At the age of 72, Sallie Bolich of Broomfield, Colorado, had pain down her buttock and the back of her thigh after a springtime of strenuous gardening. “Turning over in bed was a project, it was so painful,” she recalls.
Bolich, a handwriting analyst and author, went to a doctor who took X-rays to confirm a diagnosis of sciatica caused by compression and inflammation of the sciatic nerve, which runs from the lower back down the leg to the toes.
Before she had a chance to take the medication her doctor prescribed, Bolich started doing exercises—walking and slow swimming in a heated pool—that had helped her sister who had suffered the same problem. Within a few days the pain diminished.
Weekly sessions with a massage therapist helped loosen tense muscles around the hips. Within three months Bolich was pain-free; a year later, she still spends a few minutes a day stretching to keep the problem at bay. Aside from aspirin, she has taken no drugs and has had no surgery.
“Sciatica can develop for many reasons. We have to address the cause, not just the symptoms,” says Theresa A. Schmidt, a Northport, New York, practitioner who draws on her skills as a physical therapist, hypnotherapist, massage therapist and ergonomic assessment specialist (someone trained to spot repetitive motions that can lead to pain).
Different Causes, Same Pain
Sciatica can be triggered by a number of events. Sometimes, as in Bolich’s case, the pain follows unusual physical exertion. “If you have a job that involves lifting, and you’re hurting because you’re not lifting properly, I can calm the nerve,” Schmidt says, “But it’s better if I teach you how to lift better. Poor posture puts the muscles in an inefficient alignment, and they have to work double-hard to get things done.”
In many older people, a collapsed vertebra in the back can irritate the sciatic nerve. Having arthritis of the lower spine is a risk factor as is being overweight, which puts pressure on the area.
Sometimes, though, the cause can be amazingly simple. “I asked one patient if it hurt when he drove the car,” Schmidt reports. “When he said, ‘yes,’ I asked what was in his back pocket when he drove, and he pulled out a huge wallet.” The patient stopped driving with the wallet in his pocket and the pain went away.
Runners can develop sciatic pain from imbalances due to improper footwear, a fallen arch or running on concrete, Schmidt says. The result of these imbalances may be a twisting motion, which can compress the nerve. If muscles are tight from inadequate stretching before starting off on a run, stretching exercises will generally relieve resulting sciatic pain.
Freeing Tight Muscles
Schmidt treats many sciatica clients with myofascial release—a type of stretching that uses the application of pressure in specific spots—which helps release muscles that are tight and strengthen those that are overstretched. If the pain is so severe that the client cannot tolerate physical manipulation of any kind, Schmidt may start by applying ice or ultrasound.
People who do not respond to initial treatment may need a thorough assessment to rule out more serious problems such as tumors, which could cause a similar type of pain. If Schmidt can’t reproduce the symptoms in her office through joint manipulation, or if she doesn’t see measurable changes within one to five office visits, she sends the client to a physician for a diagnostic workup.
Energy and Nutrition
Gregg St. Clair, LAc, an acupuncturist in Clifton Park, New York, speaks of chi, the Chinese word roughly translatable as “energy” or “life force,” when he discusses the problems that lead to sciatica.
“In Chinese medicine, we would call sciatica a chi stagnation,” St. Clair explains. Pain can run down the inside or outside of leg, indicating which meridians, or energy channels, are involved. St. Clair often inserts a needle in the gallbladder meridian point on the buttock, along with other needles in more distant points, to open channels. “A channel is like a garden hose,” he says. “Both ends have to be open for it to flow.”
Bill Gottlieb is a holistic health coach in northern California and author of several books on natural healing. “If I’m counseling someone about low back pain of any kind, I have them walk regularly,” he says. “I encourage them to use a pedometer so they can start small and put together a plan to walk, say 1,000 more steps a week—and onward from there.” When sciatica is implicated, Gottlieb often sends clients to a chiropractor or physical therapist for pain relief treatment so they are able to walk comfortably.
Gottlieb often recommends herbs and supplements for sciatica. Agmatine, a breakdown product of the amino acid arginine, helps protect and strengthen nerve cells.
Alpha lipoic acid is an antioxidant that also protects nerves. Herbalists commonly recommend devil’s claw for low back pain. It has anti-inflammatory properties, as do curcumin and boswellia.
“A lot research shows vitamin D can play a role in pain relief and long-term strengthening of bones and muscles,” Gottlieb says. “If I had sciatica, I would take vitamin D regularly, try a curcumin product for six to eight weeks, and then switch to alpha lipoic acid. In an acute attack, I would go with agmatine or devil’s claw.”
Proper nerve function requires adequate amounts of vitamin B, while calcium and magnesium help calm muscular spasms. Some people have found glucosamine and chondroitin, supplements that support joint health, to be helpful.
As useful as proper nutrition and various types of therapy can be in relieving sciatica, the best way to overcome this painful condition for good is to keep moving. As Bolich puts it, “Being active makes a difference.”