The sciatic nerve extends from the lower back, through the buttocks and hips, and down along each leg. Some individuals are affected by sciatica, which causes pain in the sciatic nerve. Common causes can be from a bone spur on the spine, a herniated disc, or a narrowing in the spine. That pain can radiate down along the path of the sciatic nerve. There may also be inflammation and numbness. Sciatica typically affects only one side of the body. Nonetheless it can be uncomfortable and difficult to ease.
Individuals with sciatica may wonder what techniques they can use for the prevention and management of their pain. Learn about how you can best manage your sciatica pain, especially while in a prone position for sleeping, with a few Dos and Don’ts:
Risk Factors for Sciatica
Certain individual and lifestyle factors can increase a person’s risk for sciatica and exacerbate the resulting pain or discomfort. Increased age is a primary risk factor. Being overweight or obese can be another factor. The extra weight adds stress to the spine, which can trigger sciatica. Having diabetes may also be a factor as that condition can generally cause nerve damage.
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Certain occupations may also lead to increased risk for sciatica. Jobs that require heavy lifting and unusual movements may cause damage that results in sciatica nerve pain. Prolonged sitting such as at an office job or while driving a motor vehicle for extended periods of time, can also increase the risk of developing sciatica.
Possible Complications for Sciatica
Some individuals are able to make a full recovery from sciatica nerve pain. Sometimes that recovery happens almost spontaneously without any medical treatment. Other people find they do need medical assessment and treatment. Otherwise, the sciatica may cause permanent nerve damage. It is advisable to seek treatment either way, to ensure you do not experience adverse complications.
Complications from sciatica could include a loss of feeling or sensation in the affected leg. It could also include muscle weakness in that affected leg, wherein it is more difficult to move the leg or have adequate strength. In worst case situations, it can lead to a loss of bladder or bowel functioning.
Preventive Efforts for Sciatica Pain
Ideally, you will take steps to be generally healthy and promote spine health, which would also help to prevent sciatica. Regular movement and exercise are key parts of prevention. Specifically, do activities that will keep your back and core muscles strong. When you sit for extended periods, use good posture. Having your seating set up in an ergonomic style will also be helpful. Further, when you must do heavy lifting, avoid putting too much strain on your back. Use braces and supports as needed.
Diagnosis and Treatment Options
When you suspect sciatica, a visit to a medical provider is advised. Your doctor will conduct a physical exam to assess for sciatica. They may ask you to do various movements and will ask you to describe any pain you are experiencing. They may also ask you to participate in imaging tests such as MRI’s, CT scans, and X-rays. With all of these test results, you may receive a diagnosis of sciatica.
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There are multiple treatment options for sciatica. You may be prescribed medications such as anti-inflammatories, muscle relaxants, and narcotics for the pain. Sometimes steroid injections will be recommended. In some cases, you may be prescribed antidepressant medications and anti-seizure medications. These may sound unusual, but it will depend on your specific symptoms and situation.
Oftentimes, physical therapy will be recommended. A rehabilitation program may be used after acute pain subsides, to help correct the problem, alleviate the chronic pain, and prevent future injuries. A physical therapist may have you do exercises to strengthen your muscles and correct your posture.
In some cases, your doctor may recommend other treatment options such as chiropractic care, massage therapy, or acupuncture. A chiropractor can assist with spinal adjustments that will help to restore function and reduce pain. Massage therapy may help to relax the muscles and reduce pain. Research also suggests acupuncture may be beneficial for chronic pain management, such as that associated with sciatica.
In some cases, surgery may be required to correct sciatic nerve pain. This may be indicated in cases where there is significant muscle weakness and loss of bladder or bowel control. During surgery, a surgeon may remove bone spurs and correct herniated discs, if those are the cause of the sciatic nerve pain.
Home Remedies and Lifestyle Changes
You can also take action at home to manage your sciatica pain. In fact, for many people home remedies will be fully sufficient to alleviate the pain. Stretching exercises may help relieve pain in the lower back. When you stretch, do so in slow and extended motions. Applying heat and cold may also be helpful to reduce swelling and pain.
One area of lifestyle that can be greatly affected by sciatica is sleep. Likewise, your sleep behaviors will also affect your sciatica for the better or the worse, depending on what you choose to do. Be sure to take the following positive measures and avoid those behaviors that may only cause more discomfort.
DO-Consider Your Sleeping Surface
Many people find that a soft mattress exacerbates their sciatica pain. In contrast, a firm surface may relieve the pain. You may want to evaluate whether your mattress is the right match for your needs. It could be that you need to replace your mattress. You could also try alternative sleeping surfaces. For example, you could try sleeping on a yoga mat on the floor.
DO-Practice Good Sleep Hygiene
No matter the state of your health, you should practice what is called sleep hygiene. This is simply a term used to describe taking helpful actions and setting up the optimal conditions for the highest quality sleep.
For the best sleep possible, it is ideal to stop consuming caffeine several hours before bedtime. Also avoid exercising and eating too close to bedtime. An hour or two before your intended bedtime, you should start turning down the lights and making your environment quieter to induce sleep. When you go to bed, make sure your environment is dark, with no unnecessary lights on.
DO-Have a Bath Before Bed
As part of your sleep hygiene routine, you may find it helpful to take a bath before bed. However, this can be more than just mentally and emotionally relaxing. Make the water temperature warm but not hot. A warm bath may relax your muscles and can also release pain-fighting endorphins.
Avoid having bath water that is too hot because the high temperature may raise your body temperature and make it more difficult to fall asleep. If you are not able to take a nightly bath, you could use other methods to apply heat. For example, a hot water bottle on your lower back may be helpful.
DO-Elevate Your Knees
Sciatica pain is often worsened when the nerves in your lower back are irritated or compressed. This can occur during sleep if you are in a less than optimal sleeping position. One helpful position for more comfortable sleep is with elevated knees. To do this, lay on your back and slide one or more pillows under your knees. Find the elevation that feels most comfortable to you.
This technique will work for many people but may not work for everyone. There may be a position that is more optimal for you. For example, some people prefer sleeping on their side, with a pillow between their knees.
DON’T-Sleep on the Wrong Side
Sciatica usually affects just one side of the body. Sleeping on that side will only make the symptoms worse. Avoid sleeping on that side. You can prevent yourself from rolling over to that side by positioning pillows. Alternatively, you can try putting a tennis ball in your pajama pocket on that side of your body. This should prevent you from rolling over and staying on that side.
DON’T-Sleep on Your Stomach
Just as you should avoid sleeping on your affected side, you should also avoid sleeping on your stomach. In general, sleeping on the stomach is not recommended because it flattens out the spinal cord in ways that later can result in discomfort and pain. It also causes the neck to distort and makes strain there. If you must sleep on your stomach, invest in a medium firm mattress.
DON’T-Use an Unsupportive Pillow
A soft pillow may initially seem comfortable. However, they do not usually provide enough neck and back support. Instead, use a supportive neck pillow that will promote overall spinal alignment.
Brent Wells, D.C. is the leader among Anchorage Alaska chiropractors. He also has chiropractic care centers across Alaska, where he focuses on providing high-quality patient care. With chiropractic training in spine and nerve health, Dr. Wells is well-versed in the best practices for managing sciatica.