Holistic Recommendations for Sciatic Pain
Sciatica is described as compression and inflammation to the sciatic nerve or one of its roots or branches. It is often a symptom of underlying degenerative conditions, but can also be triggered by injury to the sciatic nerve. Pain can be acute or chronic, usually beginning in the lower back and radiating down the lower limb. People suffering from sciatica can also experience burning, tingling, numbness and weakness. Unilateral pain is a common physiological characteristic of sciatica, manifesting as radiating nerve pain on one side of the lower limb. Lumbar disc herniation, lumbar spinal stenosis, and piriformis syndrome are known causes of sciatica. Other under researched causes include trauma, pregnancy, menopause, tumors, bone overgrowth, and herpes zoster. Risk factors for acute sciatica involve a variety of personal and occupational influences including age, height, smoking, mental stress, strenuous physical activity, etc. (Koes et al., 2007). Many conventional and holistic treatments offer little or no improvement of symptoms. Understanding some of the anatomy and physiology of the sciatic nerve may be beneficial in treating the debilitating pain.
The sciatic nerve is the largest peripheral nerve in the body and the major nerve of the lower limb (McKinley, O’Loughlin, & Bidle, 2013). It originates from the spinal nerve roots L4- S3 and is formed by both the anterior and posterior divisions of the sacral plexus. The sciatic nerve innervates and provides sensory nerve signals to many of the posterior muscles of the leg and foot. The division into the tibial and common fibular nerve provides distinct innervation to specific areas of the lower limb. The tibial nerve innervates most of the hamstring, supplies the plantar flexors and provides sensation to specific areas of the foot. The common fibular nerve innervates the biceps femoris muscle and the lateral side of the knee. Each branch divides into terminal branches that further innervate the ankle, foot, and toes. It is important to consider the physiology of the sciatic nerve when seeking diagnosis and a greater understanding of the contributing factors causing sciatica.
Lumbar intervertebral herniation is the most common cause of sciatica, accounting for approximately 90% of sciatica cases. (Koes et al., 2007). Piriformis syndrome is caused by the compression of the sciatic nerve by the piriformis muscle, located deep in the glutes. It is difficult to recommend effective interventions for piriformis syndrome and other conditions causing sciatica, but a variety of both holistic and conventional options are available.
Acupuncture Therapy
Although there needs to be more available trials, research is emerging about the effectiveness of acupuncture therapy when treating sciatica. Acupuncture research findings of a meta-analysis found that acupuncture is clinically effective and reduces pain intensity (Ji et al., 2015). Results from 12 random studies including 1842 participants showed acupuncture to be more effective in treating sciatica pain than conventional western medicine (Wang et al., (2015). Research has also shown plant medicine to have some positive effects on calming inflammation and making pain more manageable.
Turmeric Root and Black Pepper
Turmeric root has been used for thousands of years in both Ayurveda and traditional Chinese medicine as support in various body systems. The healing properties of turmeric provide antioxidant and anti-inflammatory activity on a cellular level and is said to help treat oxidative inflammatory conditions within the body (Xiao et al., 2018). Like with most plant medicine, consistency, quality, and proper preparation are crucial to reap the healing benefits. The polyphenol curcumin is the active chemical compound found in turmeric root. Researchers found curcumin to have very poor bioavailability and absorption by itself. In order to increase bioavailability and absorb the healing mechanisms, curcumin must be combined with known bioavailable enhancers. The Hewlings and Kalman (2017) state, “piperine, a known bioavailability enhancer, is the major active component of black pepper and associated with an increase of 2000% in the bioavailability of curcumin. Therefore, the issue of poor bioavailability appears to be resolved … creating a curcumin complex” (p. 1). Curcumin shows significant increase in bioavailability when combined with the bioactive compound piperine. This combination aids in absorption of the anti-inflammatory healing properties. In cases of lumbar disc herniation, Xiao et al. (2018) found, “…that systemic administrations of curcumin had a regenerative effect on herniated disc, as seen by newly formed collagen and proteoglycan extracellular matrix proteins” (p. 12). The antioxidant compound shows promising medicinal benefits that have been found generally safe for most people and provide regenerative properties on a cellular level.
Individualized Treatment Plan
Sciatica can be caused by a variety of underlying conditions, difficult to diagnose, and even harder to effectively treat. Currently, treatment options are highly individualized, so finding a creditable practitioner, physical trainer, or certified coach with experience treating sciatica can be a life changer. These specialists can create specific exercise routines to meet individualized needs with the goal of building muscle, coming into alignment, and ultimately, reducing pain.
Many holistic treatments have little to no side-effects, offer a whole person approach, and provide research showing comparable analgesic effects to conventional medicine. Many times, immediate pain relief is experienced following treatments like acupuncture. Turmeric root combined with black pepper provides significant anti-inflammatory and disease fighting responses in the body, and may help reduce inflammation of the sciatic nerve. Maintaining a healthy active lifestyle, eating a nutritious diet, and incorporating regular holistic self-care (massage is great) can help alleviate sciatic pain and inflammation.
