Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Sciatica aka Sciatic Nerve Inflammation: Causes and Treatments

by Dr. Zsolt Zatrok

Ischiasis, or sciatica, is a severe lower back pain that radiates into the muscles of the buttocks or legs. It is often “deceptive” because the complaint is not pain in the lower back at all, but pain radiating down the buttocks and into the legs. But the root of the problem is in the lumbar spine. The pain itself and the underlying cause is very similar to lumbar pain. It can also be mistaken for it. My article is about what you can do about its recurrence.

The cause of sciatica

The sciatic nerve starts in the lumbar and sacral vertebrae IV-V and runs under the gluteal muscles, down the deep thighs, and down to the shin and toes.

sciatica explanation


In case of sciatica, the disc between these vertebrae weakens and presses on the nerve running through the intervertebral space (See diagram below). When the nerve is pressed, pain occurs.

Ischiasis, lumbago and herniated disc are essentially the same condition. They are now “widespread diseases”, i.e. they affect a very large number of people. The main causes are too much sitting and a sedentary lifestyle. The muscles supporting the spine weaken and do not hold the spine properly, putting more pressure on the discs. Add to that excess weight or lifting heavy objects and you have a problem. Sciatica, lumbar hernia and herniated discs usually develop suddenly, with a single movement – only to torment the “victim” for a long time.

I’ve already mentioned the most common cause, but spinal stenosis, wear and calcification of the joints between the vertebrae, or even spasmodic muscle contraction due to stress (e.g. piriformis syndrome) can also trigger sciatica.

Isiasis can also be caused by psychological factors! Psychology sees it as an overwhelming feeling of being overwhelmed – it can be triggered by past or present problems, or by fear of the future. The pain of sciatica may prompt a patient, who often feels inferior, to find a solution to their problems, to eliminate their real or imagined overload.

Symptoms of sciatica

The pain may primarily affect the lower back, but it typically radiates downward to encompass the bottom of the buttocks, the inside back of the thighs, and the back and outside edges of the shins. In mild cases, there is only pain, but there is also sensory disturbance and even paralysis.

The location of the pain can fool you and even the inexperienced doctor! Because you feel the pain in your leg, you may not even think that your back or spine is the real cause. Although your leg hurts a lot, the cause is higher up in the lumbar spine!

In this case, the lumbar spine requires treatment as the primary concern, not the leg. The aim of the treatment is to “free” the sciatic nerve from “pinching”, from pressing down on the disc.

Tips for prevention

  • Regular exercise and back muscle strengthening exercises can help prevent sciatica.
  • Choose sports that strengthen your spinal muscles to relieve the load on your discs. Ideal exercise is swimming, (indoor) cycling, yoga, any back muscle strengthening exercise.
  • Sitting in the wrong position at work often triggers these complaints. The chair should support your lower back! Raise your monitor to eye level. Don’t sit all day, stand up often and do some waist-relaxing exercises.
  • Exercise regularly, even 15-20 minutes a day can do wonders.
  • If you need to lift a heavy object, do it with a straight spine, starting from a squat.
  • Load both sides of your body evenly. If you always carry your bag on the same side, the asymmetrical load will also unbalance your muscles, which will affect your spine.
  • Use a proper recliner in your bed. It should be neither too hard nor too “lumpy”

Home treatment for sciatica

If you haven’t had sciatica before, see your GP as soon as possible. You should be referred to a neurologist (neurology) or a spine centre. You need to find out the extent of the disc herniation. If the disc is intact, they will recommend conservative treatment. However, if the cartilage is torn, your neurological symptoms may be severe, e.g. pain, sensory disturbance, muscle weakness, mobility problems, urinary and bowel problems. A hernia that has been torn out can only be repaired with surgery.

Ischiasis is characterised by recurring from time to time, caused by not strengthening your back muscles, changing your work or lifestyle despite the symptoms. Such recurring complaints do not always require a further examination (only if neurological symptoms occur).

You can help yourself by treating it at home for a few days. For one thing, you can take some medication prescribed by your doctor for just such occasions. Muscle relaxants, painkillers, NSAIDs are available in tablet, capsule, patch or even suppository form. If these drugs are taken for long periods (several weeks), undesirable side effects (e.g. stomach pain, ulcers, black stools, etc.) can be expected. If you experience any of these, consult a doctor.

Physical therapy devices are side-effect free, simple to use and effective. They are not miracle cures, of course, which means that you won’t find a single method that will make the pain go away in one treatment. You can gradually improve your condition over a few days.

Multimodality treatment

Sciatica requires multi-modality treatment. This means that you should use several different treatments in parallel, if possible, rather than trying just one.

To understand my usual example of tinkering. If you want to make a birdhouse but you only have a hammer, it will never be finished. You need a saw to cut the planks to size. A drill to make the hole for the hole. Hammer and nails to assemble the wooden boards. A hook to hang it on a branch.If you have all the tools, but you use them incorrectly (the hammer to cut, the saw to hammer), the result will be poor. If you use them in the right way and in the right order, you will have a hole.

There are also several different “tools” for sciatica, none of which alone guarantees an improvement. It’s best – and in a physiotherapy practice this is why you can get several treatments at once- if you have several different types of equipment at home. If you don’t have one, go for the simplest (and cheaper) one and if that is ineffective, move on to the more complex (and more expensive) one.

In the next section, I’ll look at what methods can be used to treat sciatica and which ones work.

What you can expect from each method

TENS treatment

Tens Treatment is a pain-relieving method that you can use instead of medication. If you use it with them, you can enhance the effect of the medication, meaning you need to take less poison. The disadvantage of TENS is that it is only temporary, i.e. it does not act on the cause of sciatica, nor does it eliminate it.

Dolito TENS deviceDolito tens device

  • two-channel TENS unit
  • modulated, conventional, endorphin and burst TENS programs
  • It can be used for pain relief in any area of the body, with the exclusion of the skull.

Microcurrent (MENS) treatment

Microcurrent Treatment is also an electrotherapy method, but it has a stronger analgesic effect than TENS. It also has the advantage of reducing the swelling (oedema) of the pinched nerve fibre and stimulates and accelerates the regeneration of the damaged nerve fibre.

Therapeutic ultrasound

Ultrasound treatment, when applied during the acute period (first three days after the pinch), reduces swelling (oedema) of the nerve fibre and relieves pain. It relaxes the muscles of the spinal cord and thus reduces pain. Ultrasound does not strengthen the muscles and does not affect possible recurrence.

M-Sonic 950 Therapeutic Ultrasound

  • Ultrasonic frequency: 1.0MHzSciatica, ultrasound device
  • Transducer area: 4.0cm²
  • Power: 1.6W/cm2
  • Max. power: 6.4 W (continuous mode)
  • Cycle time: L (5%), M (50%), H (100%)
  • Waveform: Pulsating, Continuous

Soft Laser  treatment

Soft Laser treatments help to relieve acute pain, their main role is to reduce the edema and swelling around the pinched nerve and to regenerate it. None of them strengthen the muscles, so they do not affect possible recurrence.

Personal Laser L400 soft laser

  • Laser power class  3Personal Laser L400 softlaser /LLLT, sciatica treatment
  • 808 nanometer laser beam
  • CW (continuous wave) laser
  • 400 mW power
  • 12.5 sec / 5 Joule

Muscle Stimulation (EMS)

If you have sciatica, you can expect to get the most out of muscle stimulation (EMS). Its effects are twofold. It relaxes tight muscles in the spinal muscles that have become stiff from pain. The main benefit of muscle stimulation is that, with daily use for 10-12 weeks, you can strengthen your spinal muscles to the point where sciatica symptoms are permanently relieved. This is essential because without strengthening your spinal muscles, it only takes one sudden movement to trigger a recurrence of your symptoms.

Premium 400globus premium 400

  • Dedicated Sciatica treatment program
  • Multifunctional electrotherapy device
  • TENS | EMS, NMES, FES | MENS, MCR | Iontophoresis
  • max. 4 channels (8 electrodes)

In the case of sciatica, muscle relaxant-pain reliever stimulation should be performed on the lumbar spine (because that is where the problem itself originates) and over the complaints radiating to the leg.

microcurrent sciatica pain treatment points electrode placement



Treatment strategies for sciatica at home

Keep the following in mind:

ease the pain

reduce muscle stiffness

prevent recurrence by strengthening spinal muscles

  • this is the most important step in getting rid of sciatica!
  • By strengthening your spinal muscles, you can prevent the vertebrae from stacking up and putting pressure on the nerve.
  • a good tool for this is the muscle stimulator.

Home physiotherapy devices are designed specifically to treat such conditions.. All you have to do is follow the instructions.

You can reduce your pain for some time with a single treatment, but achieving lasting results requires persistent treatment. You can typically achieve symptom relief within 10-15 days. To prevent a recurrence, you need to strengthen the muscles that support the spine and take about 60-90 days to recover.

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