First Week of Treatment of Herniated Disc Causing Sciatica
Before hopping onto a lumbar traction device you need to take other simple steps in the first few days to get sciatica pain relief. The key is not to aggravate the injured sciatic nerve any more and alow it to heal. Here is what is typically recommended but always first consult your physiotherapist or physician before attempting any self-treatment. Taking an anti-inflammatory medication like Ibuprofen or Motrin will typically reduce some of the swelling in the spine and nerves making it easier for you to get comfortable and a chance for your injured area to relax and start healing. Right away you can start putting a cold pack onto your back for ten to twenty minutes to reduce inflammation as well. Then you can alternate to a hot compress to the back a couple of hours later to encouraged blood flow and healing to the area. This is the point where you need to be off work and not doing any household chores but at the same time you need to take brief walks to encourage circulation and reduce swelling.
During this time the muscles in your lower back and buttock tend to stiffen up to guard the injured area. This is where you need your physiotherapist to come in with massage, tens therapy, or IMS. Personally I had the best results from IMS where my physiotherapist inserted a needle like in acupuncture but longer right into the muscle to make it contract then relax rapidly. With that treatment my back regained more flexibility and I was able to do my stretches better.
The most important stretching and exercise at this stage is to lay on your belly on the floor or bed and gradually lift your upper body and stretch backwards but without increasing the pain down your leg as shown below. Over time you will be able to stretch back further and further.
Another important maneuver upon waking up is to lift your injured leg up towards you while you lay on your back to give it a stretch and to move the sciatic nerve. You want to do several of these without increasing your symptoms.
Always engage your core muscles in your belly to really stabilize the lower spine and hold correct posture at all times. Always bend with your knees and go for frequent short walks.
Stage Two of Sciatica Pain Relief
This is where stretches and exercises can get more involved and you can start introducing swimming for low impact exercise. You will progress to this stage when you have been noticing some improvement. Lumbar traction can now be introduced and this will stretch your lower back so as to create more room for the compressed disc. When more room is created between the vertebrae a negative pressure like a vacuum suction is created to actually pull the bulging disc back into place. In turn this will take pressure off the sciatic nerve that was getting squished by the bulge from the disc. This can be visualized in the image below and all this can be done with the Saunders Lumbar Traction device mentioned above that you can have at home.
It is important to note that the Saunders Lumber Traction is different from inversion tables in that you are in a relaxed state laying flat on the floor rather than hanging from your ankles and letting gravity pull you. The inversion table causes your muscles to engage and resist the complete deep stretch that you want to achieve. And this explains why the inversion table did not help me with sciatica pain relief but the Saunders Lumber Traction did.
Your physiotherapist should now be introducing you to new exercise such as the ones that follow:
- Calf stretches held for 30 seconds and done 3 x per leg:
- One leg stretch 10 x held for 10 seconds:
- Hamstring stretch by rocking pelvis back and keeping straight posture:
- Rock back from being up on all fours with a straight back:
- Strengthen the back by alternating arm and leg lifts:
- Core Strengthening and Stabilization with controlled leg maneuvers:
Stage Three and Gradual Return to Work:
This stage is best started when the sciatica pain relief is complete and/or it has all localized to your lower back. Now you can begin a gradual return to work that involves practicing proper body mechanics, perhaps with some guidance with a lumbar back brace, and working half days and fewer days in a week. What we are trying to prevent is re-injury and not to irritate the sciatic nerve too much again after our weeks or months of recovery.
Your Physiotherapist will gauge your recovery and perhaps start you on more involved core strengthening exercises as well as working towards regaining full strength in your weak leg. You will want your physiotherapist to help you know what to do while on the job to prevent re-injury by having him show you proper body mechanics. If your job requires you to sit for long periods of time you might find a small back roll for your lumbar spine very helpful. You will also want to take frequent breaks to get up and move around.
You can continue to use the lumbar traction device either at home or at your physiotherapist’s office. This will continue to stretch out your spine and encouraged your intervertebral disc to heal in its proper position. It can also be your tool to increase and maintain flexibility and prevent spinal degeneration from narrowing of the intervertebral spaces over time from the force of gravity, long periods of sitting and lifting objects.