Sciatica refers to nerve pain in the leg which stems from the irritation, inflammation, pinching and/or compression of the sciatic nerve in the lower back. The pain originates in the lower back, and radiates deep into the buttock/gluteal area, travelling down the leg.
The sciatic nerve is the longest and thickest nerve in the body, made up of two nerve roots from the lumbar spine and three nerve roots from the sacrum. These nerve roots come together to form the right and left sciatic nerve, which runs through the hips, buttocks and down the leg, ending just below the knee. From here, it then branches into other nerves, which continue down the leg and into the foot.
The experience of sciatica can be a mild to severe pain anywhere along the path of the sciatic nerve. In some cases it can also lead to muscle weakness, numbness, and pins-and-needles sensation in the leg, foot and toes. The pain can be as sharp, shooting, or jolt-like, burning, electric or stabbing-like. It may also be constant or may come and go, and is usually more severe in the leg compared to the lower back. Sitting or standing for extended periods can aggravate the condition, as can a sudden twisting, jerk, cough, or sneeze. Sciatica usually affects only one leg at a time, but in some cases it can affect both legs, and can come on suddenly or develop over time, depending on the cause.
Risk factors include: previous injury, age, being overweight, obesity, lack a strong muscle core, undertake heavy lifting, poor posture, poor sitting position, sedentary lifestyle, smoking, wearing high heels, irregular exercises, sleeping on a soft mattress, pregnancy.
Medical conditions that can lead to sciatica include: tumours, abscesses, blood clots, slipped or herniated disc, degenerative disc disease(s), spinal stenosis, piriformis syndrome, injury, diabetes, osteoarthritis, lumbar spial stenosis, spondylolisthesis
The symptoms of sciatica include:
- Moderate to severe pain in the lower back, buttock and down the leg.
- Numbness or weakness in the lower back, buttock, leg or feet.
- Pain that worsens with movement and/or loss of movement.
- Pins and needles in the legs, feet or toes.
- Loss of bowel and bladder control
The goal of treatment for the condition is focussed on decreasing pain and increasing mobility. Depending on causative factor(s), many instances of sciatica heal over time with some simple self-care treatments. However, for others it can be long-term.
Self-care treatments include:
- Hot and cold packs
- Over the counter pain and anti-inflammatory medications
- Gentle stretching
- Changing posture and ways of lifting objects
- Losing excess weight
- Regular exercise and core strengthening exercises
Medical interventions include:
- Prescription muscle relaxants, anti-depressants, anti-seizure medications
- Physical therapy
- Spinal injections – corticosteroids, anti-inflammatories
- Complementary therapies
Ayurvedic Approach to Sciatica (Gridhrasi):
According to Ayurveda – in addition to the above listed allopathic/conventional causes of sciatica – the condition can also be caused by a number of other imbalances/conditions. For example, ama or toxicity in the GI tract, constipation, cystitis, vaginitis, congestive dysmenorrhea, sleeping on a soft mattress and walking for extended periods of time.
Ayurveda sees that back pain stems from a Vata imbalance, with the type of scitatica experienced dependent on the doshic involvement:
Vata dominant sciatica: Can be variable, migrating, cutting pain that is throbbing and/or intense. Severe Vata aggravation can lead to parathesis, loss of touch with numbness and tingling. Aggravated by cold, wet windy weather, which decreases as the muscles become warm or as the days warms up. It can stem from overuse of muscles, stress, travel, sedentary lifestyle/non-activity, etc.
Pitta sciatica: Can be a steady burning sensation, an intense/lancing pain. Heat will generally aggravate the pain and it lessens when the body is cooled down or in the evening. It can stem from any form of inflammation, overuse that causes inflammation, shock, excessive anger, etc.
Kapha sciatica: Can be a steady, dull, static and/or and aching pain that is deep and diffused. Cold weather will tend to aggravate the pain and warmth will help to slowly relieve it. Pain can result from non-movement, lack of exercise, congestion, overweight conditions, constipation, amenorrhea, suppressed emotions, etc.
BENEFICIAL AYURVEDIC HERBS FOR SCIATICA:
Vata Pitta Balancing: punarnava, fresh ginger, shallaki, jatamansi, turmeric
Vata Kapha Balancing: punarnava, guggulu, fresh ginger, shallaki, nirgundi, ashwaganda, jatamansi, rasna, turmeric, castor oil
Pitta Vata Balancing: punarnava, fresh ginger, shallaki, jatamansi, turmeric
Pitta Kapha Balancing: punarnava, fresh ginger, shallaki, jatamansi, turmeric, camphor
Kapha Vata Balancing: punarnava, guggulu, fresh ginger, shallaki, nirgundi, ashwaganda, jatamansi, rasna, turmeric, castor oil
Kapha Pitta Balancing: punarnava, fresh ginger, shallaki, jatamansi, turmeric, camphor
Traditional Ayurvedic Treatment(s) for Sciatica:
Ayurvedic treatment approach(es) are individualised and are fully dependant on a full consultation with an individual, the current imbalances, their age, strength, severity of the condition, and if other conditions are also present. Treatment approaches can include:
- Panchakarma detox treatments (when deemed appropriate)
- Avoid causative factors
- Balance Jataragni (digestive fire) and digestion as needed
- Remove Ama (toxins within the digestive tract and body) if present
- Balance doshic imbalances through diet/lifestyle/herbs
- Intake of clean, wholefood, organic eating as much as possible
- Abhyanga massage, kati basti, sweat therapies, pizichil, navara khizi bodywork treatments
- Oil bastis if required to balance Vata
- Reduce excess weight (if required)
General Ayurvedic Nutritional Guidelines for Sciatica:
Ayurvedic nutritional approach(es) are individualised and are fully dependant on a full consultation with an individual. One should eat compatible foods, and in accordance to one's imbalances. Some additional general guidelines include:
- One should eat the foods that one does not react to.
- One should eat according to the digestive capacity, keeping meals light, cooked, warm moist and easy to digest. As a guide, eat to fill the stomach 1/3 with solid food, 1/3 with liquid and leaving 1/3 empty to allow room for digestive secretions in the stomach.
- One should eat at regular times/intervals. Avoid skipping meals.
- One should eat wholegrains and non-processed foods.
- Foods to avoid: Cold foods, raw foods, leftover foods (24 hours), frozen foods, cold water, processed and packaged foods, soft drinks, high fat foods, greasy foods. Minimise the intake of hot chilli type foods.
- One should avoid overeating. Allow 6 hours between meals and snack 3 hours after a meal and eat only if hungry. If digestion is poor, then 4 light meals per day is advisable in place of three regular meals.
- Breakfast should be easy to digest, lunch the main meal, and dinner should be lighter than lunch.
- A small amount of buttermilk consumed after meals is advisable.
- Eat home cooked meals, preferably made on the same day as being prepared.
- Water should be drunk warm in the cooler months and room temperature in the summer months. Avoid chilled water.
- Use all of the five senses at mealtimes. Savour the food that you are eating.
- Eat in a pleasant environment. Eat seated and try to avoid TV and electronic devices whilst eating.
- Eat slowly, eat with respect/reverence for what you are eating, chew thoroughly.
General Ayurvedic Lifestyle Guidelines for Sciatica:
Ayurvedic lifestyle approach(es) are individualised and are fully dependant on a full consultation with an individual. Some general guidelines include:
- Allow for sufficient rest and sleep. Go to bed at a regular time each day, and best before 10pm. Avoid also sleeping during the day.
- Keep to a routine as much as possible during the day.
- Get sufficient daily activity and exercise, without overdoing exercise. Balanced activity/exercise is healthy, but avoid over-exertion.
- Avoid stress, anxiety, fear and tension. Look at counselling for self-care and working through any stress, anxiety, anger or any other mental health and/or emotional issues.
- Deep breathing for 10 minutes a day is very beneficial. Meditation, yoga and pranayama can also be highly beneficial.
- Make sure to be well rugged up in winter, especially when going outside.
- Do not suppress bodily urges (burping, passing gas, bowel movements etc).
- Avoid smoking and minimise alcohol and caffeine intake.
- One should avoid constipation and supresing natural urges (passing stools, gas, burping etc).
- Look at ways of improving posture, lifting heavy objects, and improved sitting techniques.
- Firmer mattresses are better for back pain than soft mattresses.
- Get sufficient rest, especially when pain is aggravated.
- Avoid excess sexual activity.
If you have any concerns about your health please be sure to consult an Ayurvedic Practitioner or your local health physician. See our Ayurvedic Practitioner Services and Consultation Page for more information.