person unable to move. For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse.
Usually, sciatica most often affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain and other sciatica symptoms may also radiate, prompting foot pain or pain in the toes.
The pain often starts slowly. The common symptoms of sciatica nerve pain include:

  • A cramping sensation of the thigh
  • Shooting pains from the buttock, down the leg, that is worse when sitting
  • Tingling, or pins-and-needles sensations in the legs and thighs
  • A burning sensation in the thigh
  • Weakness, numbness or difficulty moving the leg or foot
  • A sharp pain that may make it difficult to stand up or to walk
  • Low back pain
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Home Remedies
Take 2-4 tablespoons of mustard oil. Heat it. Fry 2-3 cloves of crushed garlic and a spoonful of pounded Bishop’s weed (Trachyspermum ammi, ajwain) seeds in it. Cool it to a bearable temperature. Filter and use it to massage a painful joint. Helps to give relief from sciatica nerve pain.
  • Nutmeg is another effective remedy for sciatica. A nutmeg should be coarsely powdered and fired in gingelly oil until all the particles become brown. This oil can be applied beneficially on the affected parts as a pain reliever.
  • The herb chamomile (Matricaria recutita) is valuable in sciatica. Its extracted oil, diluted in vegetable oil should be rubbed on the affected parts. A compress of chamomile flowers can be also be used beneficially to treat the sciatica nerve pain.
  • The warm pulp of the aloe leaf soothes joint pains. It has an awful smell, hence some people prefer less smelly remedies.
  • The use of lemon is beneficial in the treatment of sciatica. It is a sour in taste, but its reaction in the body is alkaline and as such it is valuable in rheumatic affections, including sciatica. A sufficient intake of lemon juice prevents the deposit of uric acid in the tissues.
  • Juices like the juice of potatoes and celery leaves. These juices in combination are said to provide sciatica relief when drunk in a minimum quantity of 300ml daily. The addition of carrots and beetroots to this mixture is said to fortify the strength and taste. If you can’t drink the juice drinking celery tea throughout the day is also beneficial.
  • Elderberry (Sambucus nigra) juice and/or elderberry tea is a known muscle relaxant and stimulant and is said to treat sciatica symptoms.
  • Another magical home remedy to treat sciatica is fresh minced horseradish poultice, which when applied to the painful areas and kept for at least an hour at a time stimulates the sciatica nerve and give tremendous relief from sciatica pain.
  • Water is one of the best natural treatment options for sciatica pain relief. Water can help to bring down pain by improving circulation. Taking long hot bath or a shower and following it up with a short cold shower is said to boost the body’s circulation and reduce pain. Taking hot and cold compresses too is equally beneficial.
  • Use an ice pack on muscles that are in spasm. The ice makes the muscle get numb, and it releases the spasm.
  • Consuming raw garlic or taking garlic supplements with along with additional supplements of vitamin B1 and B-complex gives relief from aches and pains, aids circulation, is an anti-oxidant and also provides the body with warmth and energy. Garlic milk can be prepared both in cooked and uncooked states. This milk is prepared by adding the pulp of the crushed garlic in uncooked buffalo milk. The proportion is four cloves to 110 ml of milk. Another method is to boil the garlic milk. Drink this concoction twice daily and the results can be seen in just a week’s time.

Caution: However, care must be taken to avoid garlic if you are taking any other medication like anticoagulants, if you have any bleeding disorders or ulcers and take the advice of your doctor before taking garlic supplements

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Exercises for Relief from Sciatica

For most people, the good news is that sciatica usually will get better on its own, and the healing process usually only takes a few days or weeks. Overall, the vast majority of episodes of sciatica pain heal within a six to twelve week time span. However, occasional flare-ups of sciatic nerve pain may be an indication of a condition that should be managed so that it does not get worse over time.
Sciatica is not a medical emergency. However, if you experience difficulty with bowel or bladder function, decreased sensation around the genitals, or progressive leg weakness, this may be the sign of cauda equina syndrome, a medical emergency.

Stretch your piriformis: One of these spindle-shaped muscles lies deep inside each buttock. The piriformis is the muscle you use when you turn out your hip and raise your leg to the side--and it's often implicated in sciatic nerve pain.
To stretch the piriformis and help relieve the pain temporarily, lie on your back on the floor and gently pull your right knee up toward your left shoulder. Grasping the instep of the right foot with your left hand, slowly draw the knee and foot across the body toward the left shoulder. Stretch for 30 seconds or more to elongate the piriformis deep in the back of the hip. Then lower your right leg, switch to the left, and repeat.

Partner up for stretches: Even better, if someone can help you with your stretches, is this routine: First lie on the floor or on a firm bed on the side that doesn't hurt. Lift the uppermost leg (on the side that hurts) and raise your knee to waist level as if you were taking a step. Then slowly drop the knee down toward the floor or bed. Have your partner hold this knee down with one hand while he raises the ankle of the same leg with his other hand. A cautionary note: He should raise the ankle only as far as it will go comfortably and hold for 15 to 30 seconds.

Do a butt press: You can ease sciatic pain by pressing on appropriate acupressure points. First find the centre of the depression at the sides of the buttocks. Then press both sides simultaneously and hard, because the acupressure points lie deep below the skin. Keep the pressure on for a count of 15, then release.

Give your calves a seat. Assuming a position with hip joints and knees bent is the best way to depress the sciatic nerve and avoid pain. Here's a posture that should help: Lie on your back on the floor and place your lower legs on the seat of a chair for 10 or 15 minutes

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Prevention
  • Rest the back by not bending, flexing or lifting heavy weights.
  • Stand and bring both your arms behind your back, clasping your hands. Keeping your hands together, begin to slowly bend from the waist going as far down as you can. You'll feel the stretch in your lower back and legs.
  • Sleeping on a mattress that is neither too soft, nor too hard.
  • Use ergonomic furniture, such as chairs with lumbar support.
  • A bulging wallet in your hip pocket can crimp your sciatic nerve, especially if you sit on the wallet for long periods of time. Put the wallet in a coat pocket or purse to make sure you don't put lopsided pressure on one buttock.
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Treatment

While sciatica can be very painful, it is rare that permanent sciatic nerve damage (tissue damage) will result. Most sciatica symptoms result from inflammation and will get better within two weeks to a few months. Also, because the spinal cord is not present in the lower (lumbar) spine, a herniated disc in this area of the anatomy does not present a danger of paralysis.
As sciatica is a symptom of another medical condition, the underlying cause should be identified and treated. In some cases, no treatment is required and recovery occurs on its own.
Conservative treatment is best in many cases. Your doctor may recommend the following steps to calm your symptoms and reduce inflammation.
Apply heat or ice to the painful area. Try ice for the first 48 - 72 hours; then use heat after that.
While sleeping, try lying in a curled-up, foetal position with a pillow between your legs. If you usually sleep on your back, place a pillow or rolled towel under your knees to relieve pressure.

Fomentation: When sciatica is accompanied by Kapha vitiation, fomentation helps substantially. Fomentation can be done with the help of electric heating pads or by putting fine beach sand in a cloth bag/pillow, heating the bag on hot plate and applying to on the afflicted areas. One can take sea salt crystals in cloth bag and use in a similar manner.
Whatever method adopted, fomentation is seen to help in sciatica pain.

Medication
Take 21 leaves of Parijata (Nyctanthes arbor-tristis, Night-flowering Jasmine) tree. Grind them coarsely and add in two cups of water. Add in ½ tsp of ginger powder. Boil on slow heat till half cup remains. Add in 1 tsp of castor oil in the tea made this way and stir well before drinking warm. Castor oil can be increased up to 6 teaspoons (30ml) gradually, as body digests it.
If ginger powder increases inflammation during motion, add ½ teaspoon of Giloy (Tinospora cordifolia, Guduchi, Heartleaf Moonseed) powder. This tea should be drunk on empty stomach morning.

Shilajit Rasayana: This formulation is a classical one and contains Giloy, Guggulu (Commiphora mukul) and Shilajit. While Giloy acts on Kapha dosha, Guggulu is highly beneficial in all Vata diseases whereas Shilajit reduces all blockages, swellings, ama and thus reduces pressure on sciatica nerve, causing pain relief. Take 2 – 2 tablets each of 250 mg chew it slightly and then swallow with water

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External Therapy

Abhyangam and padabhyangam: When sciatica is caused by Vata dosha, one can use seasame oil or Mahanarayan Tailam to gently massage the legs from waist downwards to the soles of the foot. Either the patient himself or someone else can do it. Focusing on the foot (padabhyangam) is good for sciatica pain relief.

Nadi Swedam (medicated steam bath), Elakizhi (herbal leaf bundle massage), Pizhichil (medicated oil bath), Kati vasti (a treatment done on to the back to decrease spinal compression), Vasti (medicated enema) Virechana ( purgation) and other Ayurvedic procedures are also performed for a period of 7/14/21/28 days, to treat underlying causes of the disease without any side effects.

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Yoga

Yogic asanas like Halasana (Plough Pose) improves circulation of blood and lymph, stimulates the immune system and releases stress and tension in the lower back including the spine; Shalabhasana (Locust Pose) strengthens the low back muscles. It also stimulates the endocrine, nervous and reproductive systems); Bhujangasana (Cobra Pose) develops the strength and flexibility in the spine and rejuvenates spinal nerves can be performed after pain has subsided to prevent recurrence of sciatica.


Treatments for sciatica must include a good diet, exercise and the patient must aim at improving overall health. Also to avoid such problems in the long run, sleeping on a firm mattress, sitting and standing in a good posture, avoiding lifting heavy loads should be a part of everyday care that must be taken. It is these small things that cause sciatica over a period of time.
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