What is Sciatica?

 I'm sure you have heard the phrase, "I've got one nerve left, and you're on it?" Well, hopefully, it's not the sciatic nerve. 

Your sciatic nerve is the largest, broadest nerve in your body.  Nerves are highly irritable, and any swelling or inflammation in and around the spine can potentially cause pressure on the sciatic nerve, which can be very painful.

Sciatica is irritation of the sciatic nerve that causes pain to travel from the back to the buttocks and then down the leg.

The sciatic nerve threads through a muscle in your buttocks called the piriformis. If the sciatic nerve is irritated, then it causes this muscle in the buttocks to spasm, causing buttock pain. The muscle then clenches down on the nerve creating further irritation, which can potentially cause pain to radiate down your leg, which is sciatica leg pain.

The goal of any sciatica treatment is centralization, which means getting leg pain to travel back up toward your back. A sign that pressure on the sciatic nerve is subsiding.

If you perform some simple stretching and exercises that cause your leg pain to go away; however, your buttock pain is still present, you have achieved some success in relieving your symptoms.

How Does Sciatica Pain Feel?

Typical sciatica pain radiates from your back through your buttocks and down your leg. The pain can be intermittent or constant and occurs most commonly in the back of your leg; however, it may be present in other areas of the leg as well. Burning, numbness, and tingling are also common types of sciatica pain.

Sciatica leg pain can occur on either side, depending on where the pressure on the nerve is located. It very rarely occurs on both sides.

Walking Can Help With Sciatica Nerve Pain

Some sciatica patients find walking to be helpful while others report an increase in pain; here are a few tips to consider when walking:

~Shorten your stride to decrease the amount of stretch on the sciatic nerve  with each step

~Stand up straight, with your shoulders back and head up, slouched posture creates increased neural tension

~Make sure you are not bending forward or to one side when walking

If walking is painful for you, and you have access to a pool, walking in the shallow end of a pool is a great way to decrease compression on your spine and alleviates pain.

Sitting Can Be Painful

Sitting is commonly problematic for sciatica patients due to the high amount of compression on the spine in a seated position. Therefore sitting for long periods of time is not recommended, even if it doesn't cause increased pain.

Can Stretching Make Sciatica Pain Worse?

You may have a sensation that you want to stretch, but it is essential to remember that nerves are very irritable and don't tolerate rigorous stretching.

However, avoiding stretching isn't the answer; you need to take care to stretch the muscles involved while minimizing the amount of tension that you put on the nerve. I will walk you through this in the next section.

Always listen to your body and immediately stop any stretching or exercise that makes the pain worse or causes the pain to go further down your leg.

Stretches for Sciatica Leg Pain

Performing gentle piriformis stretching is an integral part of reducing sciatic pain. The keyword here is gentle.

1. Piriformis Stretch

Cross your painful leg over the opposite leg, grasp behind the opposite knee and gently pull both legs toward the chest until a gentle stretch is felt in the buttock of the painful side. Hold for 10 seconds if tolerable, repeat 5 times.

2. Low Back Stretch

With hands behind knees, pull both knees toward the chest until a comfortable, gentle stretch is felt in the low back, hips, and buttocks. Hold for 10 seconds, repeat 5 times.

3. Figure Four Stretch 

Sit on a chair in an upright position aligning shoulders over hips. Cross your right ankle above your left knee in a figure four position. To increase the stretch gently press down on the right knee holding the stretch for up to 2 minutes. Repeat on the opposite side.

Conservative Care in the First Few Days

Within the first few days of an acute flare-up of sciatica, you should rest, use an ice pack and keep your spine in a neutral position as shown here.

You may be wondering where you should put the ice pack because the painful area is so broad. The ice pack should be alternated 15 minutes over the spine at your low back and 15 minutes over the painful area of your buttocks.

Ice decreases inflammation, which will be present in both your low back and buttocks. The pain in your leg is a symptom of the inflammation in your back and buttocks; therefore, you may notice a decrease in leg pain immediately after using ice. You can use ice for 15-20 minutes at a time, many times throughout the day for pain relief.

Exercises to Reduce Sciatica Leg Pain

4. Prone on Elbows

You can start with up to 2 pillows under your waist if it hurts to lie on your stomach. Gradually reduce the amount of pillows until you can lay you're your hips flat on the floor. Hold for 10 seconds, repeat 5 times.

5. Prone Push-Up

Once you can achieve a hips flat position on the floor, then attempt to push up. Hold for 10 seconds, repeat 5 times.

*Only progress to this exercise after you can perform Prone on Elbows (pain-free) for 5 days in a row with no pillows.

 6Foam Rolling the Piriformis 

Sit on a foam roller and cross your right ankle over your left ankle. Gently roll back and forth on the roller to scan for tender areas. When you find a sore area, stay in that position, and oscillate back and forth for a total of 2 minutes. Repeat on the opposite side. 

 7. Basic Glute Bridge 

Lay on your back and bend your knees. Tighten your stomach and buttocks at the same time (this may take a little practice). Once your abdomen and buttocks are tight, lift your hips toward the ceiling to a comfortable height. Hold 3-5 seconds, repeat 5 times. 

The following short video will summarize what you have read here and provides demonstrations of foam rolling the piriformis, the figure four stretch, and the basic glute bridge.

  Summary

It is important to remember that sciatica is a result of swelling and inflammation in your back. If symptoms persist or get worse, it is imperative that you see your doctor. Maintaining proper posture when sitting, standing, and walking is essential to a healthy back.

Easy Posture Brands carries a wide selection of options to improve back support and positioning while at home, at the office, or in your car.

Please remember to perform all exercises to your tolerance. If you experience any increase in back pain or pain down your leg, stop the activity immediately and try again at a later time.