OrthopedistSciatica is often caused by a bone spur (an abnormal bone growth) or by a disk protrusion (a torn, bulging disk in the spine), two common conditions that can crowd the sciatic nerve. You can take an anti-inflammatory like Advil (up to four tablets three times a day) to minimize pain and a prescription muscle relaxant if you have trouble sleeping. And physical therapy can help ease the muscle spasms and stiffness that often aggravate sciatica. See a doctor if the pain is severe or if the symptoms don't clear up after three or four weeks. If my patients are in a lot of pain or have bowel or bladder problems, I usually send them for an MRI to rule out more serious conditions like cauda equina syndrome-a large disk protrusion that damages the nerves that supply the bowels and bladder.
-Brian Grossman, M.D., an orthopedic surgeon in private practice in Simi Valley, Calif.
ChiropractorTension in the muscles deep in the buttocks- which can result from sitting at a computer all day or even being pregnant-can lead to sciatica. Ten minutes of deep-tissue or trigger-point massage on the buttocks once or twice a week helps relieve tightness in those muscles and takes pressure off the sciatic nerve. You should also stretch the area every one to two hours to keep it relaxed: When you're in a chair, sit up tall and place your left ankle on your right knee. Slowly lean forward, moving your entire spine as a unit, and hold the stretch for 30 seconds. Switch legs and repeat. In addition, a chiropractic adjustment of the lumbar vertebrae and pelvis will help restore proper movement. It can take from one to ten treatments to ease the sciatica, depending on its severity.
-Elon Bartlett, D.C., founder of Bartlett Chiropractic, a family wellness center in Berkeley, Calif.
TCM PractitionerSciatica is usually linked to a deficiency of kidney yin or yang-this can weaken the back, which results in a degeneration of the bones and muscles and a stagnation of qi, or life force. Acupuncture across multiple points on the body can help restore balance to the kidney. Sciatica can also come from a "damp" condition, in which the body feels heavy and sluggish because it's having trouble metabolizing fluids. (Dampness, in fact, is a major cause of pain throughout the body.) In this case, I would prescribe an herbal formula like Du Huo Ji Sheng Wan to get the blood moving and strengthen the back. The exact dosing and herbs used are dependent on the individual, so you should make an appointment with your TCM practitioner to get the correct diagnosis and treatment.
-Bryn Clark, Dipl.O.M., a TCM practitioner in private practice at Heart of the Rose, an Oriental medicine clinic in Beverly, Mass.