A Comprehensive Guide To Managing Sciatica Symptoms

As an occupational therapist and yoga therapist, I've personally experienced sciatica on and off for years, especially during periods of strenuous exercise and seated work. To feel better again often requires a thoughtful approach to lifestyle changes and medical support. 

Sciatica occurs when the nerve is impinged, crushed, or compressed in some way. 

Sciatica is most likely to occur in people in their 40s, with estimates of a person developing it between 12.2% and 27%1. Some research indicates a genetic predisposition1, though those whose work keeps them in strained or unnatural positions, like truck drivers, may be at higher risk.

Inflammation, muscle spasms, and muscle scarring can press on the sciatic nerve, which runs under it. Piriformis syndrome symptoms might feel the same as sciatica but are more localized to a specific area like the hip.

Although living with chronic sciatica presents challenges, especially with everyday tasks like sitting at the computer and vigorous exercise, implementing a few strategies can make long-term or chronic sciatica more bearable:

Use proper lifting techniques, especially at the gym or if work requires lifting heavy objects. Optimizing ergonomics in your workspace can help better support the spine and hips.

Massage could also be a helpful modality to add to your tool kit. A study on the efficacy of cross-friction massage compared to stretching exercises for patients with piriformis syndrome, which often mimics or contributes to sciatica pain, demonstrated that massage therapy significantly reduces pain and improves functional abilities.

As per acupuncture, a 2015 meta-analysis of 12 studies involving 1,824 participants showed that acupuncture for sciatica might effectively treat the associated pain3, particularly pain intensity and threshold.

Incorporating specific movements like core exercises, lower back and hamstring stretches, and low-impact activities such as walking and swimming can significantly benefit those suffering from sciatica symptoms4. A physical therapist can offer a personalized treatment plan and home exercise program to help improve symptoms. 

Another major complaint is sciatica interfering with sleep. Sleeping or lying on a flat back can put additional pressure on the sciatic nerve that is already inflamed or compressed, making the pain worse. Experts recommend sleeping on your non-affected side, with a pillow between your legs to relieve pressure on your knees. Another option is to sleep flat on your back with a pillow under the knees.

In contrast, a 2015 randomized control trial involving 61 adults with nonspecific low-back pain or sciatica and disc extrusions or bulges found that a three-month yoga course significantly reduced pain and disability7 without any reported adverse effects, further supporting yoga's safety and efficacy for this demographic.

Your primary care provider might recommend exercise, massage, or medications such as Nonsteroidal anti-inflammatory drugs, steroids, or Botox injections.

Sciatica can cause pain and activity limitations but can be managed with medical treatment, preventive strategies, and alternative and complementary modalities, such as acupuncture and massage. In most cases, the underlying cause of sciatica is a herniated disk, and how the pain is treated depends on the root issue. It's essential to seek the knowledge of an experienced clinician who has experience in promoting health and function, especially for people with chronic sciatica.