Why Sciatica Recovery Can Be a Slow Road: Understanding the Healing Process
Sciatica is a condition that osteopaths see frequently. It consists of pain, numbness, and/or tingling that radiates along the path of the sciatic nerve, which runs from the lower back through the buttocks and down the back of each leg. In some cases, the unlucky person will also experience a weakening of their leg or foot muscles.
Sciatica is typically caused by compression or irritation of the nerve roots in the lower back, but can also be caused by compression of the nerve anywhere along its path. Perhaps the most common cause of sciatica is a bulge in one of the intervertebral discs in the lower back which ends up pressing on the nerve roots as they exit the spine. It’s this compression of the nerve that damages its structure and causes the infamous sciatica symptoms.
A bulging intervertebral disc - a classic cause of sciatica.
In these situations, patients effectively end up with two separate injuries, the original injury (e.g. disc bulge or joint irritation) and the secondary injury to the sciatic nerve or its roots.
Here are a few points that can help explain what is going on and why the healing process for sciatica can sometimes be slow.
Both nerves and intervertebral discs have notoriously slow healing rates. Damaged spinal joints and muscles tend to heal much more quickly.
In the case of discs, they have a poor blood supply and are therefore relatively deprived of the nutrients and oxygen required for quick healing. In general, mild disc injuries can take a few weeks to a few months to heal, while more severe injuries may take several months or longer.
In the case of damaged nerves, their recovery can sometimes be very slow and often they take longer to repair than the initial disc bulge. First, before any new nervous tissue can be generated, the old damaged nervous tissue must be cleared away by a process called ‘Wallerian Degeneration’. This process is quite complicated and can by itself take several weeks. After this removal of the damaged tissue, new nerves (axons) will then grow, travelling from the spinal cord to the site of the damage. Nerves (axons) usually grow very slowly, typically at a rate of only 1-2 millimetres per day.
Sciatica symptoms often tend to get better nearer to the spine first. For instance, someone with sciatica who initially has a pain in their low back, hamstring and calf will often experience relief in the low back and hamstring first and be left with the pain in their lower leg for longer. Although nerve regeneration may not always occur in this pattern, this ‘central first’ recovery is believed to be connected to the way that new axons must re-grow from the spinal cord outwards.
The sciatic nerve contains a mixture of different fibres with different functions. Some control muscle movements (motor fibres) and some are responsible for pain and sensation (sensory fibres). The sensory fibres tend to be located near the outer part of the sciatic nerve and are therefore more susceptible to being squished. This means that sensory sciatica symptoms like pain, numbness and pins and needles are quite common. The motor fibres are more centrally located within the sciatic nerve and also have a thicker cushioning layer around them, making them less likely to be damaged. This means that if someone has symptoms associated with motor fibre damage (weakness in their leg or foot muscles) they are likely to have a more serious compression of their sciatic nerve. This might mean a longer recovery time.
What can you do to heal more quickly from sciatica?
Healing of any tissue requires an adequate blood supply to clear away damaged structures, reduce inflammation and deliver the right nutrional building blocks for repair. Firstly, osteopathic treatment can help restore blood flow and healing to an area by reducing pain, improving joint movement and reducing muscle tightness. If you’re sat in a chair not moving with tight back muscles and a bad mood, you are not going to heal very well.
As for reducing inflammation and providing the right building blocks your body needs, please take a look at my previous blogs where I have covered some of the supplements that have evidence for helping with nerve repair, and some natural anti-inflammatories like turmeric and willow bark.
In addition to these supplements, there are certain foods that can provide the raw materials required for nerve function and repair;
Omega-3 fatty acids: Found in fatty fish such as salmon and sardines, as well as flaxseeds, chia seeds, and walnuts. Omega-3s have anti-inflammatory properties that can support nerve health.
B vitamins: Particularly vitamins B1 (thiamine), B6, and B12, which are important for nerve function and repair. Good food sources include whole grains, beans, nuts, seeds, and animal products such as meat, fish, and dairy.
Antioxidants: Found in colourful fruits and vegetables such as berries, oranges, spinach, and broccoli. Antioxidants help protect nerve cells from damage caused by free radicals.
Protein: Needed for the production of new nerve cells and myelin. Good sources include meat, fish, poultry, beans, lentils, and tofu.
Phosphatidylcholine: Found in foods such as eggs and sunflower seeds, phosphatidylcholine is a component of cell membranes and is important for nerve health and myelin production.
So there you have it, recovery from sciatica can sometimes be a slow and somewhat unpredictable experience, but I think it helps patients to have some understanding of the processes going on in their bodies. Whilst you can’t necessarily avoid these processes, you can try to optimise your recovery time by receiving osteopathic treatment and taking in the right supplements and food to give your body the required building blocks and environment to heal.
Finally, it’s also worth noting that sometimes sciatica can be caused by more serious conditions, so you should always consult a healthcare professional to rule out these rare but serious possibilities. Come and see me with your sciatica problem at Osteostudio.
If you are looking for an East Grinstead Osteopath please get in touch with:
Cliff Russell, Registered Osteopath
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Osteostudio East Grinstead.
