Sciatica refers to pain or discomfort associated with the sciatic nerve, which runs from your lower back, through your buttocks, down the back of your legs down to your feet.
Most people will experience back pain at some point in their lives, but anyone who has experienced the particularly agonising pain of sciatica will know just how disruptive it can be to your everyday life.
What is sciatica?
The sciatic nerve runs from the lower back down and buttocks down into the back of the legs to the feet. It is the longest nerve in the body. Sciatica occurs when there’s pressure on, or damage to, the sciatic nerve, causing a sharp pain or discomfort.
Sciatica is the umbrella term used for non-specific radiating pain anywhere down the back of the leg.
Sciatica can be caused by a number of different factors creating the pain, and therefore there are a lot of factors to consider.
The most common cause of sciatica is a disc prolapse – also known as disc herniation or slipped disc, but the following causes can all result in sciatica:
Lumbar degenerative disc disease
Lumbar spinal stenosis
Because there could be a number of causes, it’s important to stress that anyone experiencing sciatica should seek the help of a medical professional to get a full assessment.
Regular exercises to help prevent or ease sciatica are very important if you are prone to it.
Try to do these three exercises daily:
• Back extensions
Lie on your front, keep your elbows bent at your sides and rest on your forearms. Keep your head down and your neck straight. Push down on your hands and arch your back up, keeping your hips on the floor and remembering not to bend your neck back. You should feel a gentle stretch in your abdominal muscles but no pain. Hold for several seconds then return to the starting position. Repeat 10 times.
• Lying deep gluteal stretches
Lie on your back with a small cushion under your head. Bend your right leg and rest your left leg on your right thigh. Take hold of your right thigh and pull it towards you, keeping your back on the floor and your hips straight. You should feel a gentle stretch in your left buttock. Hold for about 30 seconds then change legs. Repeat 3 times for each leg.
• Standing hamstring stretches
Stand upright with a straight back and put one leg on a step. Keep that leg straight then lean forward gently while keeping your back straight too. Only stretch as far as is comfortable and do not arch your lower back. Hold for 20-30 seconds, breathing slowly and deeply, then return. Repeat 3 times with each leg.
Most people with sciatica find relief after at-home remedies or self-care including:
Hot and cold packs
Using a combination of hot and cold packs can go a long way to help relieve the pain. A cold pack can reduce inflammation, which is associated with sciatic nerve pain, while heat helps to increase the blood flow to this area.
Alternating both cold and heat can give positive results in reducing pain and inflammation. Dr Henderson recommends the following:
• Start with a cold pack
Initially, you might get relief from a cold pack placed on the painful area for up to 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel and do not apply for more than a few minutes.
• Alternate with a hot pack
After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.
Stretching exercises for your lower back can help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch, and try to hold the stretch for at least 30 seconds. ‘You can do knee to chest stretch to help reduce the irritation of the sciatic nerve and improve flexibility of your lower back,’ advises Dr Henderson.
Try the following stretches:
• Lie on your back on a mat with your feet straight and hip-width apart.
• Keep your upper body relaxed and bend your right knee upwards with an inhale.
• Clasp your hands behind the thigh and gently pull it towards your chest as far as is comfortable.
• Keep the other leg flat on the surface.
• Hold this position for 20 seconds with controlled deep breaths and then lower your leg gently.
• Switch legs and repeat. Repeat 3 to 5 times.
• Finally do this exercise with both the legs 3 to 5 times. You can also do exercises like spinal rolling, knees rocking, floor twists, and back extensions.
A simple piriformis stretch will often help ease any tension on the sciatic nerve and ease the sciatic pain. If you know the sciatica is not a result of a serious back injury, such as a disk prolapse, try a technique called neural flossing.
‘Nerves don't stretch, and they're not a big fan of tension either. Nerves need to be able to slide and move freely without becoming snagged,’ says Farmer.
‘This snagging of the sciatic nerve creates tension in the nerve, and this can often lead to sciatic pain. Neural flossing is a method by which you can mobilise the nerve and ease any tension placed on it. With neural flossing it's important the nerve isn't put under further tension. Instead, it is flossed.'
A massage will not only relax the muscles in your back, it can help loosen areas affected by the sciatic nerve, while also improving blood flow. Yoga teacher Michele Pernetta recommends using natural oils to treat nerve pain.
‘Try sesame oil or buy Mahanarayana oil from a health food store, heat it and massage it in all over your body, especially the affected area and the soles of your feet,’ says Pernetta. ‘Alternatively book an Ayurvedic massage from a trained practitioner.’
A study reported that people with chronic back pain who practised Iyengar yoga for 16 weeks experienced pain reduction by 64 per cent and disability reduction by 77 per cent. The impact on sciatic pain is less clear, but Pernetta says that the heat in hot yoga can be beneficial.
‘Oil the body before and after, but do the modifications to not overstretch the hamstrings,’ advises Pernetta. ‘Stop stretching your legs as this can aggravate sciatica. Stretch your lower back with your knees bent.’
If you’re in pain, resist the urge to push through. Try to take it easy and give yourself a chance to heal. But don’t simply lie in bed, because this has been shown to exacerbate the condition. It’s important to keep mobile, while being mindful of not overdoing it. ‘Do activities you are able to tolerate, and do not expect to feel better overnight,’ says Dr Henderson.
If your sciatica does not improve in a few weeks, or if any exercises make your pain worse, then seek advice from your doctor.
Last updated: 02-10-20
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