Harvard Health Publishing Q&a: Sciatica
Sciatica image
How should I lay with sciatica?
Answered by Dr. Robert H. Shmerling
M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA
There is no single correct position recommended for people with sciatica. For many, finding a comfortable position is a matter of trial and error. To some extent, the cause of sciatica may affect which positions are most comfortable. For example, side-sleeping may be better for someone with sciatica due to lumbar spinal stenosis while back sleeping may feel better for the person with disc disease. And, of course, no matter what position you start with, people tend to move around during sleep so choosing a single position for sleep is often impossible. That said, many experts make the following general recommendations: Place a pillow under the knees and/or lower legs when lying on your back. Put a pillow between the knees if lying on your side. Try curling up in the fetal position. Use pillows to keep the head and upper back tilted forward a bit or sit in a reclining chair that allows a forward bend to the back. Stick with what works. If stomach sleeping is more comfortable, don’t feel compelled to follow advice about other positions, especially if the other positions cause more pain. If finding a comfortable position is challenging, work with a physical therapist who can help you identify and maintain positions that reduce pain when you lie down.
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Are there exercises to cure sciatica?
Answered by Dr. Robert H. Shmerling
M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA
Unfortunately, there are no specific exercises known to reliably cure sciatica. However, there are exercises that can help, including: • walking, swimming, cycling • yoga, tai chi, Pilates • stretching exercises, including bridge and knee-to-chest exercises (see below) To perform a bridge stretching exercise, lie on your back with your knees bent and your feet flat on the floor. Place your palms flat on the floor next to your hips. Keep your back straight as you lift your buttocks as high as you can off the mat, using your hands for balance. Hold for 5 seconds, then lower your buttocks not quite to the floor, then lift again. Repeat three times. To perform a knee-to-chest stretch, lie on your back with your knees gently bent and feet on the floor. Place both hands behind the lower right thigh near the back of the knee and gently pull the knee up toward the chest. Hold for 15 seconds. Then repeat for the left knee and continue alternating for 3 cycles.
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What is the minimum amount of time needed to recover from sciatica?
Answered by Dr. Robert H. Shmerling
M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA
Sciatica is a condition in which the sciatic nerve is irritated or damaged. The amount of time needed to recover from sciatica varies widely from person to person: it may take only a few days or it might take weeks to months. In some people, sciatica is chronic (long-lasting) and even lifelong. The time needed for recovery may depend on a number of factors, including: • Advanced age – conditions associated with age such as degenerative arthritis or disc disease may cause longer-lasting sciatica • Excess weight – Excess weight puts stress on the spine and surrounding nerves • Occupation and habits – a job or lifestyle that includes a lot of twisting, lifting, carrying a heavy load, or prolonged sitting may prolong sciatica • Sedentary lifestyle – Studies demonstrate that inactive people are more likely to develop sciatica so recovery may be slower among those who are sedentary • Diabetes – This condition is associated with sciatica and other nerve disease; poor control of blood sugar may be a factor in prolonged sciatica symptoms.
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What helps to relieve sciatic pain?
Answered by Dr. Robert H. Shmerling
M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA
Standard treatments for sciatica pain of recent onset include: • A short course of acetaminophen or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen • Rest, balanced with gentle stretching – maintaining physical activity (as symptoms allow) is important though activities that worsen symptoms should be avoided • physical therapy Some physicians prescribe a brief course of a corticosteroid medication for recently diagnosed sciatica. Other treatments, such as steroid injections or surgery, depend on the severity of symptoms, the progress made with the conservative treatments above, and whether the results of imaging (such as MRI) demonstrate a specific cause. When sciatica is longstanding, other treatments that may be beneficial include a stress reduction program, massage, acupuncture, duloxetine, tramadol or a muscle relaxant.
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