Are you, or someone you know, dealing with sciatica right now? Sciatica affects hundreds of thousands of Americans every year. It's uncomfortable, annoying, and sometimes it can even make you miss work, or fun times with your family and friends.
I'll be covering the top eight signs of sciatica today, as well as some helpful information to know, of what to do about this problem.
The top eight signs that you may have sciatica.
#1 Pain In The Glutes Or Back Of The Thigh.
For those of you that don't know what the glute is, we get that all the time. The glute is the butt muscle, specifically gluteus maximus, which is why it's called the glute. There are a bunch of other little muscles in the area, the gluteus minimus, gluteus medius, and some even tinier muscles deep inside. There are about six or seven in there.
All of those can affect the sciatic nerve, and it can cause pain right in the butt area. Usually the pain is felt deep in the middle of the butt, and that pain can shoot down into the thigh. So usually it's on the back of the thigh in the hamstring area. But in some cases, you can have pain on the side, or even to the front of the thigh.
Now that wouldn't be classic sciatica. It's on the side, or the front of the side, but it can be related paint on the side of the front of the site, and definitely be related to the same root problem that causes sciatica.
So, if you have thigh pain in general, front, back, inside or outside, don't rule out sciatica, it might be coming. So if you got pain in the glute, or the back of the thigh, or anywhere else in the thigh, that's a big sign that you may have sciatica. Usually it's one sided, but if you have had it long enough, usually for a couple of months or more, you can start having it on the other side as well.
# 2 A Family History Of The Problem.
If you have heard your mom, dad, brother, sister, cousin, aunts, uncles, or somebody in your family, usually older than you, or even the same age having the same problem, then that's a high likelihood that you have it as well. So if they told you yes, I went to the doctor, I went to the physical therapist, or whoever, and they told me I have sciatica. It was diagnosed and then you're having very similar problems, then that's another sign that you've got sciatica.
# 3 Cramping
Especially in the hamstring, calf or in the foot, like in the arc of your foot. This is one of the less known signs, but it happens in the most common times that people get cramps related to Sciatica there too. Or if they're just sitting still, and then they go to move, like they're sitting in a chair, sitting in the car or lying in bed, and then they begin to move to get up or to get out of that position, and all of a sudden their hamstring cramps. Or if they're walking, sometimes their calf, or the foot will cramp as well.
Usually they can stretch it out, or shake it out, and the cramp will go away. And many times, people are thinking, you eat more bananas or drink more water, I need potassium, those kinds of thoughts come into people's heads. But if you think about this, if you really had a dehydration problem, like you need more water or an electrolyte imbalance, like your potassium is low, then you would probably feel cramping in different areas of your body, and it would be the same side, not just one.
One of the reasons that muscles can cramp is because there is a nerve problem related to that muscle. If you have a hamstring, calf or foot cramp, the muscles in those areas are innervated by, or connected to the psychic nerve. There are connections from the Sciatica nerve to the hamstring, the calf area and the foot. Cramping can definitely be happening because of a Sciatica problem.
#4 Long Standing Lower Back Pain.
If you have a history of lower back pain. You have been dealing with lower back pain often over the years, maybe it comes and goes. In some cases of people, that have sciatica, it's never really been a big problem for them, the lower back pain. In fact, they thought it wasn't even a problem. They just felt some stiffness or occasional discomfort that they can get over if they, sit for a while or take some time off from whatever activity that causes the back pain.
That is probably the most common. But then there are the extremes where we see people that have pretty intense back pain and a history of disc problems and bone spurs, pinched nerves and back pain, those can definitely also contribute to sciatica. Many people with sciatica problems also have back problems, lower back problems. If you have a history of any sort of lower back stiffness, discomfort, pain, and you are getting pain down the leg, in the glute, even into the foot, as we will learn in a second, then that's another sign that you have a real sciatica problem.
#5 Sitting For More Than Two To Three Hours Continuously Per Day.
If your daily routine involves you having to sit for long periods of time, more than two or three hours, and that might be because of your commute where you have to drive a long time to work. Or you have a desk job and you just sitting at your desk for the entire morning, or the entire afternoon, or at home. You might even sit at home, watch movie, watch TV or sit at the table, or work, or whatever it might be that you're doing at home.
We have patients that are sitting there sewing or they are reading. They are sitting at home as well. That is another contributing factor to having a sciatica problem. A little bit of the science or physiology behind that is, nerves are intended to move, sciatica is a nerve problem, and if you are sitting for a long period of time, then and you have an active sciatica problem. The sciatica needs to be moved around, you need to move your sciatic nerve and so it's not helping usually, if you are in the routine of sitting for two to three hours a day. Check to see if that's one of the signs that are affecting you.
# 6 Heel Pain.
Now this one is not always there, I'd say more like two- or three out of ten-people who have heel pain, commonly think that they have plantar fasciitis. In some cases, we have people that come into our clinic for treatment for plantar fasciitis and they are focused on their heel pain. They have maybe even had gotten insoles, special custom-made orthotic insoles, or inserts, and they have maybe even had injections in their foot, we've seen that.
They have been to a podiatrist or other foot related people and had all this attention put on their heel or their foot. But when we check them out here, it turns out they don't really have real plantar fasciitis. Instead the nerve that is in the area of the heel is a branch off the bigger sciatic nerve. That's what's flared up, and if we follow the nerves upstream, up into the knee, thigh and in hip and into the back, we can identify that the real problem is actually coming from the Sciatica.
If you have been dealing with heel pain, and the way that people experienced this, is they will have pain when they first get up, usually if they have been sitting for a while, or if they have been asleep, and their first few steps after they wake up, or stand up after they sat. It hurts in just one heel usually. And then they can kind of walk a bit maybe for a few steps. In some cases, it'll take them 5 or 10 minutes, and then it'll start loosening up and it'll feel better.
That is usually a sciatica or related issue. In small cases, it is a real true plantar fasciitis situation, but we find that most cases are actually a sciatica issue presenting in the heel. So that's number six.
#7 Traditional Medications Have Not Helped
We are talking about medication such as ibuprofen, naproxen, and some of the common medications that people take over the counter, but even prescription strength anti-inflammatories, like cortisone injections. Or we are talking injections as well, so they will go get injected in their lower back, for this type of the problem. If those haven't helped a whole lot then chances are, that it is a sciatica problem. Because the sciatica nerve, it's nerve tissue and most anti-inflammatory medicines don't affect nerve tissue a whole lot. Anti-inflammatory medications like, ibuprofen, naproxen and cortisone are more effective on ligaments, tendons, muscles, joints, cartilage, and those kinds of things.
If it's a sciatica problem, a nerve problem, then it typically won't help a whole lot. Most people that get an injection will say that they had relief for maybe a week or two. But the pain wasn't even completely gone. It just got a little more tolerable, but they still had trouble with walking and standing and all that. So that's another big sign that you have a sciatica problem.
#8 You Can't Get Comfortable In Any One Single Position.
We hear this all the time! People will say, “Well, I'm I can stand and walk for 20-30 minutes and then my leg starts to hurt. I feel it in my butt, and then have to go sit. But then I can't sit for more than 20 or 30 minutes. I have to get comfortable and turn on my side, or I have to lie down. And then after a while, I don't want to do that anymore. So I get up and I go move around. And it's just a vicious cycle of not being able to get comfortable and it's especially bothersome at nighttime because I can't sleep.”
If you are not sleeping normally then you are not your normal self the next day, and in fact this can go on for days, weeks and even months. It really affects your life. So, if you are dealing with that issue, where you are not being able to be comfortable in any one single position, and especially if you are having sleep problems because of that, that is a high likelihood that you have a sciatica problem.
So there you go, you've heard all the eight signs about sciatica. And if you are thinking to yourself, I have a lot of those signs, maybe more than half, or maybe have all eight of them. What the heck do I do about it? Chances are, if you have been dealing with this for a while, you probably have tried stuff already. You may have tried medications or maybe you have tried injections. Many people will try doing exercises or stretches at home. They will try getting massages.
This is what we hear from our clients all the time. All the things they have tried prior to that. Many have been to the doctor, they have had x-rays, and MRIs. When they get x-rays, typically they come back just fine and the doctors will say everything's okay and your x-ray was negative, meaning there's nothing wrong. If they get an MRI they might find L-4 or L-5, with disc problems, but nothing severe, nothing that indicates that you need to go see a surgeon, or have any kind of surgery.
For most people, they get this in their 40s and 50s. So the doctor looking at the MRI will say, “Oh, well, this is typical for your age you it's okay to have a disc herniation here and there, but it's not terrible. Maybe some signs of arthritis, but it doesn't look terrible either.” And most doctors will just say, “Well, we can try different medication or try another injection in a few months.” And they might refer you out to physical therapy if you are lucky.
But that's about the extent of what they will do for sciatica or they will just give it time hoping that it will just go away in three to six months. Or they are hoping that the medications will hold you over until then. But as we all know, medications don't really treat this kind of problem, they just mask the pain, the symptoms, but there is usually some underlying root problem that needs to be addressed.
It's usually a mechanical problem, meaning there is some joint issues, some stuck joints, some weak muscles, something about the way that you are moving, or things like that, that needs to be addressed. A physician, a Doctor of Medicine, typically isn't prepared to be able to help you out like that, that's just not their training, their specialties. Usually Doctor of Medicine or if it's a surgeon, then it's surgery. So they're looking to see what they can operate on.
But let me give you some tips as an expert physical therapist. I'd say proceed with these next few tips here.
#1 Stop Stretching.
If you are trying to stretch out your sciatica problem, chances are you are actually keeping it there longer than it needs to be. A lot of stretches that people will do is where they bend straight over to touch their toes, and feel a big stretch in their hamstring area, or their butt area. Which will stretch out their calf or their foot muscle as well because you're feeling tight in that area. You want to avoid that.
The reason for that is because if it's a true sciatica problem, which means the nerve is involved, then you don’t want to stretch the nerve, because it's already aggravated, and nerves don't like to be stretched more than they can go. And if they are aggravated, actually shortened a little bit.
Even though it may feel good to stretch, it might be relieving, it keeps the nerve aggravated for the long term, so you want to avoid stretching.
#2 Avoid Any Sort Of Deep Massage.
A lot of people go see a massage therapist, or they rub their own leg. Or some people will get a lacrosse ball, or a tennis bal,l or even something hard, like a rolling pin or some specialized rolling device, that they sell like at sports stores, to roll on. They try to roll out their butt muscle, or their hamstring, or other parts of their thigh. That's essentially a massage in the area. You want to avoid that as well.
The reason for that is it's similar to stretching the nerves that are irritated. If you push on those nerves, they get more irritated, just like any other tissue within your body. I mean, just think about it. If you have a cut on your skin, and it's trying to heal, maybe you have a scab forming, and you go press on it. You're going to open it up again and keep it irritated. It's going to take longer to heal. So you want to avoid a massage.
Now, just a side note about massage. Because this is a sciatic nerve problem, and the nerves control the muscles, the muscles might get tight, and actually can benefit from being massage to degree. So if you are just at your wits end, and you want to just find some instant relief. Maye you are listening to this and you're thinking, “Oh my gosh, I've been trying to massage this and actually get some decent relief.” Just be careful about how you massage, and note how things are progressing, which I'll go into in a bit.
Massage with caution, is essentially what I'm saying and don’t do it if it isn't working, if it's not making you better for the long term.
Which brings me to tips number three.
#3 Don't Give It More Than 10 Days’ Time.
Waiting for this problem to go away is probably the most popular thing that people do without knowing that they're doing it. They will just give it time. Subconsciously they will take medicine, they will see the doctor, and the doctor will typically reinforce that they will give you some medication and tell you to come back in a month.
So without telling you the doctors saying we are going to give it a month. And in the meantime, they leave you to just deal with the problem, and not get sleep and all that. But a lot of sciatica problems can go away on their own, but it should be quick, it should be within about a week, some saying give it 10 days.
If you give it 10 days’ time, and it's not notably better, then you have the beginnings of a chronic sciatica problem that you should try to fix right away and get the help that you need to do that.
The other scenario that we run into a lot of times, is people will get a big flare up initially, like their sciatica hits them all of a sudden, and then they get a little better, but then they stay at the same level. They never get all the way better, they plateau.
Now, if you are in the plateau right now, and you are thinking, that it’s been week now, or it's been 10 days. Or more than 10 days. Then that's a sign that you are not getting better as well. That is it what I'm talking about, as far as giving it time. Giving it 10 days, it should go completely away. Or you should know that it's getting better and better and better every day. And there shouldn’t be a sign of it plateauing.
But if you are plateauing, or if it's been severe for 10 days or more, that is not a good sign, you need to make sure that you do something about it, get some get some expert help.
Which brings me to my next tip…
#4 It Is Always A Good Thing To Get Some Expert Help On This.
Because even if you have had a flare up, that was just a few days long, you don't want another flare up. Chances are that you have some underlying root problem that is going to set you up for your next psychotic episode in maybe a week, it might be next month or in six months. But if you are not changing anything about your exercise routine, your posture, your strength, and there are a lot of different factors, then it's probably going to come back.
Getting help now will be a lot easier than getting help after you are missing a lot of sleep and have had injections and are thinking of talking to the surgeon and all that. So, get expert help sooner rather than later. And if you have already given it 10 days or more, you really should see an expert.
Now, what kind of experts should you see? Well, ideally non-surgical experts, somebody like us here at El Paso Manual Physical Therapy, for example, would be an excellent choice. But at the very least go see your doctor, go see a physician if you haven't yet and start getting it looked at. Take this very seriously because sciatica can be extremely debilitating in worst case scenarios.
The final piece of advice I have for you is…
#5 To Keep Moving!
Just keep moving somehow, some way. That doesn't mean go exercise your way out of this problem. What I mean by that is move within reason. As long as you are not in a lot of pain, and you are unable to even stand or walk, keep on with your daily routine. Keep going to work, keep doing house chores, keep doing stuff that generally allows your muscles to get over the problem and joints to loosen up.
That will hold you over in the short term, so keep moving to be able to maintain some strength. Because one of the worst things is when people say I had a bad flare up, and now I've been in bed, or I've been on the couch, all this time for, a month or whatever it might be. Usually it's several months! People's activity just diminishes so much, and they get really, really weak during that time.
About 9 times out of 10, whenever we see somebody with a Sciatica problem here in the clinic, we are talking about strengthening them so they have to get stronger, and if they spent the last two months sitting on the couch, because their problem hasn't let them move very well, and they have been trying to rest and avoid anything that would aggravate it, then they have some more strengthening to go through that they wouldn't have had to go through had they been a little active. Had they have been at least walking around with what they can do.
So, there are the top eight signs that you have sciatica, and we covered five or six tips to deal with a sciatica problem. Now, if you are actively dealing with a sciatica problem right now, or you know somebody that is, take it to heart, take it seriously, because this is not something that will likely just go away and affect you only one time. Usually it is a recurring problem for people. I hope this helps. I hope you have a wonderful day. It is a sunny bright day here in El Paso or Sin City.
