The main aim with treating acute sciatica is reducing the inflammation of the joint and dealing with engorgement around the nerve root. Apart from reducing the pain it stops the development of post inflammatory adhesions (see below).
Inflammation of the nerve itself is extremely painful. It will be red and weeping and painfully resistant to stretch, so the straight leg raise (SLR) will be markedly reduced. With early treatment stretches for sciatica it's often necessary to have the cover of anti-inflammatory drugs to help quell any reaction you may cause. Remember, nerves often react badly to being stretched if you don't get the rate right!
Remember that acute sciatica rarely coincides with an acutely painful back. Although the back may have been a problem in the past, the usual story is that 'things changed' as the pain moved to the leg. This does not mean that you do not treat the back.
In the acute (severe) stages of sciatic pain it is important to nurse the back along gently without causing alarm. You can read here about specific calming exercises for back pain relief, called 'spinal appeasing' exercises, which are noteworthy in their gentleness. Better still, watch the videos of Sarah showing you how it's done. Doing these exercise properly is critical; it literally makes all the difference.
Proper medication through the help of your local doctor plays an important role in managing acute sciatica. So you might like to read about medications for back pain to understand more about how the different drugs work: anti-inflammatories, painkillers and muscle relaxants.
1. Knees rocking exercises release the back from over-the-top muscle clenching, get a better circulation through the water-logged tissues and help disperse inflammation. They should be done without any sense of trying to rack up the intensity or the number, at a rate and rhythm that almost sends you to sleep. It should be like rocking a baby to sleep in pram.
2. Spinal rolling is an important appeasing exercise. It breaks up the rigidity of the lower back. It's quite hard to keep going for more than a few moments, especially for the front of the neck. All normal.
3. Preparatory sciatic nerve stretches get the leg used to the idea of tension on the nerve. These sciatica stretches involve taking the knee to the chest and then pushing the heel to the ceiling. You will be surprised how difficult it is on the bad side; the knee will be more crooked than a dog's hind leg and the leg will tremble. The idea is to gently push it straighter as you push and release, coaxing the nerve free where it is bound to that joint capsule in the back.
If acute facet joint arthropathy is not treated properly it may become chronic. Chronic sciatica is a nagging pain in the leg, made worse by sitting, but also sometimes by running (sciatica is common in long distance runners).
The main aim of chronic sciatica pain treatment is breaking down and re-absorbing of adhesions that have collected around the nerve. This is where all varieties of sciatica stretching exercises come in, to float the nerve free. A normal healthy nerve pulls out of the spine like a strand of cooked spaghetti. With chronic sciatica, the nerve is like the strand of spaghetti stuck to the side of the pot. The sciatica stretches are to coax - not yank - the nerve free.
You only start sciatica stretches to wrest the nerve free of its matted imbroglio of adhesions once you're on the mend. Be careful! Although the leg often craves stretching, you can overdo things and make matters worse.
1. Using a Tennis Ball is an ideal sciatica nerve treatment through mobilising a chronically inflamed facet joint. You can knot two balls to in a pair of tights say, and use these to gently pummel the facet joints. There is much more on this in the page treatment of spinal stenosis where you can see how to position the balls on the floor and roll on them.
See here part two of short YouTube clip of Sarah showing you how to use the Ma Roller. This is quite punishing treatment and not for the faint-hearted. You can only use it once a week, and then not for too long. You can buy a Ma Roller here.
2. Floor Twists are really effective at drawing the nerve roots through the sides of the lumbar spine. The emphasis should be on trying to get the leg straight at the knee of the uppermost leg, rather than holding the toes. You can read about this exercise in Chapter 7 of The Back Sufferers' Bible. Better still, watch them being done properly in the back pain treatment videos where you will see it explained again by Sarah and how to get it right.
3. A BackBlock is best for pulling the spinal segments apart. Done properly it consists of 3 steps to create pressure changes to suck nutrients in and out of the discs, reduce soft tissue swelling, evacuate stale inflammatory products, and slide or 'floss' the nerve root to keep it free. You can read all about this in the pages do your own spinal decompression using a BackBlock. Or, if you have the time you should watch the complete video package to see Sarah explaining what happens to compress the spine and create the sciatica in the first place.
You can't beat a BackBlock for getting rid of chronic sciatica!
Chronic arthropathy and sciatica back pain may go on to develop vertebral stenosis if the condition worsens. This is a very disabling condition, where the constriction caused by the local swelling of the soft tissues causes the nerve root itself to be starved of blood. The muscles supplied by this root cease to function properly and the legs feel painfully lead-like on walking. You can click here to read more about spinal stenosis treatment.
Here you can read more about Sarah's sciatica treatment video and hear about the different causes of sciatica and how to treat it yourself.
In most instances, massaging a painful posterior thigh is pure agony! It's treating the effect, not the cause, and is simply useless
Sometimes people resort to massage for sciatica pain treatment but rarely does this give lasting benefit. It is a bit like trying to turn a light globe off at the bulb itself, rather than using the switch at the door. It may feel comforting at the time, but the ministrations are being directed at the effect, rather than the cause. Treatment for sciatic nerve pain must always be directed to the back primarily. The delving into the tissues that are inflamed increases their ability to heal and this, in turn, reduces the pain in the leg.
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