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The sciatic nerve is the largest nerve in the human body, being formed by several nerve roots that come from the spine. The sciatic nerve begins at the end of the spine, passes through the glutes, posterior part of the thigh and, when it reaches the knee, divides between the common tibial and fibular nerve, and reaches the feet. And it is in this whole path that it can cause pain with a tingling sensation, stitches or electric shock.
When there is compression or inflammation of this nerve, sciatica arises which causes symptoms such as severe pain in the back, buttocks or legs, difficulty in keeping the spine erect and pain when walking. In these cases it is important to seek an orthopedic doctor or physiotherapist so that he can guide the appropriate treatment.
To cure the inflamed sciatic nerve, the treatment indicated by the orthopedist or the physiotherapist must be carried out, with medicines, exercises, and sometimes physiotherapy.
Main symptoms of sciatic nerve
If you think you may have inflammation of the sciatic nerve, select your symptoms and find out what your chances are:
- 1. Tingling pain, numbness or shock in the spine, gluteus, leg or soles. No Yes
- 2. Feeling of burning, stinging or tired leg. No Yes
- 3. Weakness in one or both legs. No Yes
- 4. Pain that gets worse when standing still for a long time. No Yes
- 5. Difficulty walking or staying in the same position for a long time. No Yes
Often these symptoms are associated with changes in the spine, such as herniated disc, spondylolisthesis or even spinal arthrosis. For this reason, when the first symptoms appear, it is very important to consult an orthopedist or a physiotherapist, so that tests are performed in the office and X-ray examinations of the spine are performed to assess if it has any alterations that are compressing the nerve, giving the symptoms.
When the person has other symptoms such as a stinging, burning sensation, and feeling tired and heavy legs, this is not related to the sciatic nerve, but they are characteristic of the myofascial painful syndrome, which is often confused with changes in the sciatic nerve. Learn how to identify and treat this syndrome.
How to confirm if it is sciatica
The diagnosis of sciatica can be made by the orthopedist or physiotherapist based on the signs and symptoms presented. The test that consists of proving the alteration of the sciatic nerve can be done in the office is: lying on your back and lifting the stretched leg of the stretcher, if there is pain or tingling sensation, the test indicates sciatic compression. If there is pain in the other leg, this indicates a severe spinal alteration, such as an extruded herniated disc, for example.
Imaging tests like X-rays and MRIs can be useful to assess the spine, helping to identify what is compressing the nerve. If the spine is healthy and unchanged, the cause of sciatica should be muscle or fascia only, and treatment is relatively simpler.
When there is a suspicion that the nerve is actually damaged, which rarely happens, only in case of serious accidents, it may be necessary to do an electroneuromyogram, which is an exam that assesses the functioning of the nerve itself.
How to relieve the inflamed sciatic nerve
Treatment for sore or inflamed sciatic nerve can be done using analgesic, anti-inflammatory drugs in the form of pills, ointments, use of heat bags and physical therapy with specific exercises. The options are:
1. Remedies
The remedies indicated to fight sciatica can be Paracetamol, Ibuprofen, or the strongest, derived from morphine like Tramadol, but a muscle relaxant and Diazepan can also be indicated by the orthopedist. But a more natural way to fight pain is to take the vitamin B complex, as it improves the health of the body's nerves.
2. Massage
Massage with moisturizing cream or essential oils is one of the best home treatment options for inflamed sciatic nerve because it serves to relieve pain and improve movement, because it relaxes the muscles of the back, legs and buttocks, thus decreasing nerve compression, but preferably they must be performed by a masseuse or physiotherapist and does not exclude the need for treatment at the clinic.
3. Exercises
Rest makes the pain worse, as well as staying in the same position for a long time, which is why light exercises are welcome. Initially, stretches that can be done with the person lying on their back and hugging their legs, for example, are more recommended.
When the pain decreases, after the first week of physiotherapy, muscle strengthening exercises can be performed, such as: lying on your back, flexing your knees and pressing a pillow between your legs and working on your back and spine, lying on your stomach upwards, flex your knees and lift the hips and butt of the stretcher. These Clinical Pilates exercises are excellent options to cure sciatica because they strengthen the abdomen and spine. Strengthening the abdomen is a great trick to protect the spine. See how to do the exercises indicated in this video:
See other exercises for this in: 5 Pilates exercises against Back pain.
4. Physiotherapy
In most cases, the treatment of inflammation or compression of the sciatic nerve involves performing physical therapy sessions with devices that reduce pain and inflammation and strengthening and stretching exercises, and manual techniques to mobilize and stretch the affected leg, improving blood supply to the sciatic nerve and normalize the tone of the gluteal and leg muscles.
In addition, it is also recommended to apply localized heat over the region to be treated, and to perform stretches to stretch and relieve nerve compression. See other home care and options to treat the sciatic nerve at Home treatment for sciatic nerve.
Sometimes when these problems are associated with poor posture, the physiotherapist may also recommend performing a treatment called Global Postural Reeducation - RPG, in which there is a posture correction and stretching of the muscles responsible for the postural change.
5. Food
During a sciatica crisis, anti-inflammatory foods such as salmon, garlic, onion, flaxseed, chia and sesame should be preferred. But it is also important to reduce the consumption of foods that increase inflammation in the body, which are mainly processed meats, such as sausage, sausage and bacon. Learn how to make an anti-inflammatory diet.
6. Alternative treatment
In addition, there are other options that can also complete the treatment, which include performing Acupuncture and Reflexology sessions to relieve pain and discomfort.Another possibility is osteopathy, which consists of techniques that stretch the muscles, traction in order to crack the joints, being a good way to treat scoliosis, hyperlordosis and herniated disc that are usually involved in the cause of sciatica.
7. Spine surgery
It is reserved only for the most serious cases, when there is a herniated disc that does not improve with all the treatments mentioned above. In this case, the surgeon may decide to remove the vertebral disc and stick one vertebra to the other, for example.
How to prevent the pain from coming back
To prevent a new sciatica crisis, you must:
- Do regular stretches that stretch your leg and spine muscles. See some stretches you can do during the workday in 8 Stretches to fight Back Pain at Work.
- Avoid physical inactivity and regularly practice activities such as walking, Pilates or water aerobics that strengthen and stretch the muscles;
- Try to maintain the correct back posture even when sitting;
- Always be within the ideal weight;
- Keep the abdomen always strong to protect the spine.
What causes sciatic nerve pain
Pain in the sciatic nerve happens when this nerve undergoes compression, which is common when the person has a lumbar disc herniation, especially between L4 or L5, a tightening of the canal where the spinal cord passes, a misalignment of a vertebra, or when an increase in the tone and firmness of the gluteus, for example.
Women who practice physical activity at the gym and have a hard butt, may have sciatica because there was an increase in tone or even a contracture in the gluteus developed, more specifically in the piriformis muscle.
About 8% of the world population suffers from sciatica because nerve fibers pass through the piriformis muscle, and when it is very tense or contracted, it compresses the nerve, causing pain in the form of numbness, shock or tingling. Learn to identify the piriformis syndrome.
Inflamed sciatic nerve in pregnancy
During pregnancy it is common for the sciatic nerve to be affected due to the rapid increase in weight, growth of the belly and alteration of the woman's center of gravity, which can lead to compression of this nerve. When this happens, the pregnant woman should see a doctor or physical therapist, to start the treatment and minimize the symptoms presented. Treatment can be done with stretching exercises, hot compresses and anti-inflammatory ointments to pass the pain site.