The simple daily tweaks sci­at­ica suf­fer­ers say really WILL ease your excru­ci­at­ing pain ...no drugs neces­sary!

From pressreader.com

ANYONE who has exper­i­enced sci­at­ica will know how excru­ci­at­ing the pain can be and the pro­found effect it can have on daily life. A burn­ing or stabbing sen­sa­tion which radi­ates down one or both legs, or an elec­tric shoot­ing pain which can start in the lower back, hips or but­tock and pulse down­wards as far as the heels, it is endured by around three mil­lion people in the UK – wreck­ing sleep, mak­ing it impossible to work and pre­vent­ing nor­mal move­ment.

Such pain occurs when the roots of the sci­atic nerve – the body’s largest nerve which runs from the base of the spine through the but­tocks and down each leg – become inflamed or com­pressed. And while it is already a rel­at­ively com­mon com­plaint, affect­ing one in four people at one point in their life­time, anec­dot­ally, experts sug­gest it may be becom­ing more pre­val­ent and is affect­ing even younger adults. 

Singer Adele, for example, who is 37, has been open about her ‘really bad’ sci­at­ica – which stemmed from a slipped disc after sneez­ing in bed when she was 15 – which has caused her to spend half her life in pain and to ‘waddle’ on stage dur­ing her Las Vegas shows.

There are no offi­cial fig­ures to back up the recent rise, partly because sci­at­ica is the term used to describe a set of symp­toms, rather than being a dia­gnosis in itself, and because it can develop as a res­ult of other primary prob­lems such as slipped or com­pressed discs (the ‘cush­ions’ between each ver­tebra), arth­ritis or osteo­porosis.

But NHS Eng­land’s most recent Health Sur­vey for Eng­land in 2024 found 26 per cent of adults report being in chronic pain of any kind, of whom more than half were strug­gling with back pain.

Sci­atic pain is likely to be a sig­ni­fic­ant part of that bur­den, experts say. And as the Health Found­a­tion estim­ates that 1.9mil­lion more adults could be liv­ing in chronic pain by 2040 – with back pain and other mus­cu­lo­skeletal prob­lems the biggest part of that – it is clear that this is an issue which will affect increas­ing num­bers of people.

It’s partly linked to the rising tide of obesity. Around one third of adults in the UK are now obese, up from 15 per cent in the early 1990s. Excess weight can, over time, con­trib­ute to the devel­op­ment of the con­di­tions that lead to sci­at­ica as well as put­ting addi­tional pres­sure on joints and con­trib­ute to nerve com­pres­sion, mak­ing it more likely that a sneeze or sud­den twist could trig­ger it. It can also make sci­at­ica worse if you do develop it.

IN ADDITION, more sedent­ary life­styles post-Covid, and more jobs which are desk-based or involve work­ing from home, are trig­ger­ing a rise even in younger adults, experts say. Con­sult­ant neurosur­geon Alireza Shoakazemi, hon­or­ary reader in med­ical edu­ca­tion at Queen Mary Uni­versity of Lon­don, says: ‘From what I’m see­ing in my clin­ics, and from what’s known in the gen­eral pop­u­la­tion and backed by global stud­ies, the num­ber of people with sci­at­ica is increas­ing.

‘In the UK these fig­ures are rather hid­den because sci­at­ica can be caused by so many other prob­lems and it’s con­sidered a symp­tom, not a dia­gnosis.

‘An age­ing pop­u­la­tion is part of it, but what I’ve observed is a trend for younger adults to develop it earlier. There are lots of reas­ons for that, but emer­ging evid­ence sug­gests more sedent­ary beha­viour is a big factor – pro­longed sit­ting, office work­ing, and even things like con­duct­ing meet­ings in video calls rather than in per­son, may all be con­trib­ut­ing.’

Last week, when The Mail on Sunday’s res­id­ent GP Dr Ellie Can­non asked read­ers to get in touch about their exper­i­ences of sci­at­ica, we were flooded with responses. Some said they ‘couldn’t walk more than a step’ without excru­ci­at­ing pain.

One wrote: ‘I wouldn’t wish severe sci­at­ica on my worst enemy. Wak­ing every day to the con­stant, debil­it­at­ing pain was really depress­ing. It does ruin your life.’

However, most insisted they had developed sci­at­ica without being over­weight or obese. Intriguingly, some ques­tioned whether stress or bereave­ment might have triggered their phys­ical pain, while oth­ers blamed more sedent­ary life­styles dur­ing Covid.

In addi­tion, sev­eral read­ers sug­ges­ted that the mod­ern habit of keep­ing a wal­let or mobile phone in a rear pocket could be to blame.

As one reader wrote: ‘Hav­ing large wal­lets stuffed in back pock­ets cause you to sit unevenly, pla­cing addi­tional pres­sure on the lower back and nerves.’

So how much of this is true – and what else might be trig­ger­ing the sug­ges­ted rise in sci­atic pain? John Sutcliffe, lead clini­cian at the Lon­don Spine Clinic, explains that there are sev­eral cat­egor­ies of patients who develop sci­at­ica: those who develop gen­eral wear and tear of the joints as they age, those who are liv­ing more sedent­ary lives without the core strength they need to sup­port their spine and lower back, and the super-fit, who may also end up with earlier wear and tear.

‘Ergo­nom­ics is a big issue, too – we saw a lot of people dur­ing lock­down who had been work­ing from the sofa or bed­rooms with poor pos­tures and developed sci­atic pain as a res­ult,’ Mr Sutcliffe says. ‘That remains an issue as more people are work­ing from home.

‘If you’re obese you may be more prone to it if you do something as simple as sneeze or twist or turn in bed, and sedent­ary life­styles are

con­trib­ut­ing too. The counter to that is that lots of people also took up run­ning or cyc­ling in lock­down, and they weren’t fit or pre­pared enough, and that caused prob­lems too.’

Stress can also be a trig­ger. Mr Sutcliffe adds: ‘We see lots of people who are fine on hol­i­day, but their pain returns in the office.

‘When you’re stressed, the muscles tighten up, and if your core muscles aren’t strong then that pres­sure trans­fers to your spinal discs which can bulge out, com­press­ing the nerve and caus­ing pain.’

The the­ory about wal­lets or large mod­ern smart­phones wedged in back pock­ets trig­ger­ing sci­atic pain may also have some truth to it, Mr Sutcliffe sug­gests. The issue has been described in case reports in med­ical lit­er­at­ure and referred to as ‘wal­let neur­itis’ – or fat wal­let syn­drome.

‘I’ve never come across this spe­cific­ally, but any­thing that causes asym­metry can lead to pain – I’ve been known to stop people who are car­ry­ing ruck­sacks on one shoulder,’ he says. ‘And of the patients we see with back prob­lems, about 15 per cent will have one leg slightly longer than the other.’

Treat­ing sci­atic pain can be tricky, and most people are ini­tially advised to stay act­ive, con­tinue nor­mal daily activ­it­ies as much as pos­sible and to use over-the-counter paink­illers such as ibupro­fen or paracetamol and heat or cold packs for pain relief.

Most people can resolve their sci­at­ica within a few months by keep­ing up gentle move­ment.

‘Rest is the worst thing you can do,’ says Dr Dan Baumgardt, a GP and senior lec­turer in pain at the Uni­versity of Bris­tol. ‘Gentle stretch­ing and get­ting out of bed is the main thing, oth­er­wise the prob­lem will only get worse.’

THERE are stud­ies that sug­gest walk­ing, gentle yoga and swim­ming are par­tic­u­larly good for eas­ing sci­atic pain, as long as you do it con­sist­ently and reg­u­larly. If symp­toms per­sist, physio­ther­apy will help with pos­ture, strength­en­ing the core muscles and keep­ing you mobile – although there are long waits for NHS treat­ment and most people will find their symp­toms resolve before they can be seen. Other neur­omod­u­lator drugs, such as amitriptyl­ine and gabap­entin, can be pre­scribed if nor­mal paink­illers are not effect­ive.

Adele, whose flare-ups came when she was stressed or sit­ting with bad pos­ture, found that strength­en­ing her core has helped.

In an inter­view, the singer said: ‘Where I got my tummy strong, down at the bot­tom, which I never had before, my back doesn’t play up as much. It means I can do more, I can run around with my kid more.’

Dr Esther Fox, a physio­ther­ap­ist, has found that doing Pil­ates sev­eral times a week has suc­cess­fully staved off her sci­at­ica over the past 20 years.

The 47-year-old, who runs the Mount Kelly Physio­ther­apy Centre in Tav­is­tock, Devon, says any con­sist­ent, low-impact exer­cise would make a dif­fer­ence.

‘Hon­estly, there were times when I thought I would need a hip replace­ment,’ says Dr Fox, who is also a Pil­ates instructor. ‘I’d be frightened to move because you know that shoot­ing pain is com­ing. But I now no longer need to use any paink­illers and only notice it com­ing back if I don’t do Pil­ates for a few days. ‘Some people will need sur­gery, but for most it gets bet­ter by itself, and los­ing weight and being more act­ive will help.’ One reader, from Red­ditch, Worcester­shire, wrote to the MoS to say he got rid of his sci­at­ica by los­ing weight and exer­cising. The 64-year-old had piled on the pounds after giv­ing up smoking, and was told by a physio­ther­ap­ist that his sci­at­ica was ‘a dir­ect con­sequence’ of his weight. After chan­ging his diet and three weeks of daily walk­ing, his pain had gone. And two years on, he has not needed to see a doc­tor since. He wrote: ‘When my treat­ment was com­plete, the physio­ther­ap­ist told me that if all her patients took up daily walks, she would lose a lot of work.’ But for some patients with more extreme sci­atic pain, ster­oid injec­tions – designed to reduce inflam­ma­tion – may be required. About 6 per cent of patients may require sur­gery, known as a dis­cec­tomy, to remove the part of a bul­ging disc which is com­press­ing a nerve.

The bad news is that, once someone has exper­i­enced sci­at­ica, they are likely to have another epis­ode. However, it is pos­sible to reduce that risk. ‘Los­ing weight will poten­tially help, as will stay­ing act­ive – but find that sweet spot and don’t push it too hard,’ Dr Baumgardt says.

‘If poor pos­ture or work­ing from home or at a desk is the cause, speak to your occu­pa­tional health team. Avoid pro­longed sit­ting, and quit smoking – it can affect the integ­rity of blood sup­ply and disc health too.’

Mr Shoakazemi advises his patients to set an alarm on their phones as a reminder to stand and move around every 30-40 minutes, and to keep com­puter mon­it­ors at eye level to pro­mote good pos­ture.

Mr Sutcliffe adds that those at risk should make sure to sit cor­rectly in a chair.

‘Push your bum right to the back so your back is against the back­rest and you’re sit­ting nice and upright – hav­ing an arm rest helps,’ he says. He also recom­mends core strength­en­ing exer­cises, such as planks and bridges.

‘A few minutes a day can reduce the risk of hav­ing a sig­ni­fic­ant prob­lem that causes sci­at­ica,’ he adds. ‘I can’t stress that enough.’

https://www.pressreader.com/uk/the-mail-on-sunday/20260426/282325391567934