How can you treat sciatica? Are there exercises to relieve discomfort? -- Abby Warman

Sciatica is pain in the lower back or hip that radiates down into a buttock and the back of a leg, often the result of a "slipped" or herniated vertebral disc pressing on the sciatic nerve. The pain can take a number of forms -- it may feel like a cramp in the leg, may worsen when you sit, sneeze or cough, and may show up as numbness, burning, tingling or a pins-and-needles sensation in the leg.

Fortunately, sciatica usually goes away on its own within a few weeks (only 10-25 percent of all cases last more than six weeks and 80-90 percent of all people with sciatica recover, in time, without surgery), but there's a lot you can do to lessen the pain. You can apply heat or ice right away. Over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) can help, too. Beyond that, I would recommend the following treatments:

  • Acupuncture: Even the National Institutes of Health now recognizes acupuncture as an acceptable alternative to conventional therapies for low back pain. Look for an acupuncturist accredited by the American Association of Oriental Medicine or the American Academy of Medical Acupuncture.
  • Bodywork: Both the Alexander Technique and Trager Work can help overcome back pain. Trager Work (www.trager-us.org) includes table work (a practitioner gently rocks and lengthens your body to release tension) followed by a movement lesson for continued self-care. The Alexander Technique (www.alexandertech.org) can help relieve pain and prevent recurrences by correcting poor posture and teaching proper patterns of movement.
  • Therapeutic Yoga: Yoga can help relieve pain and protect against recurrences by strengthening your back. It also can balance nervous functioning, promote flexibility and neutralize stress, all of which contribute to back pain.
  • Physical Therapy: Most conventional doctors who treat sciatica recommend physical therapy with stretching exercises as soon as the pain begins to diminish. You often can begin this rehabilitation by taking short walks even before starting physical therapy. (Therapeutic yoga may offer more benefits than physical therapy.)
  • Osteopathic Manipulation: This system of manipulation of the musculoskeletal system can be highly effective treatment and usually requires only a few visits to a qualified practitioner.
  • As far as surgery to remove part of the herniated disk is concerned, you shouldn't even think of it as an option unless, after three months of treatment, you still have disabling leg pain. Luckily, that's rarely the case.

    Dr. Andrew Weil

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