by Dr. Michael Baranov, PT, May 14, 2015
One of the most common conditions we treat is lower back pain. When it radiates down into the buttock and thigh, and even the leg, it’s typically called sciatica. Does this sound like you? If you are looking for physical therapy in Ditmas Park because you have back pain or sciatica, we can help.
Sciatica Pain Relief
If you’re having trouble with pain or a pinched nerve in your lower back, you may find yourself wanting to do nothing but lounge around and wait for the pain to subside. That’s the last thing you should do. Consider this classic research study in 2000 (and the follow up to it in 2005) called a systematic review. It’s one of the best scientific studies possible. They asked the question, “Is bed rest a good idea for back pain or sciatica patients?” These were the results and their conclusion:
Nine trials with a total of 1435 patients were included. Five trials met all four validity criteria and were assessed to have low risk of bias, while four trials were assessed to have moderate to high risk of bias. Four trials compared bed rest with advice to stay active, and overall the results were heterogeneous. Overall results from two high quality studies indicate no difference in pain intensity at three weeks follow-up [Standardized Mean Difference 0.0 (95%CI: -0.3, 0.2)], and a small difference in functional status in favour of staying active [Weighted Mean Difference 3.2 (on a 0-100 scale) (95%CI 0.6, 5.8)]. Two high quality trials reported no differences in pain intensity between two to three days of bed rest and seven days of bed rest. Another two high-quality trials found no differences between bed rest and exercises in pain intensity or functional status.
Bed rest compared to advice to stay active will at best have small effects, and at worst might have small harmful effects on acute low back pain. Differences in effects of advice to stay in bed compared with advice to stay active are small for patients with low back pain with or without sciatica. There is not an important difference in the effects of bed rest compared with exercises in the treatment of acute low back pain, or seven days compared with two to three days of bed rest in patients with low back pain of different duration with and without radiating pain. As reported in the Cochrane Database System, 2000
Five years later, the study was repeated. You can guess what the conclusion was:
For people with acute low back pain, advice to rest in bed is less effective than advice to stay active. For patients with sciatica, there is little or no difference between advice to rest in bed and advice to stay active. As reported in the Cochrane Database System, 2005
We’ve Helped Many Patients that Needed Physical Therapy in Ditmas Park
Fact is, when we see patients with sciatica pain, the most common question we get is, “Will I ever be normal again?” We are happy to report that we’ve helped many. Not everyone has complete relief with physical therapy, but as we have reported repeatedly in previous blog posts, conservative care is what you should try first.
If your pain is severe or returns persistently, your doctor may recommend physical therapy that is intended alleviate the pressure on the roots of the sciatic nerve, strengthen the surrounding muscles and stretch out the area to provide pain relief.
Having problems with pain in a pinched nerve? Contact us today to see how our treatment regime can help improve the strength in the surrounding muscles and decrease the pressure in the pinched nerve, relieving pain and making it possible for you to resume your normal, active life.