The Doctor Is In

By DAMON RASKIN, M.D. | Special to the Palisadian-Post

Q:I was recently diagnosed with sciatic nerve pain. Most days I am able to do most of my regular things, but sometimes, like when walking, the pain seems to catch up with me. What are some things I can do to manage the pain?

I just saw a 53-year-old male patient last week who came to see me because of a sharp, shooting pain starting at his left buttock and traveling down his left leg all the way to his foot. This pain had been going on for the last two weeks, and he would get “electrical shock” sensations intermittently depending on his activity, with occasional numbness and tingling in the leg. This description is classic for sciatic nerve pain.

Sciatic pain is caused by compression of the sciatic nerve, which is the longest nerve in the body. It runs from the lower back through the hips, buttocks and down each leg.

Managing sciatic pain effectively requires a combination of treatments that address both the symptoms as well as getting to the underlying cause of the condition. This type of pain is a manifestation of a larger issue, such as a herniated disc in the back or other spine conditions, including spinal stenosis or degenerative disc disease.

I have seen many patients with this condition over the years, and the pain can range from mild to so severe that it impedes their activities of daily living.

For immediate relief, it is important to modify your activities to avoid aggravating the situation. Short periods of rest can help, but prolonged inactivity can worsen the pain.

Instead, engage in light activities, and avoid sitting or standing for extended periods. Use a comfortable chair with proper lumbar support and avoid lifting heavy objects, like your 6-year-old child.

Applying cold packs can reduce inflammation and numb the sharp pain associated with sciatica, but I find cold therapy works best in the first 48 hours after pain onset. After that, switching to heat therapy, such as a heating pad or a hot tub, can help relax tight muscles and improve blood flow to the area.

As far as medications are concerned, a good first step is to try over-the-counter anti-inflammatory medicines such as Advil or Aleve. Tylenol may also be a helpful adjunct, but always speak to your healthcare provider before taking anything to see if these medications are OK for you to try.

Long-term management of sciatic pain would include physical therapy and stretching exercises. A good physical therapist is adept at creating a personalized exercise program to strengthen the muscles supporting your spine, improve flexibility and reduce pressure on the sciatic nerve. Core strengthening exercises can also stabilize the lower back and help prevent future flare-ups.

Maintaining good posture is crucial in managing sciatic pain, and ergonomic adjustments in the workplace, such as using a standing desk or special chairs, may help reduce lower back strain.

While most cases of sciatica improve with conservative treatment, please seek medical attention if the pain persists more than a few weeks, worsens over time or is accompanied by severe symptoms such as severe weakness of the leg, or bowel or bladder incontinence. In these more severe cases, treatments may include steroid injections into the spine, nerve blocks or even surgery.

As you can see, managing sciatic pain effectively requires a balanced approach that includes both immediate relief strategies and long-term management techniques. Speak to your healthcare provider for the perfect plan for your case, as no two patients are the same.