The increasing pain your friend is experiencing could be due to a combination of factors related to his daily activities and posture. Here are some potential causes and possible solutions:

Causes of Increasing Pain:

1. Prolonged Sitting: Sitting for extended periods can exacerbate sciatica pain, especially if not done with proper posture and support.
2. Lack of Movement: Walking less and lying down on the floor for extended periods can contribute to stiffness and aggravate sciatica symptoms.
3. Poor Sleeping Surface: Lying on a hard floor may not provide adequate support for the back, potentially worsening the pain.

Possible Solutions:

1. Ergonomic Adjustments: Encourage your friend to use a chair with proper lumbar support and to take regular breaks from sitting to walk and stretch.
2. Physical Therapy: Continuation of regular physiotherapy sessions help to improve flexibility, strength, and posture, thereby reducing sciatica symptoms.
3. Activity Modification: Suggest incorporating gentle exercise and movement into his daily routine, such as walking or swimming, to promote flexibility and reduce stiffness.
4. Supportive Sleeping Surface: Advise your friend to consider using a supportive mattress or sleeping surface that provides adequate back support.

Do's and Don'ts for Sciatica: Do's:

• Engage in low-impact exercises like walking, yoga, or swimming to strengthen the back and core muscles.
• Practice good posture while sitting and standing, and use proper body mechanics when lifting or carrying objects.
• Apply heat or cold packs to the affected area to help alleviate pain and inflammation.

Don'ts:

• Avoid prolonged sitting or standing in one position.
• Refrain from lifting heavy objects or twisting the back in ways that may exacerbate the.
• Avoid high-impact activities or exercises that may strain the lower back and worsen the symptoms.

It's important for your friend to communicate with his physiotherapist about the increasing pain and any changes in his symptoms so that adjustments can be made to his treatment. Additionally, consider consulting a healthcare professional for personalized medical advice and further evaluation of the increasing pain.

While sciatica pain can be managed and alleviated through various treatments and lifestyle modifications, it's important note that permanent cure for sciatica depends on the underlying cause. Some potential strategies to alleviate pain and potential long-term solutions may include:

1. Medications: Over-the-counter pain relievers such as ibuprofen or naproxen may help reduce inflammation and alleviate sciatica pain. In some cases, prescription medications or muscle relaxants may be recommended by a healthcare professional.

2. Epidural Steroid Injections: For severe or persistent pain, a healthcare provider may recommend epidural steroid injections to directly target the inflamed nerve and reduce pain and inflammation.

3. Physical Therapy: Engaging in specific exercises and stretches under the guidance of a physical therapist can help improve flexibility, strengthen the back and core muscles, and alleviate sciatica symptoms over time.

4. Chiropractic Care: Some individuals find relief through chiropractic adjustments and manipulations, which can help realign the spine and reduce pressure on the affected nerve.

5. Surgery: In cases of severe or persistent sciatica pain due to conditions such as a herniated disc or spinal stenosis, surgery may be considered as a last resort after other conservative treatments have been exhausted.

6. Lifestyle Modifications: Maintaining a healthy weight, practicing good posture, and engaging in regular low-impact exercise can help manage and prevent sciatica pain.

7. Alternative Therapies: Some individuals find relief from acupuncture, massage therapy, or yoga, which can provide relaxation and improve overall flexibility and strength.

While these strategies can help alleviate pain and improve quality of life for individuals with sciatica, it's essential to consult with a healthcare professional to determine the most appropriate course of treatment based on the specific underlying cause and individual health needs. A permanent cure for sciatica may not be achievable for all individuals, but effective management and symptom relief are possible with the right combination of treatments and lifestyle adjustments.

For the management and treatment of sciatica, it's advisable to consult with the following healthcare professionals:

1. Primary Care Physician: Your primary care doctor can provide an initial evaluation, diagnosis, and may recommend conservative treatments such as medications, physical therapy, or lifestyle modifications. They can also refer you to specialists if necessary.

2. Orthopedic Surgeon: If the sciatica is due to a specific orthopedic issue such as a herniated disc or spinal stenosis, an orthopedic surgeon can provide further evaluation and discuss surgical options if conservative treatments have not been effective.

3. Neurologist: A neurologist specializes in diagnosing and treating conditions related to the nervous system, including sciatica. They can provide a comprehensive assessment and offer treatment recommendations such as medications or specialized procedures.

4. Physical Therapist: Working with a physical therapist can be beneficial for tailored exercise programs, stretches, and techniques to improve mobility, posture, and reduce pain associated with sciatica.

5. Chiropractor: Some individuals find relief from sciatica through chiropractic care, which involves spinal adjustments and manipulations to alleviate nerve impingement and related symptoms.

6. Pain Management Specialist: A pain management specialist can offer various interventional treatments such as epidural steroid injections, nerve blocks, or other procedures aimed at reducing pain related to sciatica.

It's important to seek medical advice and treatment from qualified healthcare professionals who can provide personalized recommendations based on the specific underlying cause of sciatica and your individual health needs. Always consult with your primary care physician before pursuing any specific treatments or consulting specialists.

Determining the main cause of sciatic pain typically involves a comprehensive evaluation by a healthcare professional. Here are some common methods used to diagnose the underlying cause of sciatica:

1. Medical History and Physical Examination: A healthcare provider will conduct a thorough evaluation, including discussing your symptoms, medical history, and performing a physical examination to assess reflexes, muscle strength, and sensation in the affected areas.

2. Imaging Studies: Diagnostic imaging tests such as X-rays, MRI (Magnetic Resonance Imaging), or CT (Computed Tomography) scans can help identify structural issues such as herniated discs, spinal stenosis, or other abnormalities in the spine that may be compressing the sciatic nerve.

3. Electromyography (EMG) and Nerve Conduction Studies: These tests can help evaluate the electrical activity in muscles and the conduction of impulses along the nerves, providing information about nerve function and potential nerve compression.

4. Differential Diagnosis: It's important to rule out other potential causes of similar symptoms such as piriformis syndrome, sacroiliac joint dysfunction, or other musculoskeletal issues that may mimic sciatica.

After a comprehensive evaluation, the healthcare provider can determine the specific cause of the sciatic pain and develop a personalized treatment plan based on the underlying diagnosis. It's essential to communicate openly with your healthcare provider about your symptoms and any functional limitations you may be experiencing to facilitate an accurate diagnosis and effective treatment.