This article will help clear up the confusion on treating sciatic nerve pain. Generally speaking, most think of sciatica as pain in the leg, but it can be in the back, butt, or leg. It isn’t fair to call it a total BS diagnosis since it’s not nothing, but the diagnosis is being phased out because it doesn’t provide me with any specific information to determine the best way to treat it.
Here’s 2 test to get more specific and advice on how to treat it.
Two tests to Diagnose Sciatica Nerve Pain
#1 How to do Prone Press up
- lay on your stomach with your hands close to your head
- press up from the table; keep the hips down
- do 5 reps and assess pain
- less pain? ✅ herniated disc
- less leg pain? ✅ herniated disc disc, EVEN IF back pain gets worse
#2 How to do the Slump Test
- Sit down, slump forward, tuck your chin.
- Kick the leg that hurts out straight (POSITION 1)
- Assess your pain
- Look UP (don’t move anything else), re-assess pain (POSITION 2)
- If looking up DECREASES your pain, ✅ herniated disc
To clarify, both tests are to see if the irritation is AT THE SPINE. It isn’t perfect but good enough.
What Causes Sciatica?
Remember, the term “sciatica” doesn’t tell me ANYTHING useful. Sciatic pain could be caused by the following:
- A disc herniation – read about those here
- Facet Arthropathy, i.e., known affectionately as arthritis
- Broken vertebra – the actual spinal bones, usually traumatic
- Nerve compression – the nerve is irritated SOMEWHERE, just not at the spine (read more about piriformis syndrome here)
- Muscle pain – this is the default if nothing stands out, whether it be true or not
Sciatica is a herniated disc 90% of the time. Here’s how to use the 2 tests to diagnosis yourself.
Remember, if it’s bones + you had recent trauma GO TO THE EMERGENCY ROOM. More details on that here.
These aren’t hard and fast rules, but they give enough information to start to move forward. Unfortunately it is common to have more than one source, or the muscular component is unpredictable. Or the disc source is unpredictable. The entire assessment process is actually not that good, unfortunately.
What are the best Sciatica treatments?
The below table gives basic treatment advice for each “source.” Strength training is ALWAYS the ultimate goal, but depending on the source of pain, you may have to let some healing occur before you can start, or everything will have to be modified.
Prognosis, what to expect, and final thoughts
Just to make sure we are on the same page, you don’t diagnosis sciatica. You do tests to narrow down what we THINK is the source of your pain. A herniated disc takes anywhere from 2-6 months for a full recovery. Most pain relief comes in the first 2-4 months, sometimes the first 2-6 weeks. Trying to be as active as you can be will help speed up the process. You will have to do less for some amount of time, but try not to do nothing.
Need some pain relieving techniques, read about those here.