Parsteiner Blog

Posts Tagged ‘Sciatica’

More often than not, the term sciatica is associated with pain which may pass from the low back down through the buttock and back of the leg, passing as far down as the tips of the toes. However, although pain is the most common complaint from someone suffering with sciatica, numbness and tingling (pins & needles) can also be a symptom.

Firstly I would like to clear one thing up and that is with regards to the term ‘sciatica’. Sciatica is only a descriptive term, not a diagnostic one. Therefore, two people may be presenting with exactly the same signs and symptoms as a result of sciatica, yet they may have two completely different causes. Consequently, their treatments would also be different.

The sciatic nerve passes from the lower back, through the buttock and down the back of the leg, providing innervation for the muscles and also sensations back up to the brain. When anyone suffers from an attack of sciatica, somewhere along the length of the nerve (usually in the low back or buttock region, but not exclusively) the nerve is being aggravated, typically by a compressive force.

If this compression becomes quite severe, the electrical signals which usually pass both up and down the sciatic nerve become impeded, and therefore the messages they are sending may not pass fully along the length of the nerve. If these messages are only partially restricted, a tingling or pins & needles sensation may be perceived. This is because some of the messages are getting through but not all of them.

However, if the compression is so severe that none of the electrical signals are able to pass through, numbness will be present in the region of the body which that part of the nerve supplies. With regards to the sciatic nerve, it is typically felt in the toes / feet or maybe calf (although it can be felt higher up).

If you are feeling numbness and / or pins & needles, it is important to have this assessed by a health professional. More often than not it is a just a typical symptom of sciatica which can be resolved, however it is best to have it checked first.

Finally, as well as pain, numbness and pins & needles, weakness can be another symptom of sciatica. If the electrical messages are not able to pass to your brain from the skin correctly, numbness and pins & needles may result as explained above. However, it is also possible the messages may not be able to pass the other way. Therefore, if the messages you are sending from your brain to your muscles are not passing along the sciatic nerve 100%, the receiving muscles are not going to work as strongly as they should be, resulting in muscle weakness.

Living with Sciatica during the day can be bad enough. The searing pain you will be experiencing down your leg is enough to drive the sanest person to distraction. However, that compares to nothing if you are one of the unfortunate ones who is suffering at night as well.

I have often had patients say to me it is as if as soon as they want to go to sleep, their sciatica chooses to wake up!

This can create a multitude of problems:

i) The lack of sleep makes you tired.

This is a problem, as it has been proven that our perception of pain is increased and our pain tolerance decreased, the more tired we are. Consequently, if you are experiencing pain which is preventing you from sleeping, it is going to make you more tired. This in turn will increase your perception of pain & decrease your pain tolerance. What is that going to do? It’s going to make sleeping more difficult, which will make you more tired… and so on. I am sure you can see how a vicious cycle results which can be difficult to get out of.

ii) Night Time is prime healing time.

It is during the night, while we are at rest, that the body’s fantastic healing process gets to work and aims to heal and replenish all that needs to throughout your body. Your sciatica will be at the top of the list for healing. However, if you are not sleeping at night, tossing & turning, this healing process is going to be interfered with. This creates yet another vicious cycle similar to that given above.

So what can you do?

If you are struggling to sleep of a night, let me firstly say do not replace your bed! Well, not yet anyway. More often than not, it is either the position you are sleeping in or what you were up to before going to bed which is the problem – not the bed itself. I shall discuss the latter here…

This may sound like I am stating the obvious, but it is important to avoid any particular activities you know aggravate your pain. Let’s use sitting as an example. Sitting tends to be a classic aggravating factor for sciatica (although I except it will not be for everyone). Therefore, if you are like most of us and tend to spend much of your evenings sitting down, there is a fair chance you will be aggravating your sciatica during that time.

This may express itself as forcing you to fidget regularly just to get comfortable, forcing you to stand up because of the increasing pain or your pain may feel OK while you are sitting down, but you experience increased pain and discomfort when you go to stand up from the chair.

If you are familiar with any of these, then sitting down is an aggravating factor for your sciatica.

Consequently, if you are stirring your pain up just before going to bed, it should come as no surprise that the pain is keeping you awake at night. This may not express itself immediately, sometimes it can be an hour or so after getting to sleep that you pain rears its ugly head.

In such circumstances, I would ask you to firstly think about the chair you are sitting in:

Is it the best for your sciatica?

Maybe it should be a little firmer?

Or possibly you need some support for your lower back?

Just have a think as to how you can make things a little more comfortable for your sciatica. It could well be that you need to try a completely different chair for a while.

In addition to this, I would also suggest you try to avoid sitting for any longer than 15-20 minutes without standing up. This doesn’t need to be an extensive break, a few steps up and down the room will be more than suffice, just give your body a chance to straighten up for a bit. If you are watching TV, when the adverts come on is a good reminder.

By doing this, it will help alleviate some stress from your sciatic nerve before going to bed, which in turn will decrease the pain perceived and therefore give you a better nights sleep and your body more chance to heal itself. This in turn will begin to set up a positive cycle, where more sleep will promote better healing, which will help you sleep more… and so on.

The example I have used here of sitting, is just one of many which may be aggravating your pain. It is important you gain a good understanding of your body and are able to tell what your sciatica does and does not like with regards to its healing process.

In addition to this, I have provided a link below which will discuss the best sleeping positions for you to sleep in order to gain a good night’s sleep.

I’m sure you are familiar with it. You wake up in the morning, go to get out of bed BUT are stopped in your tracks by the pain and stiffness in your lower back or sciatic nerve. It can then take a few minutes or much longer to straighten up and become more mobile again… Why is your back so stiff and painful in the morning?

Well, contrary to popular belief, it is more than likely NOT due to the bed / mattress you are sleeping on! That’s right, I believe this is a myth well worth busting, as it may save you a fortune by avoiding the unnecessary replacement of your current bed.

There are also those that may say you are stiff and painful first thing in the morning due to the fact you have moved relatively little for the previous few hours. Although I would agree that there is an element of truth in this last statement, once again I do not believe it is likely to be the main cause.

So why is your back so stiff and painful in the morning?

More often than not, it is not due to the bed itself, but rather the position you are sleeping in or what you have been doing the few hours before retiring to bed, it is the former which I am going to be discussing in this article.

So what is the best position for me to sleep in then?

The best position for you to adopt would primarily depend upon what is the cause of your low back / sciatic pain. However, as a rule of thumb, the most comfortable position to sleep in is usually side lying (either side) with your bottom leg fairly straight and your top leg supported by a couple of pillows, so that this top leg is more or less parallel with the bed.

By sleeping in this position, keeping the bottom leg straight is encouraging your lower back to be in a neutral position. Yet with the top leg being supported by pillows, it is preventing it from dropping ‘across & down’ and twisting your low back and stretching your sciatic nerve in the process.

Some people tend to lie on their side, but forget to support the top leg. This just has a twisting stress upon the lower back which is maintained for several hours while you are sleeping. Therefore it should come as no surprise that your low back or sciatic nerve may feel stiff and painful first thing when you wake up.

As I alluded to above, there are other positions which could be more beneficial, but this depends upon the cause of your pain, but side lying with pillows supporting your top leg is usually a good comfortable position to get in no matter what your diagnosis.

It is also important to realise that it may not necessarily be your sleeping position which is the problem, but rather the things you are doing to your low back before going to bed. If you try different sleeping positions, including the one given here and yet you are still having difficulty sleeping, it is likely what you are doing before going to bed which is your problem. This will need to be assessed before thinking of replacing your bed.