Just read this, then ignore it. I’m only writing it here because i want it searchable for on the web.
Instructions for curing and coping with sciatica.
Q: Who should use this?
A: If you have pain in one leg that gets better with sitting and lying, and gets worse with standing and walking.
1. Sleeping
- Bend your knees before turning over in bed
- Turn over as little as possible, cope with discomfort by extending and bending legs rather than turning over
- Wear a back support waistband at night
- Put on enough clothes that you keep as warm as you can without sweating
- Avoid heavy blankets or anything heavy on top of you, use a warm quilt or eiderdown
2. Getting out of bed
a. On back, bend both knees equally
b. Position elbow and fist ready to push up
c. Swing knees slightly away from the edge of the bed …
d. And in a single motion push up with elbow and fist, pivot on bottom and bring feet to floor
e. Position feet carefully before standing up
f. Ensure that your weight is equally on both feet before taking the first step
3. Sitting
- Sit on something warm, such as padded fabric, timber, plastic, cardboard or laminex. Not steel, aluminium, brick or concrete; except in emergencies.
- You’ll find that the pain increases for half a minute after sitting down, stick with it and the pain will decrease
- After 5 minutes or so, start massaging the sore leg
- Keep a note of which seats are most pain-free and avoid others
4. Standing and walking
- Never stand or walk for more than two minutes (or 100 long breaths) at a time
- Sit between bouts for longer than you walk
- It is slightly better to walk with quick short even steps than longer limping ones, not because it speeds up the cure but because to reduces pain from causes other than sciatica, and because you’re less likely to fall over when a stab of pain occurs. But don’t let that stop you from limping quickly to a seat.
- A walker is no use for sciatica (it is for arthritis) other than as a seat, and for carrying small items.
- If carrying a lot (eg. a major family shop) carry a lightweight (padded aluminium) stool in the shopping trolley and don’t hesitate to use it every half-aisle
5. Lifting
- Don’t lift and carry more than (in my case) 6 kg at a time.
- The normal rules for lifting apply.
- Don’t lift and twist
6. Pain diary
Record your pain levels every hour or so. Record separately stabbing pain, chronic pain and discomfort. Record the time and what you are doing (eg. walk, standing up, bed, sleep, shower, massage) just before the entry. Record where the pain is, and whether the pain is unrelated to the sciatica (eg. arthritis, tendonitis, coccyx, upper back, other leg, headache). Record what you are doing to relieve the pain. Medicines to record include not just painkillers, but also anti-inflammatory and anti-depressant. Other treatment attempts can include hypnosis, relaxation, massage; or foodstuffs that may have an effect on pain such as alcohol, chocolate, coffee, feel-good foods. Change treatment regimen every week or so, eg. go cold turkey on the painkillers to see what happens, or ramp a specific painkiller up to the maximum allowable dose.
Put fewer entries in the pain diary if writing causes a pain in your hand.
7. Painkillers and other treatments
I found that everything started off well and then declined in effectiveness over a week, except for cold turkey which started off badly and then improved over the week. Hypnosis worked well, temporarily. A long hot bath worked well. Relaxation didn’t work. Massage was dangerously deceptive – it felt good while it was happening but was followed each time by severe stabbing pain shortly after stopping. I didn’t notice significant improvement with chocolate, coffee or feel-good foods. Try them, because you may have different responses. Alcohol tended to make things worse.
I can’t emphasise enough how important it is to wear more clothing, day and night, up to the point of maximum heat before sweating. Clothing is better than heat packs, heat rubs and hot cups of tea – because the effect lasts for longer. When lying on bed, staying under the quilt is better for the same reason. A back support waist band has two or three positive effects – it warms the area of damage, it provides a warning not to twist, and it may or may not actually provide good back support.
8. Pain scale – for use in pain diary
I use a scale of 0 to 10. Sometimes I need to sum pains from different parts of my body to get a total. Chronic pain varies in intensity over a time period of a minute or more. Discomfort is constant over time periods of say half an hour.
0 = no pain or discomfort detectable
0.3 = easily ignorable discomfort
0.5 = mild discomfort or easily ignorable chronic pain
1 = annoying discomfort, mild chronic pain, or ignorable stabbing pain
2 = (you get the idea)
3 = worst discomfort, enough to make sleep impossible, mild to mid-strength stabbing pain
4, 5 = bad stabbing pain, grab onto the nearest support
6 = worst stabbing pain, worst because it’s long duration. Enough to make me fall to the ground while walking or standing
7, 8 = higher intensity than 6, but briefer, short enough that I can recover before falling.
10 = causes unconsciousness
Summary.
Rest is what’s needed most, not exercise. Avoid pain.
PS. Trust your pain diary, not your doctor, not your friends.