Updated: May 10
Sciatica is something that many of our patients coming into The Green Room Physical Therapy suffer with, but how do you know when your sciatica/sciatic pain is improving? For many people, sciatic pain can be some of the worst pain they’ve ever felt. When sciatica is at its worst, relief can seem unlikely and nothing will seem to help… So the idea of your sciatic pain getting better is a huge relief for those that struggle with it.
What Is Sciatica?
Sciatica is not a diagnosis, but a symptom of something else happening that is causing pressure on or irritation to the sciatic nerve. The sensation you’re left with is (usually severe) pain, often in your buttock and down the back of your leg and calf, sometimes right down to your foot and toes. In my 13+ years in PT, the patients who I’ve seen who are in the most severe, agonizing, tears-to-their eyes pain are almost always those dealing with severe sciatica. Sometimes, they even wish they could “just cut the leg off!”
What Causes Sciatica?
Sciatica is commonly caused by a herniated disc, which puts pressure on the sciatic nerve, and then causes the pain you’re feeling. Bone spurs and narrowing of the spine from stenosis can also cause sciatic-type pain.
However, certain behaviors/factors can raise your risk of developing sciatica. The most common factors for developing sciatica include the following:
Certain careers place a lot of strain on your back, especially those that involve lifting heaving objects, sitting for extended periods of time, or twisting movements, and especially when body mechanics and ergonomics aren’t taught and enforced.
Sitting in less-than-ideal postures, especially those that put extra stress on your lower back and sciatic nerves over time. Bad posture for prolonged periods of time, day in and day out, is not the best thing for your back. Here’s an example of "good vs. bad" office posture:
How Can I Ease My Sciatic Pain?
The problem is that if you completely rest when you’re in pain, not only does the disc herniation/spinal narrowing/chemical irritation not change, but the muscles that control your lower back will become weak, and therefore provide less support to the already problematic and painful area. Thirty years ago or so, those with sciatica would get hospitalized and put on bed rest, and that has been proven to be the wrong approach!
Limiting the amount of time that you spend sitting can help too. Sitting, even in a "good" posture, puts more pressure through the lumbar spine, discs, and sciatic nerve than walking does.
On that note, Don’t Stop Walking. Gentle walking can work wonders for those suffering from sciatica because besides pressure relief, regular walking spurs the release of pain-fighting endorphins.
Continue gentle exercise as soon as you can – swimming, the elliptical, or comfortable indoor cycling are good options to get moving initially, as long as they don’t increase your sciatic pain.
Stretch It Out!
Every day that you wake up and you’re not doing something small to help yourself to stay active, you’ll be getting more and more stiff. You’ll be losing flexibility of vital muscles and joints, and as this happens, you’re more and more likely to suffer from things like sciatica and other life-changing pains. Stretching and finding a good mobility routine is a great preventative measure for sciatica, but can also be very helpful in the treatment and recovery process. You should consult with a Physical Therapist about what stretches are safe and unsafe for your particular case and cause of sciatica, because some stretches that feel good on your back muscles may be doing more harm to your disc and/or sciatic nerve.
How Do I Know When My Sciatica Is Improving?
Determining if sciatica is getting better is actually pretty straightforward. The severity of the pain isn’t a good indication of healing, but the actual location and movement of the pain is. It’s as simple as knowing whether the pain is retreating up to the spine or whether the pain is spreading further down from the center, further down the leg. This isn’t necessarily true in 100% of cases, but it is a general rule for clinical evaluation of whether or not sciatica is improving or getting worse.
Think about it, if the pain is in your bum one day and down your leg the next, the problem has more than likely gotten worse and it’s not improving. And if the pain is ‘leaving’...it was into the calf/ankle yesterday, but only going down to the hamstring/back of the thigh today, then the sciatica is probably improving. This can also vary day to day, with symptoms getting better or worse on various days or times of day, especially in the beginning of the healing process.
Does Sciatica Get Worse Before It Gets Better?
Sciatica can get worse before it gets better – but it can get better. Specific exercises (and of course, Physical Therapy) can help. It might be painful at first but if you persist with exercises and treatment, the pain level can begin to drop. And I always tell my patients, the pain in your back may be more severe at first with the new exercises and stretches, but as long as the nerve pain is retreating up to the spine and out of the leg, we're doing well. Again, each situation is different and nothing is 100% applicable to every single patient, but this is quite typical.
Would You Like To See A Physical Therapist For Free?
We realize some people want more than just some free health tips… That’s why we offer expert advice about the worry and frustration of life-changing aches and pains – for FREE, in 30 minutes or less.
Here are just a few of the things you will learn in one of our free consultations:
What is the potential underlying cause of your back pain? (hopefully nothing too serious!)
What to do to help – which doesn’t include painkillers, resting, or surgery, etc.
What other, natural, drug-free methods are there to speed up recovery alongside treatment?
It is also important to note that if you let sciatica go too long without getting it evaluated and treated by a PT or other medical professional, you may be left with permanent nerve damage, including permanent numbness or weakness of your leg, or may increase your chances of needing surgery.
*There are some red-flags of sciatica that may require emergency surgery or at the least an immediate spinal/ER consult, do you have any of those? Examples-urinary or bowel incontinence, inability to move your leg, tripping on your foot, complete leg numbness, severe drop-foot, etc. If you have any of those, don't wait-go to an ER now!*
Our free consultation sessions are great for anyone that may be “unsure” if PT is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.
We have 5 free consultation spots available during the week of Nov 22nd. If you would like one of our limited free consultation sessions, please get in touch with the clinic using the contact details included below, and mention to the person who answers the phone that you would like to see a PT for a free consult. Also, feel free to share this blog post with a friend or family member who may benefit from reading this.
Sign up for a free consult online here https://www.thegrpt.com/events-and-offers
Or call 518-326-3771
Or email email@example.com
In good health,
Dr. Ashley Bertorelli, Founder/Owner of The Green Room Physical Therapy
Clifton Park & Troy