Sciatic nerve: first aid for sciatic pain

What helps with a painful sciatic nerve

A pinched or inflamed sciatic nerve can cause a lot of pain. What to bear in mind when treating sciatica, plus exercises that provide immediate relief.

Where is the sciatic nerve located in the body?

The sciatic nerve, also known in the profession as nervus ischiadicus, is the thickest and longest nerve in the human body. It originates in the spinal cord and extends over the buttocks and legs down to the feet.

What is sciatic pain?

Sciatic pain refers to any pain and accompanying symptoms originating from the sciatic nerve. This pain syndrome is also known as sciatic nerve dysfunction, sciatic nerve pain, or simply 'sciatica'.

Why does the sciatic nerve cause pain?

An irritated or pinched sciatic nerve can trigger strong pain that runs from the back down the leg. This pain is frequently accompanied by sensory disturbances or even signs of paralysis.

Possible causes of sciatic nerve pain

  • Muscular tension in the back and pelvis
  • A slipped (or 'herniated') disc pressing on the sciatic nerve
  • A particularly tense piriformis muscle in the buttocks
  • Narrowing of the bony canals through which the spinal cord passes
  • Damage to the nerve root
  • Inflamed nerves or inflammation elsewhere in the body
  • In rare cases, tumours in the spine
A patient suffering from a pinched, injured or inflamed sciatic nerve is in severe pain.
Stefan Hummler, specialist in rheumatology, physical medicine and rehabilitation at the Hirslanden Klinik St. Anna located in the Lucerne railway station

What symptoms point towards sciatica?

Sciatica can take the form of lower back pain, but may also cause tingling in the back of the knee.

The most common signs:

  • Pain that extends from the lower back through the buttocks to the leg, even as far as the toes. Usually only one leg is affected.
  • Pain that increases under strain - for example when lifting a heavy object - and sometimes when coughing, sneezing or pressing.
  • Pain that is accompanied by sensory disturbances such as tingling, burning or numbness, or signs of paralysis in individual muscle groups in the leg.

The right way to treat sciatica

If the sciatica is severe and lasts for a longer period, a medical check is advisable. Your doctor will check your ability to move and your sensory perception. Methods for this include the Lasègue test: while the patient is lying, the doctor slowly lifts the stretched leg. With a damaged sciatic nerve, this movement will cause the patient to experience typical symptoms (Lasègue signs) when the leg reaches an angle of around 45 degrees. Doctors may also use imaging procedures to find the cause of the sciatic pain.

Immediate help for intense pain

It's usually tense muscles, hardened muscles or malpositions that trigger acute sciatic pain. In order to quickly relieve acute pain and restore normal mobility, doctors will use anti-inflammatory and pain-relieving medication as first aid measures. They can also be injected, depending on the severity of the symptoms.

Apply heat & take exercise

In addition, warm compresses or massages can help. Health professionals also advise against sitting or lying down for too long a period. Because even though resting may temporarily ease the pain, movement can help you get better faster.

What exercises help for sciatica?

Generally the pain fully disappears: at the quickest after a few days, at the longest after a few weeks. Once the painful phase has passed, active prevention is important in order to lower the risk of recurrence. It's particularly important to focus on building up the bod's core muscles and to strengthen the muscle groups that tend to get neglected on an everyday basis. It's also worth consulting a physiotherapist or sports therapist on how to reverse any muscular imbalances in your back, posterior or leg muscles.

Stretching the gluteal muscles

This exercise stretches the muscle group that often tenses up with sciatic pain: the gluteal muscles.

  1. In a lying position, bend the right leg.Bend the left leg and place it on the right knee. The left ankle joint lies on the right knee.
  2. If you feel a stretch in this position, maintain the pose as it is.
  3. To increase the stretch intensity, press lightly against your right knee with your right hand, or you can even reach under your right thigh and pull both legs up towards your shoulders.
  4. Hold the position for 20 breaths and ideally repeat 2-3 times per side.
ischiasnerv-dehnung.jpg
Stretching the muscles in your buttocks can sometimes help ease the pain. It also relaxes the lower back.
To increase the stretch, grasp the right thigh with both hands and pull it towards the chest.

Self-massage with a ball

This exercise lets you massage tense muscles, like the piriformis muscle in the buttock region, yourself.

  1. Lie on your back on the floor.
  2. Place a ball (such as a tennis or fascia ball) under the upper half of the buttocks.
  3. Place some of your weight on the ball and slowly roll the ball along the buttocks.
  4. Carefully massage each painful point with small rolling movements until the tension eases.

Did you know? Piriformis syndrome is the name given to the pain that occurs when the piriformis muscle spasms and presses on the sciatic nerve.

ischiasnerv-selbstmassage.jpg
Self-massage with a ball eases tense buttock muscles. Important: if the pain is severe, reduce the pressure.

Be aware of the following:

  • Ensure that any pain remains at a tolerable level.
  • Discontinue the massage if you feel a strong, stabbing pain.
  • Massage only briefly to start with, and with little pressure. After a time, you'll develop a feel for how much pressure benefits you.

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