sciatic-nerveSciatica or Sciatic nerve pain is a very common symptom for a variety of causes.  These can include but are not limited to herniated disks, lower back strain and usually an impingement to the sciatic nerve.  Sciatica can develop over time or be a sudden result of a quick and usually misaligned movement.   Sciatica  can be a short term or long term condition.  Sciatica can be very debilitating and exhausting because there is often a loss of mobility and a good deal of pain involved with having sciatica.

The Sciatic nerve runs from the lower back through the Gluteals down the legs and finally branches to the foot.  It exits the spinal column through  the Sciatic Foramen created by the sacrum and hip bones.  Any tight muscle or misalignment through these areas can cause sciatica.  The lower back and Gluteals are particularly sensitive to strain especially if there is weakness or instability in the hip or Sacral-Iliac joint (base of the spine).  The Periformis muscle can be responsible for “strangling” the nerve if it is very tight as it also lies in tandem with the sciatic nerve.

Sciatica can be a result of an already tired body pushing itself too hard as in my case.  Years ago I suffered for about three weeks with sciatica and I still cringe when I think of the pain and exhaustion associated with it.  I was teaching an introductory workshop on Cranial-Sacral therapy.  The class was on the floor as many body-work classes can be.  It was a soft, carpeted floor but the class involved a lot of twisting and turning on my part as I instructed and then observed students.   The next day I had a client who had a very old and heavy table.  As I lifted it from one room to the next I suddenly felt my back snap.  It really startled me but I continued with the session.  The next morning I couldn’t get out of bed.  It took 15 minutes to stand up.  I knew I was in trouble.  Fortunately through some great physical therapy and massage it healed and I was able to function after about three weeks of dealing with the pain of sciatica.  Now I try to schedule lighter days as my work can be very physical.  I do not lift as many tables anymore but if I have to try to be more mindful of engaging my abdominal muscles when lifting.

Common complaints during a bout with sciatica are that at times you need to sit then stand then sit again.  This can cause complete exhaustion by the end of the day.  Using a chair with a good deal of support is usually best.  A hard wooden chair that can keep one in good alignment as opposed to a soft, fluffy chair that does not keep one as aligned is a good idea.  Using pillows and bolsters while sleeping can be helpful.  This constant switching of positions throughout the day combined with the pain can lead to a very deep exhaustion as mentioned.  It is challenging while dealing with sciatica to rest because one is often not comfortable in any one position for very long.  It is of course important to rest but it is also often equally as important to mobilize the area.  I was instructed to take two fifteen minute walks a day by my physical therapist.  This was a challenge as I lived in a fifth floor walk up at the time and it was a lot to get up and down the never ending staircase, but in the end it really saved me.  My inclination would have been to want to rest as much as possible but it was the combination of rest and using the muscles that really helped me get back on my feet.  My Physical Therapist also used gentle manual techniques to help break the deep spasm that was a result of the initial injury.  For an explanation of how deep spasm can result  in more pain please see my article entitled, Pain–Spasm-Pain Cycle.

NSAIDS (non-steroidal anti-inflammatory drugs) are often prescribed by a doctor.  These can be very useful in that they help reduce inflammation.   They can be difficult if one has a stomach issue or other digestive issues.  Consult with your doctor before use.  As with many issues sciatica is best tackled when treated early and not ignored.  R.I.C.E. (rest, ice, compression, and elevation) is also often recommended in helping sciatica.    Heat is not generally recommended as sciatica is considered an inflammation and you never want to place heat on an already inflamed area.

Wearing good, supportive shoes is essential.  Especially if one suffers from or is prone to sciatica or lower back pain.  For more discussion on this please see my article entitled Why High Heels Cause Foot and Joint Pain

An interesting fact I learned in Massage School is that sciatica is most common in pregnant women and truck drivers!  In pregnancy, the hormone Relaxin helps the ligaments relax to accommodate the ever enlarging uterus and eventually to mobilize the entire hip and pelvic region to eventually widen to help in the birthing process.   The loosening of the ligaments creates an instability in the region and  the extra weight that the woman is now carrying can a contributing factor in throwing the woman out of alignment and causing an impingement in the sciatic nerve.  Fortunately, not all woman are doomed to suffer sciatica through pregnancy.  It is very important to strengthen your lower back, abdominal region and pelvic floor muscles to help with the extra pressure.  This strengthening will also be beneficial for labor and delivery.  Tight Gluteals and a tight Piriformis muscle can also be a factor in sciatica during pregnancy.  These muscles can contract in order to help support the weight at the front of the body.  There are many great stretches and strengthening exercises which can be found through a qualified physical therapist, personal trainer or Pilate/yoga instructor.  Just like finding the right Doctor, make sure there is a trust in the qualified professional before beginning an exercise program.

Truck drivers are often diagnosed with sciatica because they drive for hours and hours with their wallets in there back pockets.  The wallet placed in the back pocket while sitting presses directly on the sciatic nerve.  So, please if you are taking a long trip or even a short drive don’t sit on your wallet!

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