The alternative road to sciatica relief

From newindianexpress.com

While modern medicine has plenty to offer for those burdened with sciatica, here is how acupuncture, physiotherapy and yoga can help address this debilitating pain

CHENNAI: A condition of lower back pain that radiates down to the legs, sciatica is most commonly found in people between 25 to 45 years of age. The estimated prevalence of sciatica has been found to be widely varying in medical literature, ranging from 1.2 per cent to 43 per cent in different studies. The condition derives its name from the sciatic nerve that branches down from the lower back through the hips to the legs. It is usually caused by a herniated disc that results in compression of a nerve, causing inflammation and pain in the areas affected by that particular nerve.

While the intensity of pain and distress is different from patient to patient, sciatica is a debilitating condition that negatively impacts the quality of life and productivity. In modern medicine, sciatica treatment involves the administration of anti-inflammatory drugs, muscle relaxants, and corticosteroid injections. However, prolonged use of these drugs is associated with adverse side effects on patients.

When the condition is severe enough to cause bowel or bladder changes or significant leg weakness, surgical intervention to remove a part of the herniated disc is considered. On the other hand, alternative therapies such as acupuncture in conjugation with physiotherapy have been found to be highly useful in reducing sciatica pain without any negative repercussions or major surgical intervention.

Acupuncture for sciatica
Acupuncture is a widely-used alternative therapy derived from traditional Chinese medicine. Acupuncture therapy is based on the belief that a vital force or energy circulates between the organs of the human body via certain channels or pathways. The disease is a result of a disorder occurring in the normal functioning of these pathways that obstructs the flow of vital energy. Acupuncture practice uses very fine needles on concerned points to remove the channel obstruction and stimulate the flow of energy and blood circulation.

Acupuncture points also stimulate sensory receptors which in turn induce the hypothalamus to release neurotransmitters and endorphins two essential elements in the body’s natural pain relief and healing mechanism. This theory postulates that there are over 2,000 such points that connect with 20 pathways in the human body. People struggling with chronic pain who fail to find effective medical solution in modern medicine often turn to acupuncture and find long-term relief.

Acupuncture is particularly useful for relief of chronic pain such as sciatica or arthritis pain. A comprehensive study published in the journal Evidence-Based Complementary and Alternative Medicine in 2015 analysed 12 previously conducted studies to gauge the impact of acupuncture on sciatica patients. The study concluded that acupuncture was more effective than conventional western medication in reducing pain intensity and increasing pain threshold in patients with sciatica. In fact, being a drugless and minimally-invasive procedure, acupuncture is one of the safest and most effective treatments for sciatica.

Physiotherapy
Physiotherapy is another critical element in the rehabilitation of sciatica patients. Physical therapy for sciatica patients may involve physiotherapists, chiropractors as well as spine rehabilitation experts working in tandem to offer pain relief and healing to the patient. This may be done in conjugation with conventional medicine as well as with acupuncture therapy.

A physical therapist will examine the patient in-depth and then prescribe a combination of therapies including manual therapy, soft tissue mobilisation and multiple back strengthening or stretching exercises. This will also include exercises to correct spine posture and adaptive mechanisms to prevent injuries and restore mobility. Physiotherapy provides symptom relief to sciatica patients and promotes healing of the underlying cause of the condition while preventing the recurrence of pain.

Yoga poses for relief
When performed consistently, yoga poses help align and strengthen the lower back while also helping to loosen the hip muscles. Spinal twist poses can also help address the pain arising out of nerve compression. Here are a few yoga poses to help relieve sciatica pain:

Gomukhasana
The cow face pose is one of the best poses for lengthening and stretching the spine and back muscles. To perform this asana, you have to sit on the floor in a staff pose. Then, draw your legs towards each other so that your knees are stacked on each other. Then, stretch out your arms behind your back, one stretching from down the shoulder and the other reaching out from down the other side. Now, try to touch and hold the fingers of both hands together.

Gomukhasana (Cow Face
Pose) by B Shalini, PhD
scholar, MAHER

Ardha Halasana
This asana helps stretch the hamstring and relieve sciatica pain. It involves lying down on your back
and gradually raising one leg up by keeping the knee straight. Maintain the final position for some time and keep taking deep breaths before slowly bringing the leg down. And then, repeat the pose with the other leg.

Ardha Matsyendrasana
This sitting half spinal twist pose gives the piriformis a  mild stretch, also helps stretch the spine and back muscles while relieving stress on the hip muscles. To practise this pose, you have to sit on the floor, raise a leg knee up and twist your body one by one to each side. Twist your back as much as you comfortably can.

https://www.newindianexpress.com/cities/chennai/2021/mar/31/the-alternative-road-to-sciatica-relief-2283643.html

What’s the Best Sleeping Position With Sciatica?

From healthline.com

Your sciatic nerve is the largest nerve in your body. It starts at your spinal cord, runs through your hips and buttocks, and continues down the back of each of your legs.

Sciatica is an impingement of your sciatica nerve. It’s most commonly caused by a herniated disc in your lower back. The hallmark symptom of sciatica is shooting pain along the nerve. Pain can vary from mild to excruciating and typically affects one side.

Getting a good night’s sleep with sciatica can be difficult. Lying in certain positions can put pressure on your irritated nerve and cause a flare-up of symptoms. However, some positions are less likely to cause pain.

Learn how to best sleep with sciatica.

Best positions for sleeping with sciatica

Sciatica and other sources of low back pain can have a devastating effect on your sleep quality. Studies have found up to 55 percent of people with chronic lower back pain deal with sleep disturbances.

Finding the best position to relieve sciatica may be a matter of trial and error. But as a general rule, it’s a good idea to stick to positions that maintain the natural alignment of your spine.

On your side

You may find that sleeping on your side helps reduce pain by taking pressure off your irritated nerve.

How to set up:

1. Lie on your mattress with your injured side on top.
2. If there’s a gap between your waist and mattress, you may want to put a small pillow here to reduce side bending.

Place a pillow between your knees

Placing a pillow between your knees helps keep your pelvis and spine in a neutral position. It also prevents your legs from rotating during the night.

How to set up:

1. First, put your shoulder on your mattress and then settle the rest of your body against your mattress.
2. Bend knees slightly and put a thin pillow between them.
3. You can also put a small pillow under your waist if there’s a gap.

Foetal position

The foetal position opens up space between your vertebrae and may reduce back pain caused by a herniated disc. However, some people also find it aggravates their pain.

If you experience discomfort in the foetal position, try one of the other positions on this list.

How to set up:

1. Lie on your side and bring your knees to your chest so your body makes a “C.”
2. You can also add a pillow between your knees or under your waist.

On your back with a pillow under your knees

Lying on your back helps distribute your weight evenly across your back. Putting a thick pillow under your knees may help maintain the curvature of your spine by relaxing your hip flexors.

How to set up:

1. Lie on your back with a pillow under your head for support.
2. Put one or two pillows under your knees and rest your heels comfortably against your mattress.

With a towel or pillow under your lower back

Putting a towel or thin pillow under your lower back can help keep your spine in a neutral position by reducing the gap between your back and mattress.

How to set up:

1. Lie face-up with a comfortable pillow behind your head.
2. Slide a thin pillow or towel under your lower back so that you can comfortably keep your pelvis in a neutral position.
3. You can also combine this technique with a pillow under your knees if you find it more comfortable.

Sleep on the floor

Soft surfaces can cause your spine to bend out of proper alignment. You may find sleeping on the floor helps you better keep your spine in proper alignment.

How to set up:

1. Put a thin mat such as a yoga mat or camping mat on the floor where you intend to sleep.
2. Lie down in any of the positions above or any other position you find comfortable.

Best sleeping position for sciatica in pregnancy

Doctors often recommend sleeping on your side during pregnancy.

Sleeping on your left side is often referred to as the ideal position because it’s thought to allow for optimal blood flow through your inferior vena cava. However, a 2019 review of studies found that sleeping on your left or right side is equally safe for you and your baby.

If you’re dealing with sciatica, you may find sleeping on your uninjured side helps reduce your symptoms. Putting a pillow between your waist and the mattress or putting a pillow between your knees may also help reduce pressure on your injured nerve.

Avoid these sciatica pain sleeping positions

It’s generally recommended that you avoid sleeping on your stomach if you’re dealing with sciatica or other forms of lower back pain.

When you sleep on your stomach, your spine tends to curve toward the mattress. This curvature can put stress on your muscles or joints, especially if you sleep on a soft mattress.

No matter what position you sleep in, it’s a good idea to avoid twisting your spine or hips since this may put pressure on your sciatic nerve.

https://www.healthline.com/health/how-to-sleep-with-sciatica#sciatica-sleeping-positions

Your Sciatic Nerve Will Thank You if You Do These 2 Things

From princetonsjc.com

The term sciatica is often used to refer to leg pain originating from the spinal nerves in the lower back.

Here are 2 uniquely important remedies that almost everyone can benefit from—they help relieve sciatica in the short term and prevent future recurrences.

1. Avoid prolonged rest and start a structured, progressive exercise routine.

While it seems counterintuitive to recommend staying active rather than rest, your pain will increase with prolonged inactivity and decrease with motion. 

Useful tips to help you stay active during the day are:

• Use the stairs instead of an elevator.
• Park in a distant parking space to get a few extra walking steps.
• If you have a desk job, get up every 30 minutes to an hour and walk a short distance.
• Consider switching to a standing desk with adjustable height.
• Perform simple stretches that you can do while sitting on your office chair, such as stretching your hamstrings.
• Go for regular, short walks in the morning and/or evening, even if it is for a few minutes every day.

It is a good idea to work with a physical therapist and/or make exercise a part of your daily routine. A regular routine of structured exercise can help support and hold up your spine and lessen your sciatica symptoms by strengthening your abdominal, core, lumbar (lower back), and pelvic muscles. Your spinal discs are also nourished when you exercise, allowing the flow of nutrients and encouraging healing.

Staying active has an overall beneficial effect

When you stay active and exercise on a regular basis, it can help reduce weight or keep your weight in check (preventing sciatica), produce endorphins (natural pain fighting hormones), and reduce anxiety and depression that is usually a part of chronic pain.

2. Be meticulous about supporting your spine throughout the day.

Your sitting, standing, lifting, walking, and sleeping postures can go a long way in helping your sciatic nerve heal or worsening your symptoms. For example, when you habitually slouch while sitting at your desk, the excessive stress along the front of your spine may cause your discs to bulge or herniate, irritating your sciatic nerve roots. Likewise, a sudden lifting injury can herniate your disc, impinging or irritating a sciatic nerve root.

Important postural adjustments that you can make to prevent damage to your sciatic nerve roots are:

• Sitting. While sitting, keep your back flush against your chair with your head over the spine, your shoulders rolled back, and the shoulder blades down. Place a small pillow or rolled-up towel to support your lower back and maintain the lumbar curve. You can also purchase a lumbar support pillow that you can use while driving, at work, and/or while you travel.
• Lifting .While lifting a heavy object off the floor, squat down in front of the object by keeping a straight back and bending your knees. Hold the object close to your chest while you straighten your knees to stand up.
•  Sleeping. While sleeping, place a pillow under your knees if you’re a back sleeper or tuck a pillow between your thighs if you’re a side sleeper. Also, avoid beds that are too soft or have sunken over time. You may want to consider rotating or flipping your mattress periodically. Certain types of pillow-top mattresses can be too plush and cause back pain over time. 
• Walking. While walking, keep your spine straight, relax your shoulders, make sure to land on your heel and then gently roll forward to push off the front of your foot. With each step, reach the opposite arm forward to achieve a gentle spinal rotation.

If you commit to using correct and supportive posture continually, it will help keep your sciatic nerve from getting compressed or irritated, preventing sciatica.

The health of your sciatic nerve also improves when you quit smoking, stop using tobacco products, get a good amount of restorative sleep, and eat a healthy diet containing anti-inflammatory foods. It is also advisable to avoid highly processed foods and foods containing high amounts of simple sugars.

Use these tips and techniques on a regular basis to see the improvements in your sciatica pain. If your sciatica pain does not improve or continues to worsen, consult your doctor to get an accurate diagnosis and treatment plan of your underlying lower back condition. If you develop worsening numbness, tingling, and/or weakness in your legs, see your doctor immediately—since these symptoms may indicate a more serious underlying condition, such as cauda equina syndrome.

https://princetonsjc.com/sciatic-nerve-will-thank-2-things/

5 Things You Need to Know About Sciatica

From abingtonhealth.org

Back pain can be a real nuisance. It can potentially interrupt your ability to sleep, work, exercise, and affect other normal activities. However, that pain can be particularly worrisome and have a real impact on your life when it radiates down into your backside and leg, which is known as sciatica.

Sciatica is relatively common – about four out of 10 people will experience it at some point in their lives. Here’s what you need to know about that pain, including where it’s coming from and what you can do to ease it.

1. Sciatica is different than your typical back pain

“Back pain and sciatica pain are two completely different things,” said Dr. Guy Lee, an orthopaedic surgeon with the Rothman Institute.

Low back pain is usually due to strain or injury to the muscles and ligaments supporting the back, with the pain focused in the muscles next to the spine, potentially moving to the buttocks.

“People can suffer back pain on and off for a variety of reasons, but once it radiates down your backside and leg, that’s sciatic pain,” he said. The sciatic nerve is made up of the lower nerve roots in the lumbar spine. When those nerves are irritated, the pain travels down the sciatic nerve, typically through the buttocks and down the back of the leg.

2. Sciatica is a symptom

“Sciatica is a fairly generic term – it implies inflammation with the sciatic nerve,” Dr. Lee said. “It's usually associated with a herniated disc.”

The discs are rubbery cushions between the vertebrae that build up your spine. “These discs are like a jelly donut,” Dr. Lee says, “and if the jelly leaks out, it can touch or compress the lumbar nerve, which leads to sciatica.”

“If the disc tears, the ‘jelly’ can leak out and if it’s on the right or the left side, it can compress the nerve,” he explained.

3. Certain positions and movements can worsen the pain

When the sciatic nerve becomes irritated or inflamed due to a herniated disc, the pain is generally worse when seated.

“When you sit, you’re putting pressure on the disc and the disc can push out a little more,” Dr. Lee said, noting that if he walks into an exam room to see a patient with a back issue and they’re standing, that patient is likely suffering from a herniated disc and sciatica pain – and they’re more comfortable standing.

Heavy lifting can make the pain worse and coughing can cause more of the “jelly” to leak out, potentially causing or worsening the pain.

4. There are some things you can do to ease the pain

If you have sciatica pain, you should be taking anti-inflammatories.

“If a herniated disc leaks out, anti-inflammatories can help alleviate the symptoms,” Dr. Lee said. “Sometimes a doctor will prescribe steroid medication – that can lower the inflammatory response, helping with the pain.”

Rest can also help, but relative rest is best.

“You can rest for a day or two, but you want to be up and stretching your leg,” Dr. Lee recommended. “We try to do nerve gliding exercises to keep the nerve moving so it doesn’t get stuck.”

When it comes to using heat or cold to ease the pain, Dr. Lee said there’s no science behind either one helping.

“Some people think applying heat can help. You can try heat or ice, whatever makes it feel better,” he said. Just be careful if you do try either one.

“With heat or ice, you can burn yourself if you leave it on too long,” Dr. Lee cautioned.

5. Severe pain should signal you to call your doctor

It’s very common to have a herniated disc, which leads to sciatica pain, but, according to Dr. Lee, a lot of the time, the herniation will go away on its own and get better with conservative care.

However, there are some signs that you may need more treatment. Those signs include weakness, especially in the leg, numbness beyond pain and bilateral symptoms.

“If the herniated disc is big enough, there can be more permanency if you don’t get it treated,” Dr. Lee said. In some cases, the herniated disc can get so large, he said, that it can cause a massive hernia, knocking out your bowel and bladder function.

“That’s a surgical emergency…once you start to have bowel and bladder issues, you can be left with permanent disability,” he said.

https://www.abingtonhealth.org/healthy-living/health-news/library/articles-related-to-bone-and-joints/5-things-about-sciatica/

What’s Up Doc? Do I need an MRI for low back pain?

From eu.metrowestdailynews.com

By Jeff Hersh, Ph.D., M.D.

Q:  I tweaked my back and have been having back pain for the last week.  Do I need an MRI?

A:  Risk factors for low back pain (LBP, including sciatica as discussed below) include smoking, obesity, older age, both strenuous and certain sedentary (for example office work with lots of sitting) types of work, others.  Trauma, whether minor like “twisting my back” or more severe trauma such as a car accident, fall or another traumatic event, is the most common inciting factor.  Risk factors for a more serious underlying condition (as discussed below) causing someone’s LBP include immunocompromised state, being on hemodialysis, having a history of intravenous drug abuse, having certain active infections (such as endocarditis), and others.

Almost 90 percent of Americans will have at least one episode of LBP in their lives, with 50 percent having a second episode within six months and three quarters having a second episode within a year.  Many others will have another episode at some later time in their lives.

The most common etiology of LBP is non-specific muscular-skeletal pain; that is there is no specific identifiable underlying condition or disease.  Less than 1 percent of cases of LBP are due to systemic issues such as cancer, infection, cauda equina syndrome (where part of the cauda equina- the “horse tail” bundle of nerves/nerve roots leaving the spine- is compressed), or other systemic causes.

Only about a third of LBP patients seek medical care, although this is still enough to make low back pain one of the top two reasons people see their healthcare provider.  The other two-thirds of LBP patients "ride it out," typically with a similar resolution of their symptoms as discussed below.

A thorough history and physical exam to help identify the small percentage of people with a risk for more concerning causes of their LBP, such as a history of malignancy, fever or other risk for an infectious cause, focal neurological symptoms, point tenderness or others, is indicated.  The very small subset of the patients felt to be at a higher risk of some of these conditions may require an MRI (or some other test, such as a blood test, other imaging tests, etc.), but the overwhelming majority of patients do not require any further testing; so the overwhelming majority of LBP patients do not require an MRI.

A subset of patients with LBP develop sciatica, where there is pressure on the sciatic nerve.  Sciatica patients’ symptoms include pain, weakness, numbness, and/or other symptoms that radiate down their leg.  There are disks (soft, cushioning tissue that acts as a kind of shock absorber) between the spinal vertebrae that enable the spine to be able to bend and twist.  The most common cause of sciatica is pressure on the sciatic nerve from a herniated, slipped or bulging disk.  However, it should be noted that serial MRI’s show that most people with disk herniation actually have their herniation improve/worsen on and off over time, and about a third of people without back pain or sciatica have some disk herniation; so disk herniation clearly comes and goes in many people and in and of itself is not a necessary or sufficient finding for LBP or sciatica. 

Episodes of LBP and/or sciatica overwhelmingly resolve over days to weeks to months; three-quarters of patients have their symptoms resolve over days to weeks, and almost 90 percent have resolution within a couple of months.

Since the overwhelming majority of cases of LBP resolve over days to months, the initial treatment aims to help with the acute symptoms.  Treatment options include massage therapy, application of heat, acupuncture, spinal manipulation (for example from a chiropractic or other health care provider trained in this procedure), and/or topical medications or non-steroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen; in some uncommon cases other medications such as muscle relaxants may be utilized.  Certain other treatments, for example injections, cold application, traction, yoga, and others, have limited data supporting their effectiveness but may sometimes be recommended in select cases.  Surgery may be considered in some selected patients with refractory and severe symptoms, but is usually only considered for certain specific indications and only after aggressive attempts with other treatments have not helped.

After improvement from an acute episode of LBP, physical therapy (PT) and an appropriate exercise regimen can help, specifically to decrease the likelihood of recurrent episodes.  The appropriate PT/exercise for each individual should be evaluated by an appropriate healthcare provider. 

https://eu.metrowestdailynews.com/story/news/healthcare/2021/03/15/do-need-mri-low-back-pain-caused-when-tweaked-my-back/4702047001/

How to Get Better Sleep With Sciatica Pain

From health.clevelandclinic.org

Sciatica pain can keep you up — here’s how to get relief

Sleeping and sciatica don’t mix. Who can possibly get a good night’s rest if their back or legs are throbbing or tingling? (No one.)

But there’s hope: Yes, you can get to the bottom of that sciatica pain and stop feeling like a zombie. Physical therapist Cara Sieberth, PT, tells us what you can do to get relief from sciatica and finally get some shut-eye.

What is sciatica?

Sciatica refers to nerve pain that happens when your sciatic nerve is compressed, irritated or injured. The sciatic nerve starts in your pelvis, runs through your buttocks and down your leg to the knee. At the knee, it connects to other nerves that run down the calf and through the foot.

Sciatica isn’t the same as lower back pain. Lower back pain is limited to pain in an area of your back. But if you have sciatica, you might notice:

• Sharp, burning or shooting pain that travels from the lower back to the foot.
• Muscle weakness in one or both legs or feet.
• Numbness in one or both legs.
• A pins-and-needles sensation in the leg, foot or toes.

The location of sciatica pain can vary depending on which area of the nerve is affected. “You could feel pain or tingling down the front, back or side of your leg,” Sieberth says. “The pain can be constant, or it might bother you when you sit or lie in certain positions.”

First step: Find out why you have sciatica pain

Getting relief from sciatica takes some detective work. First, try to find out the cause. Then you can take steps to address it. This might require a visit to your doctor and some sessions with a physical therapist.

Causes of sciatica include:

• Bulging or slipped disk.
• Compressed or irritated nerve.
• Tight muscles in the back or hips.
• Vertebrae (bones of your spine) that are out of alignment.
• Spinal stenosis (narrowing of the spine).
• Injury to the sciatic nerve from a fall or accident.
• Tumour or growth near the sciatic nerve (in rare cases).

“The cause of your sciatica affects what positions or activities bother you,” Sieberth says. “This will also determine which sleeping positions work for you. For instance, someone with a bulging disc may find back sleeping comfortable, while someone with stenosis might prefer side sleeping.”

Experimenting with sleeping positions

There’s no perfect sleeping position, mattress or pillow that always works for sciatica pain. But that doesn’t mean you have to suffer night after night. With the help of a physical therapist, you can figure out which sleeping position will work best for you.

Start with good spinal alignment

As a starting point, see if sleeping with a straight back is comfortable for you. “Many people find that getting their spine in a neutral position is helpful,” says Sieberth.

“When you lie down, ensure that your head, shoulders and hips are in a straight line,” she adds. “Put a small pillow under your neck and head but not your shoulders. Sometimes it’s necessary to put a pillow under your knees to prevent your back from arching too much. Once you get in this position, think about what hurts or what feels good. Then you can tweak your sleeping position from there.”

Try side sleeping

Some people find that side sleeping is comfortable. It can take some of the pressure off your sciatic nerve, especially if you sleep on the side opposite of where it hurts.

“Putting a pillow between your knees can make side sleeping more comfortable,” Sieberth says. “It aligns your hips and takes pressure off the pelvis. Another option is to place a pillow behind your back for support. This also keeps you from rolling onto your back.”

Curve it forward

If spinal stenosis is causing your sciatica, bending forward slightly may give you some relief. A bent-forward position helps open the narrowed spaces in the spine.

You can mimic this at night and get some quality sleep by:

• Using a large wedge-shaped pillow under your head and upper back.
• Sleeping in a reclining chair or adjustable bed with the head elevated.
• Sleeping in the foetal position (on your side with knees curled up).

If arching your back feels good, try stomach sleeping

Stomach sleeping isn’t for everyone. It forces you to turn your head to one side and arch your back. However, it works for a few people. If you get relief from arching your back, you might find stomach sleeping to be helpful.

“If stomach sleeping isn’t causing back or neck pain, you can usually keep doing it,” Sieberth says. “For a few people, arching their back actually provides relief from sciatica. Stick with this sleeping position if it feels good to you.”

Do I need a new mattress or pillow for sciatica?

Because there are so many variations in sciatica pain, there’s no mattress that works for everyone. Some people find relief from an extra firm mattress or even sleeping on the floor. Others can’t get a wink unless they have a soft, cushy pillow-top mattress.

“You don’t have to get a new mattress right away if you have sciatica,” Sieberth says. “Instead, use the mattress you have to find a comfortable position. Use your pillows or even a mattress topper to make some small changes first. Once you figure out what gives you some relief, then you can decide whether a firmer or softer mattress might work for you.”

Don’t tolerate sciatica pain

Whatever is causing your sciatica, don’t assume you have to live with it. If it’s interfering with your quality of sleep (and life), talk with your healthcare provider about solutions, including a referral for physical therapy.

“Even just a few sessions with a physical therapist can be helpful for many people,” Sieberth says. “Your therapist can help you figure out which sleeping positions and activities are best for you. Sciatica is such an individual condition, so there’s no one-size-fits-all solution.”

With the right medical treatment, you can get relief from sciatica pain — and head off to dreamland again. 

https://health.clevelandclinic.org/how-to-get-better-sleep-with-sciatica-pain/

Exercise for Sciatica: Moves to Try and Which to Avoid

From verywellhealth.com

Sciatica is a term used to describe a collection of symptoms such as pain and an "electric" sensation felt in the lower back and hips, often radiating down one leg.

Sciatic nerve pain can have several causes, including herniated discs, a tight piriformis muscle, spinal stenosis, or a misaligned sacroiliac joint. You may have more than one of these conditions at the same time.

Unless you have "red flag" symptoms (such as losing control of your bladder, bowels, or a lower extremity) you may be able to use certain exercises to help manage your sciatic pain.

While staying active might help reduce your discomfort, there are some activities that can worsen sciatic pain. Here's what you need to know about exercising with sciatica, including which moves might help and which ones might irritate your sciatic nerve.

Exercises to Avoid

Any exercise that makes your sciatica worse or causes new pain won't provide any benefit and may cause further injury by aggravating nerves and muscles.

Here are three stretches that are best avoided if you have sciatic nerve pain.

Bent-Over Row

The bent-over row is a full-body integration exercise that targets the arms and back. While the stretch can be beneficial when done properly, it's easy to do the exercise with poor form (i.e., rounding your back when you pick up a weight bar or weights).

Performing any exercise with improper form puts you at risk for strain or injury, but moves like the bent-over row specifically increase your risk for disc herniation—a condition that could cause or worsen symptoms of sciatica.

Double Leg Lift

Exercises that require you to lift both legs at the same time engage your core and can be great for strengthening your abdominal muscles and back, but they can also aggravate sciatic pain.

It's also important to be aware of moves that can be easily over-stretched. Placing too much strain on muscles that aren't yet strong enough to properly support the movement or hyper-stretching them can exacerbate sciatic pain or cause injury.

You may injure your lower back by performing a double leg lift when you are really only strong enough for a single leg lift.

Before trying leg lifts, consider whether you're in proper shape. If your abs are weak, the weight of your legs gets taken on by your lower back. This strain can put you at risk for disc herniation, which in turn can lead to sciatic pain.

Can you lift your legs without moving your pelvis or trunk? If you can't, your abs probably aren't yet strong enough to carry the weight of your legs. Increasing your core strength will help prepare you for these exercises and may even help improve lower back pain.

Leg Circles

Exercises that involve swinging your leg in a full circle require you to stretch your hamstring suddenly, which may irritate the sciatic nerve. For example, you may want to avoid some Pilates moves, yoga poses, and circuit training workouts that engage your leg muscles this way.

You may also want to take a break from playing high impact sports such as football, which can put you at risk for further injury.

Exercises for Sciatica

You're most likely to feel sciatic pain in your lower back and hips, and sometimes down one of your legs. While sciatica usually gets better on its own with time, there are certain types of exercise that might help relieve your symptoms as you heal.

A 2012 study from the University of Southern Denmark found symptom-guided exercises improved outcomes for people with sciatica. Several patients in the study who qualified for surgery to treat sciatica found they were able to manage their pain using the symptom-guided exercises.

Here are three exercises that may help manage sciatic nerve pain.

Sitting Spinal Stretch

An irritated sciatic nerve can cause pain and tightness in your hamstrings. Try exercises like the sitting spinal stretch to ease symptoms without putting you at risk for injury. Instructions:

1. Start by sitting in a chair with your feet slightly wider than shoulder-width apart and firmly on the ground.
2. Put your hands behind your head. Interweave your fingers so your elbows are out to the side of your head.
3. Tuck your chin down.
4. Keeping your elbows out, twist your torso left and bring your right elbow to the inside of the right knee. Do not move your head. Hold for 30 seconds.
5. Untwist your torso and return to the starting position.
6. Perform the same movement on the other side. Keep your elbows out and twist your torso to the right as you bring your left elbow to the inside of the left knee. As before, don't move your head and hold for 30 seconds.
7. Untwist your torso and return to the starting position.
8. Repeat five times on each side.

Standing Hamstring Stretch

Similar to the seated version, the standing hamstring stretch can also help reduce the tightness and discomfort of leg muscles aggravated by sciatic pain. Instructions:

1. Place your right foot on an elevated surface, such as a chair or ottoman, at or below hip-level.
2. Flex your foot so your toes and leg are straight (it's okay if you need to bend your knee a little).
3. Bend your body slightly toward your foot. The further you go, the deeper the stretch will be. Go slowly and don't push to the point of pain.
4. Release the hip of your raised leg, letting it move down rather than lifting it up. 
5. Hold the stretch for at least 30 seconds, then repeat on the other side. Aim to do five stretches on each side. 

Make this stretch easier by using a yoga strap or exercise band over your right thigh and under the left foot.

Don't overdo hamstring exercises, as repeated or intense stretching can irritate your sciatic nerve. Stick to five stretches on each side of your body.

Knee to Opposite Shoulder

The knee to opposite shoulder exercise is a simple stretch to relieve sciatic nerve pain. It helps by loosening gluteal and piriformis muscles, which are located deep in the buttocks. When these muscles become inflamed, they press against the sciatic nerve and cause pain and other symptoms. Instructions:

1. Lay on your back with your legs extended and feet flexed up.
2. Bend your right leg and clasp your hands around your knee.
3. Gently pull your right leg across your body toward your left shoulder. Hold for 30 seconds. Only pull as far as you comfortably can; you should feel the stretch but it shouldn't hurt.
4. Push your right knee back until your leg returns to the starting position.
5. Repeat three times on the starting side, then switch legs.

A Word From Verywell

There isn't a one-size-fits-all exercise routine for managing sciatic nerve pain. Try different exercises to see which ones help you to feel better and be sure to note (and avoid) any that make your pain worse or cause new pain.

If your sciatic nerve pain continues for more than a few months, even if mild, make an appointment to see your doctor. While research has not definitively shown that it will improve sciatica for every patient, you may find it helpful to work on an exercise program with help from a physical therapist.

https://www.verywellhealth.com/exercises-that-could-worsen-sciatica-297246

Use Salts to Soothe Your Sciatica Pain

From vivaglammagazine.com

Sciatica is a life-changing condition; however, there are some ways that can help you manage the pain. For example, Epsom salt is a popular home remedy that can ease your discomfort. So, how can you use Epsom salt for sciatica pain? This post will answer this question and provide other information about this beneficial product.

What is Epsom Salt?

Epsom salt may look like regular salt; however, its chemical composition is different. To be specific, this product contains magnesium and sulfur. These two minerals have therapeutic effects on your body, such as reducing inflammation and removing toxins.

Epsom Salt for Sciatica Pain

Today, a lot of people use salt baths to ease their pain. In fact, some athletes use Epsom salt to relieve their muscle aches. Unfortunately, there are no clinical trials that can confirm this therapeutic benefit, but there are some anecdotal accounts that can support this effect. So, how does Epsom salt ease sciatica pain?

As mentioned, Epsom salt has anti-inflammatory effects. As you know, a common cause of sciatica is inflammation. For this reason, anti-inflammatory foods are among the best products that can help ease your discomforts. You can also take Epsom salt baths to relieve your pain.

Aside from that, this product can also help relax tensed muscles. Remember, sciatica pain can be due to the irritation of the sciatic nerve, which can be caused by tight or tensed muscles. By taking an Epsom salt bath, your tight muscles can relax. At the same time, your pain will be reduced.

How to Use Epsom Salt for Sciatica Pain?

Using Epsom salt to ease your discomforts is easy. First, you need to fill your bathtub with water, making sure that the water is not too hot. Afterwards, add the Epsom salt to the tub. Typically, you can use around one to two cups of salt. You can also check the product’s label for the suggested amount. Once the salt has dissolved, you can submerge your body in the warm water for about 12 minutes and enjoy your bath.

Keep in mind that can flush out toxins in your body. This effect is wonderful; however, it can leave you tired after the bath. As such, you can take a salt bath before bedtime. Additionally, this product is potent, so you have to limit your bath time to 12 minutes. Also, you have to make sure that you are hydrated while taking a salt bath.

https://vivaglammagazine.com/use-salts-to-soothe-your-sciatica-pain/

Five surprising ways you might be worsening your sciatica

From uspainfoundation.org

By Brent Wells, DC

Sciatica is a chronic condition that most commonly comes from narrowing of the spine, bone spurs, or a herniated disk. Although sciatica can be painful, it usually resolves on its own after a few weeks, although over time, it may return. From sitting too much to wearing heels, a variety of otherwise common activities are often the culprits of recurring sciatica pain. In this article, we will explore the symptoms, causes, most common ways you may be triggering your sciatica, and what you can do to finally find consistent relief.

Symptoms

Below are symptoms that are often associated with sciatica:

• Pain from your lower back/spine into your butt and down the leg
• Mild aching to sharp, burning pain in the affected area
• Pain is worse when you sneeze or cough
• Numbness
• Tingling
• Muscle weakness
• Pain, generally on one side of the body

Pain is most commonly felt in the lower back and butt, and for some people, down one or both legs. The severity of sciatica pain can very widely: it can simply feel like a dull ache or it can cause intense shooting pains that are almost unbearable.

Causes

Sciatica is a chronic condition that can have a variety of causes, most commonly bone spurs, herniated disks, and pinched nerves. In very rare cases the pain is linked to diabetes and tumours in the affected area.

People who are older, are obese, sit for long periods of time, have diabetes, or jobs that require heavy lifting and bending throughout the day are more likely to develop sciatica during their lifetime. It is estimated that around 40% of people will experience sciatica during their lifetime.

Surprising Ways You May Trigger Your Sciatica

High Heels and Uncomfortable Shoes

Fans of fancy footwear: if you have sciatica and just cannot seem to shake the pain, your high heels may be causing your discomfort. High heels change your distribution of weight, putting pressure on the front of your foot and causing you to push your hips forward.

When you walk or stand too long with your pelvis pushed forward like this, it puts stress on your hamstrings, stretching them. Since the sciatic nerve is located by the hamstrings, this constant stretching and pressure can do a lot of damage to your sciatic nerve.

Uncomfortable and un-cushioned shoes can also be hard on your feet and your hamstrings.  At minimum, try to wear shoes with support built in them, avoiding heels and non-supportive shoes like flip-flops. There are also shoe inserts you can purchase that are designed specifically for people with sciatica.

Carrying Items in Your Back Pockets

If you find yourself always carrying your phone, wallet, or other bulky and heavy items in your back pockets, you could be unknowingly triggering your sciatica. Although this is not an officially recognized cause of sciatica, many people who suffer from this condition have coined their own terms such as “back-pocket sciatica” and “cell phone sciatica.”

When you sit down with items in your back pocket, they can put unnecessary pressure on your piriformis muscle, which is located right by your sciatic nerve. Imagine you have a full wallet in one pocket:

Tight Pants

Do you often wear tight and form-fitting pants, skirts, or shorts? Believe it or not, this could lead to unwanted sciatica pain. Overly tight bottoms put a lot of pressure on your hips, butt, legs, and sometimes even your lower back and spine. This constant compression in these areas puts pressure on the sciatic nerve and surrounding areas, triggering pain and discomfort. You don’t have to change your entire wardrobe! Just make sure nothing is so tight that it’s digging into you or causing you pain.

Sitting Too Much

Sitting too much can also trigger or worsen sciatica pain. Sitting is another activity that puts a lot of pressure on your glute muscles, lower back, and your sciatic nerve. Moving around gives your sciatic nerve a break, a chance to stretch and allow blood to flow to the area. If you work a desk job, you can try a standing desk, take a short walk around the office every hour, or dedicate part of your lunch break to a stroll by yourself or with a co-worker. Even inside the office, you can spend a few minutes doing  leg and back stretches to get that blood flowing and to stretch out tight areas in your lower body.

Being Overweight and Inactive

If you are overweight and/or don’t get enough exercise, recurring sciatica pain is all too common. Extra weight, especially in the mid-section, puts pressure and strain on the pelvis and the lower back.

Lack of exercise and physical activity also make sciatica pain worse in the long run. If you do not move around and never give your body a chance to get stronger and more flexible, you are doing yourself a serious disservice.

Coming up with an exercise routine, losing a few pounds, and incorporating stretching into your weekly routine can ease up pain and trigger your sciatica less.

When it comes to managing your sciatica and doing things that will stop triggering your pain, it takes some trial and error to see what works for you. Trying out the above options are a great starting point when you have tried other remedies, and nothing has worked.

If you still find your sciatica is triggering too much and are unsure of the cause, a trip to a chiropractor specializing in sciatica, massage therapist, or other medical professionals may be the way to go.

https://uspainfoundation.org/blog/five-surprising-ways-you-might-be-worsening-your-sciatica/