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first aid for sciatica

Do you actually have sciatica?

You woke up in the morning with severe pain in the lumbar region of the back (lower back) and found it extremely difficult to get out of bed due to pain and reduced mobility. Also, do you feel tingling and burning along one or both legs that create significant discomfort and restriction? 

Chances are that sciatica has caught you, which according to research at some point in life affects as many as 85% of people in the world. And here we are talking about the more severe symptoms of sciatica or lumboshialgia on this large number of people. 

We all probably have minor sciatica symptoms at least once in our lives (most of us significantly more times than that). 

What's the solution to the problem? Should you contact a physical therapist, doctor or other medical professional immediately? Or can you help yourself so that the problem does not get worse or even improves? 

We will tell you all about it in our new blog! 

First aid for sciatica
Sciatica symptoms

Whether you can help yourself depends on the severity of the symptoms!

2 situacije postoje kada NIKAKO ne bi trebali pomagati sami sebi. Te 2 situacije su kada ste completely immobile and when you can't control urine and stool. 

These situations indicate extremely serious conditions in which there may be significantly larger deficits and long-term dangerous conditions for your health. 

In these 2 situations, please urgently find a specialist doctor who will examine you and refer you to an MRI to see if you need urgent surgery. 

You can try to help yourself in about all the other situations except the first 2 listed here. 

How can you help yourself?

As we said in the previous chapter if you are sure that the situation is not serious and that you do not have the above 2 dangerous situations, you can try to help yourself with the following techniques and advice. 

Some of the ways you can help yourself are:

  1. Change the mattress you sleep on
  2. Walk slowly up to 1km distance
  3. Warm the painful area with warming creams and gels
  4. Drink twice the recommended daily dose of magnesium
  5. Perform static exercises to strengthen the core 
  6. Perform light gluteus activation exercises
  7. If the pain is too great to endure, use painkillers (we do not recommend doing this in the long term) 
How to sleep in sciatica

1. Do not sleep on a soft surface!

Have you noticed that literally, the first part of the first sentence of this blog was "You woke up"? 

For a reason we asked you if you woke up with pain in the lumbar spine or sciatica because this is the most common situation in which the symptoms of lumboshialgia begin to appear. 

But why do most symptoms occur only in the morning? 

We spend a third of our lives sleeping on our beds. This information is extremely important for the health of our body and spine. 

7-9 hours a day we are in a lying position and it is extremely important that we lie on an adequate surface and do not expose our spine to any additional unnecessary loads and problems. 

One of these problems, especially when you have symptoms of sciatica is the too soft surface/mattress on which you sleep! 

Why is the mattress a problem and what should it really be like?

Extremely soft mattresses are problematic because the spine adapts badly to them during the night, and our back "falls" through the mattress. This position of the back unnecessarily activates the muscles of the spine, and the spine struggles to maintain proper position throughout the night. Because of this unnecessary muscle activation, you wake up with stiff and overstrained muscles and symptoms of sciatica as a result. 

The surface on which you sleep should be relatively hard to avoid these problems and to keep the spine in a neutral position while you sleep. 

2. Don't stop moving!

You must have heard the advice “get some rest!" many times from the doctor when you get pain in your spine or any other joint or muscle.

This advice is completely wrong and when a specialist advises you to get complete rest (unless the situation is extremely alarming) get a second opinion. 

Rest is in most cases by far the worst option because we prolong the problem and our muscles go to atrophy in the long run because of that same rest. 

So it is not possible to achieve a solution to the pain in the spine by resting! 

What can you do instead of rest?

Here you would be advised to do the opposite thing, and that opposite thing is MOVEMENT! 

Namely, by moving, you will activate and move the muscles and spine, stimulate circulation in the body and consequently make a more suitable environment for the recovery of the body. 

For a start, we would advise you to take a light walk up to 1 kilometer and over time increase the distance to the limit of pain. When the pain starts to come more significantly, finish the walk. 

Minor pain and discomfort when walking are normal because the painful and inflamed tissue is moved and you do not need to worry about that situation. 

Hot and cold therapy

3. Do not ice the painful spot!

You must have heard this advice countless times from doctors, other medical experts, and even your family and friends whenever something hurts you just need to cool it. In most cases, this advice is completely wrong. 

Why is it wrong?

Cooling tissue narrows blood vessels, reduces the flow of circulation in the tissue, and consequently reduces the ability to regenerate tissue and additionally “stiffens” the muscles.

So what's the real solution?

The solution to this problem is in most cases to heat the tissue. Tissue heating expands blood vessels, stimulates circulation and increases the ability to regenerate tissues and relax muscles. 

What is the best way to warm tissue when having sciatica?

We can warm tissue with sciatica in many ways:

  • massage Deep Heat or other similar cream that warms exactly to a painful and tense place 2 to 3 times a day 
  • fill the hot water pack and put it in a painful place for 10-15 minutes or to the limit of heat tolerance on the skin 
  • fill the bath or pool with warm water and immerse the body in it for half hour to 1 hour 

4. Avoid pain medication if possible!

Painkillers such as Ibuprofen, Ketonal, and similar that every doctor will prescribe are short-term solutions to the problem and actually mask the symptoms. In the end, it is necessary to discover the cause of the problem, not mask the problem itself. 

Instead of painkillers, start taking a magnesium supplement on a regular basis. Magnesium is one of the most important minerals in the human body that helps in the proper function of muscles and peripheral nerves and will help you in the long term by reducing muscle tension that primarily caused sciatica and your muscles and nerves will function optimally. 

Magnesium also has anti-inflammatory properties that will be very useful in lumboishialgia because this is actually an inflammatory process in the ishiadicus nerve. 

It is very important to consume magnesium daily and at the minimum recommended daily dose of 375 mg. Athletes can freely take a double dose of magnesium, but it is necessary to watch for problems with digestion when taking it. 

Magnesium citrate
Plank position

5. Feel free to exercise! (adapted to the problem)

As we have already mentioned before, the most common advice here from various experts is to get rest which is completely wrong. 

Muscles should be activated to stimulate circulation in them, relax them, strengthen them in the long term, and consequently reduce pain and lack of function. 

One of the simplest exercises that can significantly help with sciatica is PLANK. Plank is a static trunk strengthening exercise that will help you reduce pain and stabilize the spine by strengthening the muscles of the trunk itself. 

Plank can be performed on stretched hands or on elbows and it is very important that you perform it correctly. Your whole body must be in the right line when you are in the plank position and also try to squeeze all the muscles starting from the abdominal, back muscles, and all the way to the leg muscles. 

Stay in the plank position for 15-30 seconds in 3-4 series depending on your pain and tolerance. Over time, increase the length of the position and the number of series. 

6. Activate the glutes!

The vast majority of people in the modern age have extremely weak muscles of the body with an emphasis on muscle weakness of the buttocks or gluteus. The cause of this problem is the sedentary lifestyle that most people are exposed to today. 

The Gluteus maximus is one of the strongest muscles in the human body and has a very important role for the body during walking. 

In case of atrophy or weakness of the glutes, the body compensates so that the load during walking, sitting, and standing goes to the muscles of the lumbar spine and the same muscles under this load stiffen. 

Stiffness occurs because the lower back muscles are much weaker than the gluteus maximus and stabilization of the body is not their primary function. 

A simple exercise with which you can fix this, even when you have already been caught by sciatica is the BRIDGE exercise. 

Na strunjaču ili drugu podlogu lezite na leđa s nogama savijenim u koljenima i rukama pored tijela. 

Odignite stražnjicu od poda i zadržite ju u gornjem položaju 3 sekunde. 

Vježbu ponavljamo 10 puta unutar jedne serije u 3-4 serije. Vrlo je bitno da u gornjem položaju stisnete mišiće stražnjice! 

Glute bridge
Pain medication

7. If the pain is unbearable, take painkillers short-term

There are situations where the pain is extremely acute and unbearable, and in this situation feel free to take medications such as ibuprofen, which is very effective for musculoskeletal pain. 

In the long run, we would not recommend taking medications because they mask the pain and the real source of the problem, and you get used to them. 

If the pain lasts for a long time and none of our previous solutions helped you feel free to contact your physiotherapist or a specialist doctor in order to instruct you with further tests and solution to the problem. 

Do not neglect the problem that lasts for a long time, because the longer the problem lasts, the longer it will take to solve it! 

Bsc. PT. Toni Marić

Bsc. PT. Toni Marić

Toni is bacc. physical therapist and the owner of the Ad Sacrum clinic who has been treating top athletes for years and also teaches at the Dry needling courses for physiotherapists.

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