Sciatica Pain: Home Remedies

Sciatica results from pressure on the sciatic nerve. The sciatic nerve exits the spinal column and runs down the leg. Because one nerve runs down each leg, sciatica typically affects only one side of the body (1).

Sciatica commonly manifests as low back pain, but it’s important not to assume that low back pain is due to sciatica, or that sciatica only manifests as back pain. People suffering from sciatic pain may also experience pain that radiates down the back of the leg, as well as numbness, tingling, and weakness in the affected leg or foot. Patients often describe sciatic pain with terms like “sharp” and “stabbing” (2).

Cases of sciatica can range from mild to severe, depending on the underlying cause. Herniated spinal discs are the most common cause of sciatica (3). Bone spurs on the spine may also lead to sciatica. Other possible causes include spinal stenosis, which refers to the narrowing of the spinal canal, and spinal fractures (4).

Self-Mobilization Techniques

Studies show that self-mobilization techniques are useful for leg pain that accompanies sciatica. Here are some easy exercises you can do at home:

• Lie on the floor with your knees bent at 90 degrees and feet on the floor. Place both hands on your abdomen and keep your spine as neutral as possible. Slowly raise your pelvis off the floor (5).
• Lie on the floor with your legs outstretched or bent at the knee at 90 degrees. Flex your knee and hip joint on the affected leg and draw your knee in toward your chest. Place your hands on top of your knee and gently pull your knee in closer for a deeper stretch.
• Sit in a chair with your spine either straight against the back of the chair or curved. If you’d like to sit in a curved position, consider placing an exercise ball on the tops of your thighs so that it touches your abdomen. Then curve over the ball with your arms around it and hands interlocked. Plant your feet on the ground. Lift the foot of the affected leg off of the floor until it’s extended 90 degrees. Keep your foot flexed (6).‍

Hamstring Stretches

Scientific literature supports hamstring stretches as a treatment for sciatic nerve pain. See below for some useful hamstring stretches:

• Lie down on the floor on your back. Lift your leg with your hands under your thigh and knee bent. Keep your knee aligned with your hip. Align your leg as parallel to the floor as you can. Keep your other leg flat on the floor. Straighten your lifted knee. Keep straightening until you feel a stretch. Hold for a few seconds then lower your leg to the floor (7).
• Sit on the floor. Straighten your affected leg in front of you. Bend your right knee and place the sole of your affected foot against the inside of your other thigh. Sit up as straight as possible then slowly bend over your left leg. Keep your back straight. Keep bending until you feel a stretch in your hamstring. Allow your hands to rest on the floor near your outstretched foot or wrap them around that foot. Hold the stretch for 30 seconds (8).
• Stand up straight. Extend your affected leg in front of you. Plant your heel on the floor and flex your foot. With your hands on your upper thighs, bend forward with a straight back. Continue to bend until you feel a stretch in your hamstring. Hold for 10 seconds (9).‍

Stretches for the Piriformis Muscle

The piriformis muscle extends from the sacrum – the bone at the base of the spine – to the greater trochanter, which is the knob-like bump on the top of the hip (10, 11). The piriformis muscle is very close to the sciatic nerve, so if it becomes enlarged (hypertrophic), sciatica can follow. This specific condition, in which the piriformis muscle presses on the sciatic nerve and causes severe pain, is referred to as piriformis syndrome. Piriformis muscle stretches may help relieve pressure on the sciatic nerve (12).

Try out the following stretches:

• Sit in a chair with your spine straight against the back. Lift your affected leg off of the floor and stretch its ankle across your opposite knee. Lean forward slowly until you feel a stretch in your buttock. Hold for ten seconds then slowly extend your bent leg and place it back on the floor (13).
• Ground yourself on your hands and knees. Spread your knees apart as far as you comfortably can. Sit up as straight as possible so that your spine is long. Inhale then slowly exhale as you bend forward until your chest meets your thighs. Stretch your arms forward with your palms on the ground and rest in this stretch for thirty seconds.
• Lie on the floor. Lift your non-affected leg with the knee bent. Once you’ve brought your knee parallel to your hip, lift your affected leg with the knee bent. Cross the foot of your affected leg over the knee of your non-affected leg. Pull your non-affected leg in toward your chest with your hands wrapped around the back of the non-affected thigh and elbow pressing the affected knee into a deeper stretch (14).‍

Risks and Side Effects

Stretches, when performed properly, are generally safe and largely only carry a risk of temporary discomfort. Risk of injury increases if you stretch to the point of pain, so stretch gently and cautiously. If you notice a sharp increase in pain with any particular motion, slowly transition out of that stretch and try another.

While ice therapy and heat therapy are sometimes recommended by physicians for treating sciatic pain, the results seem to be mixed (15). Ice and heat are not particularly effective at resolving disc herniations, which are the most common cause of sciatica (16). However, a healthcare practitioner may suggest that you’ll find some minor relief from heat and ice as long you pair it with other treatment options (17).‍

Ice

Ice therapy, also known as cryotherapy, can be applied via homemade ice packs, bags of peas or cold gel packs purchased over-the-counter at a pharmacy or online. Wrap a towel around the cold object so that you don’t irritate your skin. Hold the wrapped, cold object on the affected area for up to twenty minutes (18).‍

Heat

Heat therapy may provide temporary pain relief for people suffering from sciatica. Consider a hot bath or shower. You may also want to try a heating pad or hot pack. Again, make sure you wrap the item in a towel or place it over a cotton t-shirt rather than placing the heated object directly onto your skin. This will protect your skin and minimize the possibility of side effects like burns or blisters.‍

Risks and Side Effects

Heat therapy can cause inflammation, and both ice and heat therapy may cause some discomfort. When applied properly, both heat and ice therapy are generally safe.

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) have therapeutic efforts for sciatic pain (19). The NSAIDs ibuprofen (Advil) and naproxen (Aleve) are available at pharmacies as well as online. Acetaminophen (Tylenol) is also available over-the-counter at pharmacies and online and can help relieve pain from sciatica.

In terms of side effects, NSAIDs may cause gastrointestinal problems (stomach pain) and cardiovascular issues (heart problems). Acetaminophen may cause liver damage. In general, these over-the-counter pain relievers are safe when taken properly. If you have any family history or personal clinical history of stomach, heart, or liver problems, speak to a healthcare practitioner about the potential effects of using NSAIDs or acetaminophen to relieve your sciatic pain.

When to See a Doctor

There are some instances where sciatic pain may not be treatable at home. If any of the following issues arise, make an appointment to see a doctor:

If you notice bowel incontinence or other bladder issues arise, or if there is significant weakness in lower extremities, or if there is a history of malignancies, then you should consult a doctor(20):

• Bowel incontinence
• Bladder problems
• Significant weakness in your lower extremities
• History of cancer‍

Manual Therapies

Physical therapy can help patients strengthen their abdominal muscles, which will then be better able to support their spines. In some cases, this is enough intervention to relieve pressure from their sciatic nerves and alleviates their pain (21). Hands-on therapies like osteopathy, chiropractic care, and trigger point massage may also treat pain caused by sciatica (22).‍

Prescription Medications

Stronger drugs may be worth considering in some challenging cases of sciatica. Anticonvulsants like gabapentin can provide short-term pain relief from sciatica (23). Muscle relaxants can relieve sciatic pain, and antidepressants can have therapeutic effects as well (24, 25).‍

Injections and Surgeries

In particularly severe cases, steroid injections or surgery may be worth consideration. Steroid injections relieve pain from herniated discs, the most common cause of sciatica (26). Discectomy, a surgical procedure that removes abnormal spinal disc materials pressuring nerves, has an 80-95% success rate (27).‍

Risks and Side Effects

Anticonvulsants have been linked to kidney problems, depression, dizziness, liver failure, and drowsiness, in addition to more side effects (28). Muscle relaxants may cause clumsiness, confusion, skin rashes, and problems urinating, while antidepressants can result in drowsiness, weight gain, and insomnia (29, 30). Steroid injections may cause a temporary increase in pain in response to the injection and skin irritation at the site of the injection. A discectomy carries the surgical risks of reactions to anesthesia and potential infection.

If you’re considering prescription medications, injections, or surgeries, talk to your doctor about your family’s medical history and personal clinical history to determine the safest treatment plan for you.

Before you schedule a doctor’s appointment, give some home remedies a try. Time and rest resolve most cases of sciatica, so initial treatment should focus on pain relief while allowing the body to heal (31). However, if you notice that additional symptoms arise, or you simply cannot get your pain under control, immediate professional care is necessary.

If rest, over-the-counter medications, heat and ice, and exercises fail to relieve your sciatic pain, stronger drugs, injections, or surgeries may help you. There’s a wide range of options for responding to sciatic pain so don’t get discouraged – try what you can at home, rest as much as possible, and, if you’re still in pain, give a doctor a call.