Introduction
Call your doctor if any of the following conditions occur:
Sciatica Warning Signs
- If the pain exhibits a relentless course, defying amelioration over several days or, conversely, exacerbates, seeking medical evaluation is prudent.
- In instances where sciatica strikes individuals at the nascent age of less than 20 or during the later years, beyond 55, it necessitates special attention.
- Particular caution is warranted if you have a current affiliation with cancer or boast a historical connection with this ailment.
- In scenarios where a substantial and unaccounted-for weight loss transpires, or if mysterious chills and fever couple with back pain, vigilance becomes paramount.
- If you are amongst those who are HIV positive or partake in intravenous drug usage, the gravity of your situation warrants recognition.
- Persistent difficulties when bending forward, extending beyond the one- to two-week threshold, should alert you to seek professional assessment.
- Should you observe a progressive escalation of muscle weakness, it is advisable to prioritize your health and seek guidance.
Indicators Necessitating Immediate Medical Attention
If any of the ensuing red flags co-occur with sciatica, an urgent hospital visit becomes imperative.
- If, despite earnestly endeavoring to alleviate the pain through initial home-based measures, the anguish remains intolerable, heed this warning.
- In situations where the onset of sciatica is linked to a traumatic incident such as a perilous fall from elevated surfaces or a vehicular collision, the gravity of the matter is self-evident.
- Should the source of agony manifest within the posterior region, adjacent to the chest, immediate evaluation becomes inescapable.
- If you experience an incapacitation of your limbs or lose sensation in your lower extremities, a prompt response is non-negotiable.
- In the event of incontinence of bowel or bladder, or numbness affecting your genitals, expedited medical attention is a categorical imperative.
- If your body temperature surges beyond the 101°F threshold, recognizing the urgency of the situation is paramount.
Self-Care Measures in the Home Environment
The Management of Sciatic Pain at Home
The throes of sciatica invariably impose limitations on one's daily activities. Consider the following strategies to alleviate this discomfort within the confines of your home.
- Refrain from bending, heavy lifting, or occupying plush, low-seated chairs, as these actions are liable to exacerbate your suffering.
- Assuming no contraindications such as allergies or medical restrictions—exemplified by the use of anticoagulants like Coumadin—over-the-counter analgesics like acetaminophen (Tylenol), aspirin (Bufferin or Excedrin), or ibuprofen (Advil, Motrin IB) are likely to confer respite from your distress.
- Experiment with the application of a cold pack to discern its efficacy in ameliorating your discomfort. In the absence of a designated cold pack, a sizeable bag of frozen vegetables can serve as a makeshift first-aid cold compress. Alternatively, solicit the assistance of a confidant who can execute a massage, following a triangular pattern, with an ice cube, targeting the afflicted areas. Ensure vigilance in moving the ice cube should it approach the brink of skin-chilling (anticipate the melting of several ice cubes).
- Post the cryotherapeutic interventions, consider a transition to heat application via an electric heating pad, assessing its potential in mitigating your pain. However, it is imperative to exercise caution and refrain from slumbering with the heating pad positioned on your dorsal anatomy to forestall the perils of burn-related injuries.
- In cases where access to an electric heating pad is constrained, resort to submerging a hand towel in scalding water, extracting and draining excess moisture, and laying it gently upon your posterior. Esteemed authorities in the realm of physical therapy contend that the virtue of moist heat resides in its superior penetration and enhanced analgesic attributes. A word of caution: preclude the use of drenched compresses in conjunction with an electric heating pad to avert the latent hazards of electrical shock.
- Some may discover relief by adopting a recumbent position, supine upon a rigid substrate, augmented by the placement of a cushion beneath the knees. Alternatively, the lateral decubitus posture with an intervening cushion between the knees may serve to preserve the structural integrity of the lumbar region. An accommodating recliner may also offer respite.
- While it is prudent to embrace repose, excessive confinement to the bedchamber, extending beyond a two-day threshold, bears the potential to exacerbate the condition. Engage in activities commensurate with your tolerance level, all while tempering expectations of immediate convalescence.
Other Therapy
You may receive special instructions from your doctor on dealing with
back pain. Some suggest complete bed rest—getting up only to go to the bathroom. Others suggest you sleep on the floor or put a board under your mattress for support. Some will tell you to use heat, others cold. You may also get a sheet with pictures of
back exercises
you are expected to start when the pain improves. (These patient education sheets come from different sources and may have conflicting information.)
Current research recommends that you stay active, within limits imposed by your pain. If you can avoid reinjuring yourself, you should try to stay at work. If the pain forces you to rest, do so, but avoid staying in bed just because you have
back pain.
If you are not improving after a week or 10 days, talk with your doctor about
alternative therapies
. Millions of people get some relief by visiting physical therapists, osteopaths, and
chiropractors. Others find that relaxation techniques and
acupuncture
work for them.
Recent studies in Europe and Scotland show that injection of botulinum toxin (BOTOX ®) gives relief to many people suffering from long-term sciatica. There are, thus far, not enough cases or completed studies to make this more than an experimental procedure.
Follow-up
Common sense should tell you what to do.
- Continue the simple home care measures for easing the pain. Use pain medicines, both over-the-counter and those prescribed for you by your doctor.
- Avoid reinjuring yourself. Pain will be your guide. If you hurt too much, back off on what you are doing and rest. Go slowly, if necessary, but try to keep active.
- Using a cane or a crutch for support will be helpful until the pain is under control.
Prevention
- Proper lifting techniques in keeping your back straight while bending your knees to pick up items often help avoid mechanical back problems.
- Keep flexibility and muscle tone by performing stretching exercises. These will help keep your back from bothering you. Maintaining your weight within your recommended limits for your height will go a long way to maintaining a healthy back as well.
Outlook
Most of the time, the pain associated with sciatica goes away in days to weeks. Pain can become more chronic in a small number of people, leading to some disability. Sciatica tends to reoccur frequently, sometimes without warning.
As your back is recovering, avoid twisting your back while bending at the same time because this move may aggravate your
healing
back and may slow your recovery.