Sciatica & Finding Positions of Relief
Sciatica refers to low back pain that is accompanied by leg pain (predominantly the back of the leg). This type of pain is typically made worse with bending forward, sitting, and/or sneezing/coughing. This may also be accompanied by the leg feeling weak, numb or tingly. It is most common to experience sciatica pain between the ages of 20-50, though it doesn't always discriminate this way! This sort of pain can come on quite suddenly, and last for days to months.
The most common cause for sciatica type pain is due to a disc herniation or disc bulge (though it can also be from a variety of other factors including inflammation and swelling in the area of the nerves, or a tight piriformis muscle-among other things your health care provider will diagnose).
The primary mechanism of injury is repetitive lumbar spine flexion (ie bending forward without adequately bracing the spine)
This video demonstrates in simplistic terms how a disc herniation may happen, and how it can cause sciatica.
Part of the challenge with sciatica becomes that while pain is increased with low back flexion, we find ourselves moving into positions of low back flexion (our brain isn't always that smart!) So, we need to find positions of relief and ways to move that aren't going to repeatedly aggravate our symptoms. The three most important things are to learn to stand up from a chair, how to kneel to the ground and stand, and how to get out of bed without flexing the spine. We do these movements many times a day, so ensuring this movement isn't painful is helpful in overall recovery.
As the video above demonstrates, drive the feet into the ground, hinge from the hips, keep the low back neutral (straight) and use the hips and buttock to stand up. It is important as well to have the feet wider than hip width apart, this allows you to recruit more hip and glute muscles to make standing easier. This way, there is less flexion through the back (which is important since flexion is a main aggravating factor!)
Getting out of bed without causing pain is important. The best way to do this is to brace your core, keep your spine straight, and use your arms to assist you as you push up to a seated position. Remember to breathe as you brace your core!
The above video demonstrates getting down to the ground and then standing up from the ground. Again, as with the other activities we MUST keep our spine neutral and spine braced as we do these movements.
By keeping a neutral spine, bracing the core, and moving with intention we can move effectively while dealing with acute low back pain and sciatica. We can also use these same movement strategies to prevent low back pain from plaguing us. These should help make your back feel better as you move, never worse.
These movement strategies should always be accompanied by a proper evaluation of your condition by a health care provider to ensure these are right for you!