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• Method 1 of 2: Dealing with sciatica at home
• Method 2 of 2: Treating sciatica

Sciatica is a nerve pain that starts in the back and continues through the buttock to your leg. It is a pain in the longest nerve in your body, the great sciatic nerve, also known as the sciatic nerve. This nerve starts in your spinal cord and runs through the buttock down the back of the leg. The pain can develop anywhere along the nerve and it can be very intense depending on what is pressing on the nerve, such as a muscle, a spine or something else, and where. The pain is usually only on one side and mainly occurs in a particular position (such as sitting). It can last for a few days to weeks, depending on the cause. Sciatica can be caused by all kinds of conditions of the lower back or spine that irritate the great sciatic nerve, such as a hernia or pregnancy. You can relieve the pain at home with a combination of simple techniques and medication. Medical treatment of the symptoms depends on the underlying cause of the sciatica and requires the expertise of a physician.

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Method 1 of 2: Dealing with sciatica at home

1. Rest your back. Take it easy for the first few days of your sciatica. If you are less active, the pain will diminish, your muscles can relax and you will not irritate the large sciatic nerve too much. However, don't stay in bed for more than a day or two. If you are inactive for too long, your muscles that support the bones in your back become weaker, which can cause more irritation to the sciatic nerve, which ultimately leads to more pain.
   • While it is important to stay active after the initial rest period, be careful not to irritate the great sciatic nerve. Avoid strenuous activities such as lifting heavy things or turning your back too far.
2. Take anti-inflammatory painkillers. Irritation of the great sciatic nerve can lead to inflammation, which can make the pain from sciatica worse and longer. Many over-the-counter anti-inflammatory painkillers reduce the pain of sciatica. Ibuprofen and naproxen are two popular and effective choices. Make sure you follow the dosage instructions in the package insert.
3. Treat sharp pain with cold compresses. Most patients find that cold helps best when the pain from sciatica is at its worst, usually 2 to 7 days after it starts. Place an ice pack (or something else cold, such as a plastic bag with ice cubes, a bag of frozen peas, etc.) where it hurts and let it sit for 20 minutes. Repeat the treatment every two hours.
   • Always wrap your ice pack in a cloth. Putting ice directly on your skin can feel like your skin is burning.
4. Use a warm compress to relieve nagging pain. Many patients find that the pain becomes less sharp 3-7 days after it starts. During this phase, heat is better than cold for pain relief. Place something warm on the sore area, such as a water bottle or heating pad, or take a warm bath. Place something warm on the painful area for 20 minutes, and repeat this every two hours.
   • Make sure to follow the manufacturer's instructions when using a heating pad.
   • While many people prefer cold at the beginning of the sciatica and warmth during the later stages, this is not the case for everyone. If one or the other doesn't seem effective in relieving your pain, try alternating heat and cold every two hours.
5. Stretch your lower back. By gently stretching your legs, buttocks, and lower back, you reduce tension in your muscles, making the great sciatic nerve less irritated. Do consult your doctor or physiotherapist so that you know how to stretch safely. While there are many variations, the simplest and most effective stretch for sciatica is simply to pull the knees up to the chest:
   • Lie flat on your back, lift one knee so you can wrap your hands around it and interlock your fingers.
   • Gently pull your knee towards you until you feel a gentle stretch in your buttocks and lower back.
   • Hold this for 20 seconds and breathe deeply.
   • Gently lower your leg and put it back down.
   • Repeat the exercise three times, then stretch your other leg in the same way.
6. Make an appointment with your doctor. Usually sciatica resolves on its own after a few weeks. But if the pain is not getting better, or if it is severe and home remedies are not working, make an appointment with your doctor to discuss treatment options. In rare cases, more severe symptoms may develop requiring immediate medical intervention. Call 112 if:
   • One or both legs go numb
   • One or both legs go limp
   • You suddenly lose control of your bladder or bowels, or you cannot urinate or defecate.

Method 2 of 2: Treating sciatica

1. Consult your doctor. Sciatica can be caused by a variety of conditions of the lower back or spine. Your doctor knows how to test you for these conditions. The type of exams your doctor chooses will depend on the symptoms and your further health, and may include simple physical exams and imaging techniques such as an X-ray or MRI scan. Be as detailed as possible when describing your symptoms to the doctor so that he / she can better determine which tests should be done.
   • Known causes are: a hernia or displaced spine, piriformis syndrome, spinal stenosis, or spondylolisthesis.
2. Treat the pain and inflammation with prescription medication. Normally, the pain from sciatica subsides after a few weeks. If your doctor has determined that surgery is not necessary, you may still be given medication to relieve the pain while you recover from the sciatica. These are for example:
   • Oral steroids, which have powerful anti-inflammatory properties to reduce inflammation and irritation around the site of the great sciatic nerve.
   • Muscle relaxers or heavy painkillers to relieve the pain.
3. Ask for steroid injections if the pain is excruciating. Steroid injections work in much the same way as oral steroids, by temporarily reducing inflammation and irritation in the area around the great sciatic nerve. Injections are more invasive than oral medications, but also more effective. Your doctor can prescribe injections if the pain is severe.
4. In severe cases, consider surgery. Sciatica can be caused by a variety of factors and conditions, which usually don't require surgery to resolve. But if the sciatica is caused by vertebrae or bones physically pinching the great sciatic nerve, the doctor may need surgery to correct the problem. Two types of surgery are usually performed:
   • In the case of a hernia (when the intervertebral discs that dampen movement in the spine have weak spots and the insides protrude), a microdiscectomy can be performed. In this procedure, the piece of disc that touches and irritates the nerve is removed.
   • In lumbar spinal stenosis (if the intervertebral discs are constricted and pinch the nerve), lumbar laminectomy may be recommended. This is a major operation in which the intervertebral discs are reshaped so that the nerve is no longer trapped.
5. See a physical therapist. After your doctor has given you medication and possibly suggested surgery to get rid of your sciatica, it may be good to start physical therapy. Your therapist can teach you exercises to strengthen your core and support your spine. By creating strength and stability in the lower back you can eventually get permanent relief from sciatica.
6. Go to a chiropractor. Many people who suffer from sciatica find relief with a chiropractor. While more research is needed to prove the effectiveness of chiropractic care, recent research has shown promising results for people with sciatica.
7. Explore alternative treatment methods. If traditional treatments don't work for sciatica, talk to your doctor about lesser-known options. Here are some examples of alternative therapies you can discuss:
   • Therapeutic massage to reduce tension and inflammation.
   • Yoga classes to make the core stronger and more flexible.
   • Cognitive behavioral therapy to better deal with the pain.
   • Acupuncture, or other traditional therapies.