Today’s episode is entitled “What is the best treatment for sciatica?” and it covers:

• Know the cause of your sciatica
• Avoid aggravating it
• Manual therapy as treatment for sciatica
• Acupuncture
• Exercise as treatment for sciatica

Know the cause of your sciatica

If you want to know what the best treatment for your sciatica is, you need to understand what the cause of it is, first. I split sciatica into two groups: nerve compression sciatica, yet unknown nerve compression sciatica. There are a number of possible causes of each and it’s not that important to know exactly the cause of your sciatica, but it’s certainly important to know what isn’t the cause. It’s important to know that you don’t have a pathology (infection, cancer, metabolic disorder, cardiovascular problem). This is very rare, but it can happen. All sorts of things can lead to sciatica, but the most common causes are referred pain and pain related to them, pinch of a disc on one of your spinal nerves.

Avoid aggravating it

If you’re trying to treat your sciatica but at the same time you’re doing something that aggravates it, then it’s two steps forward and three steps backward. Identify what is aggravating your sciatica and stop doing it, or at least to minimize their impact, do them differently. You can try and observe your pain and see when it gets worse and when it gets better. But if you’re struggling to assess it, you can get some insights from engaging with our chat-bot at backpainandsciatica.com. You can do the free assessment there and it will give you a good output.

Manual therapy as treatment for sciatica

This means using your hands. Who should be doing that? An osteopath, chiropractor or physio therapist. Make sure they’re registered with appropriate qualifications. They should be able to help you with physical therapy for your sciatica. It’s also worth throwing into that mix a good massage therapist, particularly if it’s muscularly related. There are many other causes aside from muscular causes.

Acupuncture

If you aren’t getting better with manual therapy, acupuncture can work very well. It’ been removed from the clinical guidelines in the UK in the last couple of years, but you can get tremendous results in symptom relief. And that’s what you want, to feel better, it doesn’t really matter what the mechanism of action is.

Exercise as treatment for sciatica

You could do McKenzie exercises, where you’re lying on your front, pushing down on the floor with your hands and making an arch at the small of your back. Theoretically that alleviates the pain, if it’s related to disc herniation, but, it can make other things worse. If your sciatica is related to piriformis syndrome (the piriformis muscle tightens up), you may find that stretching your piriformis muscle (the buttock area) helps.

Another one is flossing. You’re stretching a cyanotic neuro from opposite ends in turn, in order to free off its movement through the interim virtual door forum and the little gap that the spinal nerve comes through and then travel that to your sciatic nerve. Theoretically that nerve can be tethered, caught irritated in that space. Psychotic flossing can be very good at freeing that off. It’s usually a bit uncomfortable to do, but it should lessen over time. Remember, if the discomfort is increasing when you do the exercises, you’re doing the wrong exercise. Use it or lose it, but don’t abuse it.