A man doing a yoga pose.Estimated reading time: 4 minutes

Ranjeet’s story

Ranjeet* is a 62-year-old father of Devender, a first-generation Indian immigrant living in San Jose. He has retired from a government job in India, and he and his wife want to spend some quality time with his son and his family in the US. 

For the past two weeks, after his long air travel from India, he has been suffering from a moderate, tingling pain in his lower right back radiating from the left leg all the way to his foot. The pain is aggravated by coughing, sneezing, bending, or lifting his legs upward when lying on his back. Worried, Ranjeet approached us for advice.

Q: What could this pain be due to?

Dr. Sharma: Ranjeet, from what you are describing, and the pain being one-sided, it seems to resemble a condition called sciatica. Sciatica is nerve pain from an irritation or injury to one’s sciatic nerve, which is the longest and largest nerve in the body. This nerve originates from the lower back and runs down each side of the legs. When this nerve is compressed or pinched, it can cause pain. In addition to pain, it can involve tingling or numbness in one’s back or buttocks that may also radiate down the leg, just like what you are describing.  

It is a common condition, and some studies have shown its prevalence in the general population to be as high as 40%. However, it is recommended that you seek a proper diagnosis from a primary care physician.

Q: What causes sciatica?

Dr. Sharma: Since you mentioned that you took a long trip and may have also lifted heavy bags, that could be a possible cause.  Besides, there could be other causes such as herniated disks, degenerative disk disease, spinal stenosis, and osteoarthritis. Other risk factors for sciatica include injury, the effect of aging, excessive body weight, having poor strength in the muscles of the abdomen and back (reduced core strength), occupations that require lifting weights, having a poor posture, smoking, diabetes, and physical inactivity or a sedentary lifestyle.

Q: What tests could the doctor do?

Dr. Sharma: Your doctor will start with a detailed health history, then they will do a physical examination, which will include observing your gait while walking, conducting a straight leg test in which they will ask you to lie down and raise your leg straight out. They will also check for your strength and flexibility in the lower limbs and core muscles.  

In some cases, X-rays of the spine, CT scan, MRI, nerve conduction tests, and electromyography may be ordered. They may also order routine blood work to rule out any other conditions.

Q: What are the treatments for sciatica?

Dr. Sharma: Ranjeet, most cases (80-90%) of sciatica get better with self-treatment that includes putting icepacks in the initial days, followed by heat therapy.  In your case, since it has been two weeks, applying a heating pad for 20 minutes a few times a day will be helpful. You can take over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the pain and swelling. 

Stretching muscles is beneficial. Stretches, typically recommended under the guidance of a physical therapist, such as the knee-to-chest, figure-four (piriformis), pelvic tilt, and others, are helpful. However, if the condition worsens, for example, if there is muscle weakness or numbness, then it becomes mandatory to consult a healthcare provider. They may be able to prescribe muscle relaxants, physical therapy, spinal injections, and sometimes surgery.

Q: Can sciatica be prevented?

Dr. Sharma: Yes, some practices can help prevent sciatica.  These include maintaining good posture, quitting tobacco, maintaining a healthy body weight, staying physically active, and avoiding lifting weights or injuries to one’s spine from falling. Remember: do not exert if pain is present.

Q: Can yoga and meditation help?

Dr. Sharma: Yes, yogic asanas are quite helpful for stretching muscles (such as the hips, hamstrings, and glutes) and strengthening the core and back, which can provide relief from sciatica. Meanwhile, meditation helps in coping with pain. Poses like Shashankasana (Child’s Pose), Bhujangasana (Cobra Pose), Setu Bandhasana (Bridge Pose), and others are beneficial. However, these should be done under proper guidance, and knowing one’s own body’s capabilities.

Q: Can you suggest some additional resources?

Dr. Sharma: Here are some additional resources for more information on sciatica:   

If you have questions, reach out to Dr. Manoj Sharma at editor@indiacurrents.com. 

*Names changed upon request.

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