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Why does my sciatic nerve hurt?
I often ask myself “why does my sciatic nerve hurt”? Well, it’s important to realise sciatica refers to the issues arising when you have a problem with your sciatic nerve. Sciatica itself is not the cause of your pain, sciatica is the pain! The cause of pain is normally a herniated, bulging, diseased disc. Or an issue with your piriformis muscle where it restricts the movement of the nerve.
This restriction of the sciatic nerve is the initial trigger that causes sciatica. The restriction of the nerve causes irritation, this irritation causes inflammation, the inflammation causes pain. When you have acute sciatica, this can be treated with time (2 to 6 weeks), ice and heat packs, medication like paracetamol and ibuprofen along with gentle stretches and physio exercises etc.
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Acute sciatica can become chronic.
The above treatments are normally enough to break the chain of irritation, inflammation and the pain associated with acute sciatica. When you start moving past acute to maybe chronic sciatica (persistent or regular pain that you’ve had for more than 6 weeks – chronic is normally defined as lasting more than 6 months) then this would suggest your issues are not responding well to the normal acute sciatica treatments. You may need to visit your GP who would usually prescribe strong anti-inflammatory and pain killing medication such as naproxen, diazepam or amitriptyline.
Will my sciatic nerve always hurt?
It might be you have acute sciatica and over a few weeks your pain will disappear. Chronic sciatica though can be a life time issue, you may never – although there is hope – be completely pain free!
It’s important to realise if you suffer with chronic sciatica, you may have to make long lasting changes to your lifestyle to get on top of your pain and prevent it becoming worse, minimise flare ups and hopefully lead to its reduction. This may include:
- Long term use of daily medication
- Regular use of ice packs, heat gels and TENS machines
- Daily physio, stretching or yoga exercises
- Change of job role e.g. a job with less standing/sitting/driving/lifting etc
- Lifestyle choices e.g. diet, exercise
- Hobbies e.g. no more Battle of Hastings re-enactments swinging a 15kg sword awkwardly around your head – or take on a new hobby like gardening
Breaking the pain spiral can help cure sciatica.
I wrote a recent blog on “Can Sciatica be Cured” where I spoke about small changes making a big difference on improving sciatic pain. Some advice I give to all chronic sciatica sufferers is that you have to try several treatments to begin to get on top of managing your pain. No one thing is going to cure you. By trying various treatments you’re more likely to start reversing the sciatica pain spiral. Instead of more irritation leads to more inflammation leads to more pain. You get less irritation leading to less inflammation leading to less pain and so on! The great thing is is that because this pain spiral acts like a chain reaction, breaking that chain at any point, whether that be the irritation, the inflammation or the pain, will knock on to the next reaction.
The goal of any sciatica treatment must be to promote and encourage the patient to enter a decreasing pain spiral rather than an increasing one!
There are some great recommendations on our home sciatica remedies and treatments page to get you started.
“When told by my GP that nothing could be done for my sciatica I doubted anything would ever help. I now lead a pain free life”!