Sciatica and nerves
Sciatica care advises gentle movement and limits long bed rest
Gentle movement is the usual advice for sciatica, and long periods in bed are discouraged [1][2]. Sciatica usually gets better in a few weeks to a few months, though it can last longer [1].
Key points
- Staying as active as you can is advised, and too much rest may cause discomfort elsewhere in the body [2].
- Walking, stretching and guided exercise from a physical therapist are the common kinds of activity [2][3].
- Back pain is more likely if you exercise too strenuously after being inactive [4].
- Numbness around the genitals or anus, or trouble controlling your bladder or bowels, needs emergency care [1].
- Nonsurgical treatment is less successful when bone spurs or spinal stenosis are the cause, though improvement is still possible [2].
Gentle motion helps reduce inflammation in people with sciatica
Do not stay in bed. Too much rest may cause other parts of your body to feel discomfort, and motion helps reduce inflammation [2]. Try not to sit or lie down for long periods. Even if moving hurts, it is not harmful and can help you get better faster [1].
Carry on with your normal activities as much as possible [1]. Find positions that are comfortable, but be as active as you can [2].
Sciatica happens when the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed [1]. It often gets better in a few weeks to a few months, but it can last longer [1].
Physical therapy adds guided exercise to walking and stretching
| Activity | What to know |
|---|---|
| Short walks | A doctor may suggest them [2] |
| Stretching | Starting early can help you return to activities without sciatica pain [2]. It may relieve pressure on the nerve [3] |
| Back strengthening | Walk and move while limiting too much bending or twisting [2] |
| Physical therapy | Guided exercises may improve strength and reduce nerve pressure [3]. Care may include massage and other hands-on techniques [1] |
| Routine chores | Cooking and cleaning around the house are fine [2] |
A physical therapist may teach you exercises to do in the office and at home, and show you how to do them safely [3]. One example is a hip lift:
Heat and cold packs may soothe painful muscles
You may find gentle heat or cold soothing on painful muscles [2]. Ice may help reduce pain and swelling during the first few days, and heat may help after that. Use either for about 20 minutes at a time [3].
Medicines such as ibuprofen, aspirin, naproxen or muscle relaxants may offer relief [2]. A pharmacist can answer questions about painkillers, and it is not clear how much anti-inflammatory medicines help with sciatica [1].
Overdoing exercise after inactivity can strain the back
- Back pain is more likely if you exercise too strenuously after being inactive for a while [4].
- Limit too much bending or twisting while you stay active [2].
- Heavy lifting, frequent bending and sitting for long periods can strain your lower back [3].
- Using a safe lifting technique and good posture when sitting and standing may reduce the chance of sciatica returning [1].
- Smoking can increase your risk of getting sciatica [1].
Common mistake
Staying in bed because of the pain is not advised, since too much rest may cause discomfort in other parts of the body [2].
Weakness, pain or numbness in your legs along with back pain is also a reason to see a doctor [4]. Moderate to severe pain, numbness, tingling or muscle weakness needs medical care [3].
When to get care
Numbness around the genitals or anus can signal a back problem needing emergency care
These signs need emergency care [1]:
- Weakness or numbness in both legs that is severe or getting worse [1].
- Numbness around or under your genitals, or around your bottom (anus) [1].
- Trouble starting to pee, being unable to pee, or being unable to control when you pee, if this is not normal for you [1].
- Not noticing when you need to poo, or being unable to control it, if this is not normal for you [1].
These could be symptoms of a serious back problem that needs hospital treatment as soon as possible [1]. Do not drive yourself. Ask someone to drive you [1].
If you think you may have a medical emergency in the United States, call 911 or go to the nearest emergency room.
Bone spurs and spinal stenosis make nonsurgical sciatica treatment less successful
Sciatica can come from a herniated disk, where a soft cushion between spine bones pushes out. It can also come from spinal stenosis, a narrowing of the part of the spine where nerves pass, or from spondylolisthesis, where a spine bone slips out of position [1].
A herniated disk is typically the cause in people under 40, while older adults more often have bone spurs and arthritis [2]. Nonsurgical treatment is less successful with bone spurs and spinal stenosis, but there is still a good chance of improvement [2].
A doctor starts with your history and a physical exam, which may include walking on your heels and toes or a straight-leg raising test [2]. Talk with a provider if symptoms have not improved after a few weeks [3]. The same goes if sciatica is stopping you from doing your normal activities [1].
Surgery may be considered if you still have disabling leg pain after 3 or more months of nonsurgical treatment [2]. Sciatica can also return after it has gone away [1].
Sources
- Sciatica nhs.uk
- Sciatica orthoinfo.org
- Arrow Down my.clevelandclinic.org
- Back Pain Symptoms, Types, & Causes niams.nih.gov
Not medical advice. This page is general education written from the sources above. It cannot diagnose a condition or replace a licensed clinician who knows your history. If you may be having an emergency, call your local emergency number or go to the nearest emergency department.