29 January 2018
Don’t start the new year in pain with sciatica. There are steps you can take to help yourself and more that can be done to relieve the problem. Brighton and Hove Independent talks to Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon at The Montefiore Hospital in Hove.
Anyone who has ever experienced sciatica knows how agonising it can be. It is more common in people aged 30 to 50 and can greatly impact on their daily life. Even simple actions like walking, sitting or driving can be painful. The pain radiates down the sciatic nerve from the buttocks, down the leg to the ankle, and can cause numbness and weakness in the foot.
The most common cause of sciatica is a prolapsed disc. In eight out of ten cases, symptoms will improve with rest, painkillers and time – usually between six to eight weeks. For persistent sciatica, an injection of cortisone (a powerful anti-inflammatory) around the pinched nerve can help. Called a `nerve root block’, it is administered under X-ray guidance and can reduce swelling and bruising. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. But the first step is to try these self-help tips. If you have sciatic pain for more than six weeks, your GP may prescribe stronger painkillers, recommend physiotherapy, or refer you to a specialist.
Self-help for sciatica:
- Use hot and cold packs on the lower spine regularly and try stretching exercises.
- Avoid lying or sitting for too long as this can worsen the condition. If you are sitting at a computer, adjust your chair to give good back support. Take regular breaks and go for a walk around the office.
- Use over-the-counter painkillers such as ibuprofen (check with your pharmacist if you are on other medication).
- Ensure to bend your knees and keep your back straight when lifting objects.
- When driving, especially long distance, take regular stretch breaks. Have your hands at ‘nine to three’ on the steering wheel to keep the sides of your trunk balanced. When not changing gear, keep your left foot on the rubber pedal (a feature in most cars) to allow both legs to be in the same position to maintain a balanced pelvis.
- When in bed, lie flat on your back with knees slightly bent. Place a pillow behind the knees for support. If you prefer to sleep on your side, place a pillow between your knees to prevent your back from twisting.
Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon, holds clinics on Mondays, Thursdays and Fridays. For more information call 01273 828 148.
First published in Brighton and Hove Independent on Saturday 20th January 2018.