Sciatica is the clinical word used to describe a set of symptoms caused by the compression of the sciatic nerve, which begins in the lower back and runs down the leg. The pain and/or numbness may be felt in either the hip or buttocks and also in leg and foot on the side affected.
Because sciatica is the symptom and not the disease, the treatment for sciatica will differ depending on the cause of the irritation or damage to the sciatic nerve.
Some causes of sciatica are: a herniated disc in the lower back, spinal stenosis (narrowing of the spinal canal), and, less commonly, piriformis (tensing or damage to muscle near the nerve).
Sciatica is not normally treated with herbal remedies, with the exception of arnica when the sciatica was caused by muscle damage.
Many of those who suffer from sciatica find relief from following other holistic practices, such as a careful regimen of cooling and heating the affected area, gentle stretching for the lower back, and appropriate yoga poses. Acupuncture is also becoming more frequently used as a treatment for sciatica and lower back pain in general.
Although not well documented in the scientific literature, there are few medicinal herbs that have the potential to alleviate nerve pain and can therefore be used as herbal remedies for sciatica. These herbal medicines may belong to one or more class of medicines or modes of action.
These modes of action are:
- non-narcotic pain relief through anit-inflammatory activity;
- narcotic analgesics, acting on the central nervous system; and
- muscle relaxants—in the case of piriformis-induced sciatica.
Commonly available herbal remedies for sciatica
Turmeric (Curcuma longa)
Turmeric is well known as a spice that flavors Indian curries and other Asian dishes. It has also been used for centuries as a medicine in the ayurvedic tradition and in Chinese medicine. The anti-inflammatory agent in turmeric is diferuloylmethane, more commonly known as curcumin.
As with many herbal medicines, there is a lack of clinical evidence (testing the active ingredients on human subjects in controlled conditions) but some promising laboratory work.
There are a number of studies confirming that curcumin is effective in treating the symptoms of pain and swelling in many chronic inflammatory diseases such as allergies and rheumatoid arthritis. (See the review by Aggarwal and Harikuma. The mode of action is the interruption of inflammatory signals at the cellular level; therefore, it is possible that curcumin may have a similar beneficial effect in treating nerve pain in general and sciatica in particular.
More research on the exact causes of sciatica at the cellular level would be needed in order to know if an herbal medicine with anti-inflammatory action, such as the curcumin found in turmeric, is effective in treating not only the symptoms but the root cause of sciatica.
Directions for taking turmeric vary. Dr. Linda White suggests either cooking frequently with the spice or taking capsules, in 250 or 500 mg, several times a day. She cautions that turmeric, because of its heat, may be unpleasant to those with gastrointestinal problems or women going through menopause. As well, anyone with gallbladder disease should avoid using turmeric.
Garlic, arnica, and St. John’s wort are three common herbal supplements that are often cited as effective against conditions of nerve pain such as sciatica; however there has been very little scientific study of the analgesic properties of any of these.
Arnica (Arnica montana)
Various species of arnica or ‘mountain daisy’ have been in use in folk medicine since the middle ages in Europe.
Today, arnica is recommended by many homeopaths for treating bruises and torn and swollen muscles that occur in sports injuries and lower back pain in general.
If arnica is indeed effective in treating muscle tears then it could heal sciatica that is brought on by damage or stress to the muscles nearest the sciatic nerve.
According to research cited by Dr. Steven Karch, the anti-inflammatory mechanism of arnica is quite different from typical anti-inflammatory medicines.
The active chemical in arnica is helanalin, which combines with and interferes with the inflammation signaling molecule NFKB. This means that if the arnica is applied soon enough after the injury, the inflammation never begins.
However, Dr. Karch also cautions that arnica has several side effects: possible allergic reactions on the skin and adverse affects on the liver and heart.
Arnica is almost never taken internally. It is applied topically as a compress, and there are a number of commercial preparations in cream or gel form. It should never be applied to wounds.
Garlic (Allium sativum)
Garlic, usually thought of as an aid for heart health, is sometimes recommended as an herbal remedy for sciatica.
There is very little evidence of its effectiveness in this regard and no discussion of the exact modes of action. Herbalists recommend that garlic be eaten raw either in solid form or as garlic milk—two minced cloves in half a cup of milk, taken twice daily.
St. John’s Wort (Hypericum perforatum)
Some commercial herbalists recommend St. John’s wort for the treatment of muscle pain and it may, therefore, have some effect on sciatica caused by muscle damage. The anti-inflammatory agent is thought to be hyperforin.
It should be remembered that St John’s wort is normally used as an anti-depressant and caution should be exercised when attempting to use it as a pain reliever. St. John’s wort, although very popular and widely available, can have interactions with other drugs. A medical doctor should be consulted before it is used.
There are a number of topical herbal treatments mentioned for sciatica—all with undocumented scientific evidence—and these include poultices made of horseradish and rubbing wintergreen oil or night jasmine on the affected area.
All of the aforementioned herbal remedies for sciatica are non-narcotic. The pain relieving effect, if any, is brought about by anti-inflammatory action.
Other medicinal plants that may treat sciatica
Below are descriptions of two plants in another class of medicines: narcotics. The mode of action of narcotics is the interference with pain receptors in the central nervous system. Jamaican dogwood and kratom are both powerful analgesics that can be harmful if misused or if the dosage is not certain. Anyone taking these medicines should only do so under the supervision of a medical doctor.
Jamaican Dogwood (Piscidia piscipula and P. erythrina)
This tree is native to tropical, coastal areas of the New World. It is also known as Florida fishpoison or “fishfuddle” because native people have used an extract, containing the toxin roteone, to sedate fish in the water, making it possible to catch them by hand.
It has also been traditionally used to treat nerve pain, as in tooth-aches and the more severe cases of sciatica. The plant contains a number of other alkaloids that in large enough doses can be toxic to humans. The sedating and anti-spasmodic properties of Jamaican dogwood are thought to be due to one or more cannabanoids.
When used in traditional practice, Jamaican dogwood is normally taken in capsule or tincture form. The extracts of this plant are powerful analgesics and sedatives and it possible to over-medicate, especially since the concentration of the active ingredients will vary.
Those who are sensitive to neuro-active drugs, especially children and pregnant or nursing women, should avoid it. Sweating, tremors and numbness are symptoms of over-medication.
Jamaican dogwood should not be taken by anyone already using drugs for insomnia or anxiety and it should not be taken before surgery as it may complicate the anaesthesia.
Kratom (Mitragyna speciosa)
Kratom is a tree in the coffee family and grows in the tropical regions of southeast Asia. It has been used in those regions as a remedy for anxiety and insomnia and to treat chronic pain.
It is therefore a candidate for treating sciatica. Like many other plants in the coffee family, kratom contains numerous alkaloids. The primary alkaloid in kratom has been given the name mitragynine and it was first synthesized in the laboratory in 1995.
In those countries where kratom grows in the wild, the raw leaves are chewed or a tea is prepared. Recently, kratom extract has also been made available in capsule form.
Kratom has been effective in treating opiate withdrawal symptoms; however it may itself be addictive or at least habit forming.
In interviews with 562 kratom users in Malaysia, 460 (82%) reported that they were not able to stop their use of kratom. Whether kratom is truly addictive (any more than caffeine) has been greatly debated.
The criminalization of kratom in many countries, including Thailand, has hampered research on its medical properties. The U.S. Drug Enforcement Agency has listed kratom has a “drug and chemical of concern”.
Kratom is just one of a great many traditionally used narcotic analgesics that have caught the interest of both researchers and commercial drug developers. Almeida and colleagues carried out a survey of the scientific literature and cataloged 210 narcotic analgesic plants from all over the world.
The motivation behind this kind of research is the need to find powerful pain killers that are non-addictive or less harmful than the standard opiates such as morphine.
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