Heel pain secondary to sciatica is a result of pressure on the L5-S1 nerve root, which provides segmental innervation to the posterior thigh, and the gluteal, anterior, posterior and lateral leg muscles, as well as sensation to the heel. https://www.nhs.uk/conditions/sciatica/
Bottom of foot pain may occur if the sciatic nerve’s S1 spinal nerve root is affected. Typical symptoms of pain in the bottom of the foot may include weakness in the gastonemius muscle, making it hard to walk on the tiptoes, raise the heel off the ground, or even complete everyday activities like walking or driving. https://www.nhs.uk/conditions/sciatica/
It could be related to sciatica or it could be piriformis syndrome. Sciatica nerve roots come out of the spinal column low in the back and then pass behind the hip joint. Piriformis syndrome: The piriformis muscle typically runs on top of the sciatic nerve in the buttocks and can compress the sciatic nerve if the muscle becomes too tight. The symptoms may get worse after sitting for a long time, walking upstairs, walking, or running. https://www.nhs.uk/conditions/sciatica/
That’s because the sciatic nerve is the longest in the human body running from your lower spine through the buttock and down the back of the leg. The tightness tends to move along the sciatic nerve and at times the pain can be felt all the way to the toes. https://www.nhs.uk/conditions/sciatica/
- Get some extra support. Utilising lumbar support will be key in helping those suffering from sciatica pain.
- Don’t hunch forward when driving.
- Check your driving positions.
- Be careful how you get in and out of the car.
- Drive for short periods.
- Take frequent breaks and get out of the car during break time.
- Do your stretches.
- Choose the right car.
- Utilise heat pads. https://www.nhs.uk/conditions/sciatica/
Below are some of the possible causes of sciatica pain at night:
Attention and Distraction
You may simply be more aware of your pain at night when there is less to distract you from it. This doesn’t mean the pain isn’t real — it is — only that you may be noticing it more at night than you do when you have other things to occupy your mind.
When you lay down, the weight of your body may put pressure on your nerves in ways that it doesn’t when you’re upright. This is particularly common with sciatica and other chronic pain caused by pinched or compressed nerves.
Cooler temperatures help many people sleep better. However, cold can also make sciatica pain worse.
Medication Timing and Dosage
The medications that control your pain well during the day may be wearing off too soon at night. You may then need a different dose at night.
HOW TO SLEEP BETTER WITH SCIATICA PAIN?
Try Sleeping in Different Positions
If your sciatica pain is caused by pinched or compressed nerves, adjusting your sleep position may relieve some of the pressure. For example, people with sciatica who prefer to sleep on their side often find it helpful to sleep with their affected leg on top. People with hip or knee pain may find relief by sleeping with a pillow between their legs.
Adjust the Temperature
Experiment with different room temperatures when you sleep. It may take some time to find the best temperature for you: cool enough to help you sleep, not cold enough to make your pain worse.
Get Appropriate Exercise During the Day
Exercise during the day can help reduce some kinds of chronic pain, and it may help you rest better too.
Practice Good Sleep Habits
While the day’s stimulations may distract you from your pain, they won’t help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath.
Prepare Your Mind for Rest
The stress of chronic pain can make it even harder to rest. Try meditation or deep breathing exercises to lower your stress and help reduce your perception of pain. https://www.nhs.uk/conditions/sciatica/
The first thing your doctor probably will do during the first visit is asking questions about your back pain. Your doctor will ask questions like:
- Do you have numbness or weakness in your legs?
- Do certain positions help your discomfort?
- Has the pain kept you from doing any activities?
- Have any home remedies eased your pain at all?
Your doctor may also want to know about your lifestyle and may ask these questions:
- Do you do a lot of physical work, like heavy lifting?
- Do you sit on a chair or hard surface for long periods?
- How often do you exercise?
Your doctor may want to give you a physical exam to try to figure out which nerve is causing your problem. They may have you do some exercises to see if the exercise make your pain worse, such as rising from a squat, walking on your toes and heels, and raising one leg while lying on your back.
If your pain is ongoing (chronic) or severe, your doctor might also get some imaging tests done. X-rays, CT scans, and MRIs can look for herniated disks or bone spurs that clearly would be causes of sciatica.
If your doctor diagnoses you with sciatica, it is important to remember that in most cases sciatica clears up in a few weeks without surgery. If over-the-counter drugs haven’t made a dent in your pain, your doctor probably will prescribe anti-inflammatories or muscle relaxants. You might also need to do physical therapy or get steroid injections to help relieve your discomfort. Acupuncture and treatment by a chiropractor are alternative treatments that also may be helpful. The conversation about surgery will start only after you’ve first tried non-surgical treatments. https://www.nhs.uk/conditions/sciatica/
The first visit to your doctor when you have sciatica pain may be very stressful because you don’t know if indeed what you are experiencing is sciatica pain or you have a sprain or you accidentally pulled a muscle. Below are some of the questions to ask your doctor in this first visit:
- Is my activity level or lack of it attributed to this pain?
- Is this pain permanent?
- What is sciatica and how to differentiate it from a sprain or pulled muscle?
- How to diagnose sciatica and how to diagnose a sprain on the back?
- Will I need surgery?
- If I have sciatica, will it clear up after a few weeks with medication?
- Will physical therapy or acupuncture help my pain? When do I start physical therapy or acupuncture?
- Will I be able to do things I could do before the pain started?
- Is this condition hereditary? https://www.nhs.uk/conditions/sciatica/
Sciatica is often worse for people in the morning because of the way they sleep. Lying down in an incorrect position can further irritate nerve roots. This is because of the way the spine rests when you are lying on your back. In this position, the sciatic nerve exit spaces in the spinal column, called the foramina, become more compressed. This limits the space nerve roots have to travel through and can worsen the underlying cause of the sciatic pain.
WHAT TO DO TO LESSEN SCIATICA PAIN IN THE MORNING?
If you’re experiencing sciatic nerve pain in the morning, try and do the following:
- Fix your posture: Try to elevate your legs while lying down. This position helps alleviate the pressure of your spine’s natural curve, which may be able to reduce your pain. Place a pillow beneath your knees, or between the knees if you’re sleeping on your side. Additionally, if you sleep on your side, avoid laying on the side affected by sciatica.
- Stretch: When you wake up, incorporate some simple stretches to your morning routine. Yoga poses like child’s pose, as well as soft stretches of the lower back like pulling one knee to your chest while laying on your back, may help elongate the spine and alleviate some pressure placed on the sciatic nerve overnight. https://www.nhs.uk/conditions/sciatica/
(1) Worsening neurological symptoms
Severe damage to your sciatic nerve roots can cause progressive neurological symptoms and requires immediate treatment.
The symptoms may affect one or both legs and typically include the following:
- Abnormal sensations, such as crawling
- An abnormally increased sensitivity to pain (hyperalgesia)
It is also possible for the symptoms to occur only below the knee without involving the entire limb. While these symptoms may not warrant surgery, some form of immediate medical treatment is usually needed.
(2) Changes in bowel and/or bladder control
Consult your doctor immediately if you have any sudden, unexplained changes in your bowel and/or bladder control. These changes may include:
- An inability to control your bowel and/or bladder movements.
- Difficulty in passing urine, a reduced urinary sensation, a loss of desire to pass urine, or a poor stream.
These 2 symptoms above indicate a rare, but serious medical condition called cauda equina syndrome. Cauda equina syndrome can occur suddenly or gradually and typically requires immediate surgery to control the symptoms. If patients with cauda equina syndrome do not receive prompt treatment, it can result in difficulty in walking and/or other neurological problems, including lower-body paralysis. Doctors advise treating this condition within 24 to 48 hours of symptom occurrence to preserve lower limb function. https://www.nhs.uk/conditions/sciatica/