Steroids vs. Exercise for Sciatica Pain Relief

Many people experience sciatica pain in their lower back or legs. Sciatica is not a disease but a description of symptoms. It involves discomfort related to the sciatic nerve, which branches from the bottom of the spine to the backs of the legs. Sciatica can feel like aching, burning, tingling, numbness or shooting pain. The condition is also known as lumbar radiculopathy.

Several strategies help to relieve sciatica symptoms. Among initial treatment methods are regular exercise, over-the-counter painkillers and hot and cold compress application. To target persistent or severe pain, your doctor might administer steroids through either oral or epidural means. In some cases, other treatment methods may be necessary, such as minimally invasive procedures. If you suffer from sciatica, it’s important to understand various treatment avenues. Different methods can help ease your pain.

What Does Exercise Do for Sciatica Pain?

Dealing with sciatica pain often requires several different treatment measures, such as hot and cold application, pain medication, steroids and physical therapy. Exercises and physical therapy regimens are almost always part of a recovery plan for a sciatica patient. Certain stretches can alleviate your sciatica pain in many different ways. They strengthen, support and stabilize your lower back. Exercise serves to:

Increase healing blood flow: When you exercise, the blood vessels in your muscles dilate, allowing more nutrients and oxygen to reach your lower back. In that way, exercise can have healing capabilities.
Decrease the pressure on your spinal nerves: Stronger muscles reduce the pressure on your nerves. Regular back-strengthening exercises can help to alleviate the workload your spinal nerves must endure.
Help you improve your posture: Stronger core muscles allow you to sit and stand with better posture. Since poor posture is a common cause of lower back pain, improved posture is one way to prevent future sciatica issues and other injuries.
Establish better flexibility: Exercises also help you establish flexibility. A wider range of comfortable flexibility decreases your risk of pinching your sciatic nerve.

When you exercise for sciatica relief, be sure to start slow and choose low-impact workouts. Maintain proper form to avoid injury. Use a heating pad beforehand and an icepack afterward — the heat will improve your blood flow, and the cold will cut down on inflammation. You’ll find regular stretching and exercising can help you recover from a variety of ailments. Strengthening your core, which includes all of the muscle groups surrounding your organs, can improve both stabilization and mobilization.

Stabilization and Mobilization

Stabilization refers to supporting upright posture while sitting or standing, and mobilization gives you the strength to move around. If the muscles are weak, your body will rely on ligaments and other structures for posture and movement, which often causes pain. For that reason, building up your muscles provides relief for a wide range of chronic pain symptoms, including sciatica. Exercise can also reduce your chance of injury, improve your balance, ease breathing and aid digestion. All things considered, an exercise routine should be part of your daily life whether or not you struggle with sciatica pain.

With that said, exercise alone may not be enough to ease pain for sciatica patients. Your doctor might also prescribe steroids, taken by mouth or injected into the lower back, among other treatment methods. Although exercise is always an important part of sciatica management, additional measures might also be necessary.

How Do Steroids Treat Sciatica Pain?

A spine specialist might prescribe steroids to alleviate persistent sciatica pain. Steroids, which are the human-made equivalent of your body’s hormones, target inflammation to reduce pain and swelling. Steroids can be either taken by mouth or injected.

Oral Steroids for Sciatica

The oral steroid for sciatica is methylprednisolone. Prednisone for sciatica mimics the effects of a class of hormones called glucocorticoids, which allows it to reduce inflammation and calm an overactive immune system. Its capabilities make it a possible treatment for issues other than sciatica, as well, such as:

Allergic reactions.
Gastrointestinal issues.
Multiple sclerosis.
Autoimmune disorders.

Epidural for Sciatica

If over-the-counter pain drugs and oral steroids prove ineffective, your doctor may suggest a sciatica epidural steroid injection. An epidural stops the pain signals that travel from the spine to the brain. Because it blocks feelings in the lower half of the body, it’s a common method for easing labor pain. Epidurals are an effective pain relief method — one injection is often enough to minimize sciatica pain for weeks or months at a time. Steroid injections can also treat issues such as tendinitis and joint inflammation related to arthritis.

Not everyone will be a good candidate for an epidural. An epidural can cause the patient’s blood pressure to fall, so a patient with blood pressure irregularities might not be able to have an epidural. Another possible risk is a local infection at the injection site. In addition, the injection can cause headaches, drowsiness and nausea. In extremely rare cases, an epidural can lead to permanent nerve damage or death. Your doctor will discuss your options with you and review your medical history to see if an epidural is right for you.

Is It Unsafe to Use Steroids for Sciatica?

In most cases, your doctor will first suggest stretches, exercises and over-the-counter inflammation reduces for sciatica pain. If those measures are not effective, steroid tablets and injections are the next step. Steroids tend to provide symptom control rather than a definitive cure. Their effectiveness varies. Given that steroids have rare but serious possible side effects, it’s essential to exhaust other avenues for pain relief first. For cases of extreme or unyielding sciatica pain, steroids are a common solution.

Can Exercise and Steroids Be Used Together?

Regular exercise is always an important aspect of sciatica treatment, and steroids can be part of a longer-term pain management plan. The duration of pain relief following steroid treatment varies from one patient to the next, so pre-scheduled steroid treatment can be helpful.

Be aware, too many steroid shots for sciatic nerve pain can cause nerve and tissue damage. For that reason, your doctor will be careful not to schedule injections too often. They’ll also incorporate additional treatment methods into your long-term plan.

Example Exercises for Sciatica Pain Relief

Exercise is vital for reducing sciatic nerve pain. With that said, be sure to consult with a professional before starting an exercise program. Otherwise, your exercise attempts could exacerbate the issue and prove counterproductive. With your specialist’s approval, try lengthening and strengthening exercises. Always maintain full, slow breaths as you stretch, and try not to overexert yourself. Here are some stretches and exercises to build your strength and flexibility:

Hamstring Stretches

In some cases, sciatica results from tight hamstrings, which causes pressure on the lower back area. To stretch your hamstring:

Place your heel on a raised surface.
Flex your raised foot.
Lean forward to feel a gentle stretch in the back of your leg.

Another hamstring stretch is the downward-facing dog yoga pose. To do the pose, you’ll need to:

Start on all fours, with your hands shoulder-width apart and your shoulders above your wrists.
Lift your knees off of the ground, tucking your toes against the floor. Your body will make the shape of an upside-down letter “V.”
Press into your palms and the balls of your feet to deepen the stretch.
Hold your body in the pose, paying attention to your breath.
To release, bring your knees down toward the floor in a slow, controlled motion.

Pelvic and Gluteal Stretches

It’s also essential to stretch your pelvic and gluteal muscles. To stretch your pelvic muscles:

Lie on your back.
Bend your legs at the knees, pulling your feet toward your buttocks.
Lean your knees to the right, lowering them to the floor. Be sure to keep your shoulders flat against the floor.
With your knees as low as you find comfortable, hold the pose.
Lift your knees back up.
Repeat on the other side.

This rotational pelvic stretch will target the minor muscles in your buttocks, which can be challenging to reach otherwise. To target your gluteal muscles, try this stretch:

Lie on your back.
Pull up your knees toward your chest.
Place your right ankle on your left knee.
Pull your left leg toward your center.
Repeat on the other side.

Additional Yoga Poses

Additional yoga poses, such as the cat and camel poses, will stretch the muscles surrounding your spine. To do these poses:

Start on your hands and knees, with your shoulders stacked above your hands and hips stacked above your knees.
Put your chin to your chest and lift your back upward. Your back will arch resembling an angry cat. This is the cat pose.
Lift your chin to the ceiling and arch your back the opposite way, pushing your stomach toward the floor. This is the camel pose.
Alternate between these two poses, holding them for a set number of breath counts.

Quadruped Raises

Quadruped raises are excellent for developing balance. The steps to do a quadruped raise are:

Start on your hands and knees. Again, you’ll want to stack your shoulders above your hands and your hips above your knees.
Raise your right hand and left leg, stretching as far as you can.
Lower them back to the start position.
Raise your left hand and right leg the same way.
Repeat as many times as desired.

Donkey and Flutter Kicks

Kicking exercises can strengthen your core and glute muscles. Donkey kicks involve getting on all fours and then swinging each leg up while keeping the knee bent. For a flutter kick, you’ll lie on your stomach, lift your arms and legs off of the floor and then paddle your feet as if you were swimming.

Bridges

Bridges are another useful strengthening exercise. To do a bridge, you’ll:

Lie on your back.
Pull your feet up so your knees are bent.
Lift your legs, hips and buttocks off of the ground, making a straight line from your shoulders to your knees.
Lift one foot off the ground to make the exercise more challenging. Keep the lifted leg bent at the knee.

Other Ways to Treat Sciatica Pain

In addition to exercise and steroids, a specialist may suggest additional treatment methods. Every patient is different — a method that works for one patient may not work for another. For that reason, it’s vital to exhaust various treatment options. Here are some of the ways a spine specialist might target your sciatica symptoms:

Hot and Cold Application

Heating pads and ice packs can relieve various types of pain. The application of heat improves blood flow — blood carries fundamental healing nutrients to the affected region. In that way, heat restores your body and lessens your pain. Cold treatment, on the other hand, decreases inflammation. It has the opposite effect as heat treatment — it reduces blood flow to a region and stunts nerve activity. Ask your spine specialist about when and how to apply hot or cold treatment.

Acupuncture

Many patients find sciatica pain relief through acupuncture treatment. Some studies have even found acupuncture to be more effective than conventional Western medicines, although some consider it a pseudoscience. Acupuncture has been a common healing practice in China for thousands of years. Practitioners insert hair-thin needles into specific points on the body, believed to improve energy flow. Your spine specialist may suggest acupuncture therapy for sciatica pain.

Tricyclic Antidepressants

Another possible treatment method is a prescription of tricyclic antidepressants. As mental health conditions and chronic pain often coincide, treatment for one often improves the other. Even if a mood disorder is not present, an antidepressant may impact neural processing in a way that decreases pain. With that said, effectiveness is not certain.

Anticonvulsants

Anticonvulsants can also help relieve sciatic nerve pain. Since anticonvulsants calm the nerves, some specialists believe they can reduce nerve-related pain. They work by stopping the transmission of overactive pain signals, which can quiet shooting pains throughout the body. However, some studies suggest anticonvulsants are ineffective for treating lower back pain.

Over-The-Counter Non-Steroid Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter non-steroid anti-inflammatory drugs (NSAIDs) are often part of a sciatica treatment approach. Such drugs can lessen pain and inflammation due to a wide variety of causes, both acute and chronic. Over-the-counter drugs are most effective against minor pain symptoms — more severe cases will call for stronger treatment methods. Your specialist might recommend such drugs as part of a long-term treatment plan. Always consult with your doctor before relying on over-the-counter drugs for relief.

Minimally Invasive Procedures

In some cases, minimally invasive surgical procedures may be necessary, such as Vertiflex® interspinous spacers, which a specialist implants between the vertebrae. The titanium spacers reduce the pressure on affected nerves. Compared to more invasive options, the procedure is quick and presents minimal risk. The interspinous spacers can:

Reduce lower back and leg pain.
Improve function and allow you to participate in more activities.

Schedule an Appointment With the Metropolitan Pain & Spine Institute

Sciatica is a common ailment that causes discomfort in the lower back and legs. If you’ve experienced sciatica pain, you know that finding effective methods for pain relief is vital. Several techniques have proven to ease symptoms, including simple exercises, steroids, other medications and hot and cold therapy. In some cases, minimally invasive procedures may be necessary for severe pain.

If you’re looking to ease sciatic nerve pain, connect with the experts at the Metropolitan Pain & Spine Institute. Our physicians are committed to providing an environment of honesty, education and effectiveness. We offer tailored treatment plans to provide our patients with pain relief, using the least invasive procedures so you can resume your daily life activities as soon as possible. To learn more about sciatica treatment options, schedule an appointment with the Metropolitan Pain & Spine Institute.

Steroids vs. Exercise for Sciatica Pain Relief