Sciatica, a malady characterized by a pain starting in the low back and buttocks that radiates down the leg, affects about 3 million people each year. It is uncomfortable, inconvenient, and even debilitating, but also highly treatable. You see, sciatica is not actually a condition on its own; rather, it is a symptom of an underlying medical condition. The underlying condition could be anything from a herniated disc to pregnancy, but once the cause is determined, the treatment is fairly straightforward. Typically, doctors can prescribe a combination of physical therapy and prescription drugs to cut down on inflammation and pain and expedite recovery. But before it gets to that point, you can incorporate simple lifestyle adjustments to minimize discomfort and prevent future sciatica flare-ups.
Sciatica is a term that refers to pain from the sciatic nerve. This pain typically starts in the low back or buttocks and radiates down one or both legs. Though often thought of as a malady on its own, sciatica is typically a symptom of another condition. If you experience sciatica-like pain, see a medical professional as soon as possible. Doctors may use a physical exam, x-ray, MRI, and/or CT scans to determine the cause of the pain and start you on a course of treatment.
Sciatica feels like a pain in the low back that radiates down to the buttocks, down the back of the thigh, and sometimes even down to the calf. It can range in severity from a mild ache to a sharp pain. Sciatica typically only affects one leg, but in some cases may affect both. Sciatica pain worsens when the individual is seated for an extended period of time. Many people with sciatica experience particularly sharp pain while coughing or sneezing.
Sciatica pain may be accompanied by inflammation, tingling, and even numbness.
Sciatica is the result of compression of the sciatic nerve—the largest single nerve in the entire body. The sciatic nerve begins in the lower back (the lumbar spine and sacral portion of the spinal cord), and travels south through the buttock, behind the piriformis muscle, and down the back of the thigh. At the back of the knee (popliteal fossa), the nerve branches out into two sections—the tibial nerve and the peroneal nerve—and travels down the back of the leg all the way to the heel.
When the nerve is compressed, some other part of the body is putting pressure on and pinching the nerve. This is how sciatica pain begins. The longer the nerve is compressed, the more severe the symptoms. To eliminate sciatica, the cause of the compression must first be determined.
Sciatica can be caused by a number of different conditions. Most commonly, sciatica is caused by a herniated disc in the low back (lumbar spine). Between each of the bones (vertebra) in the spine, there are small spongy discs of cartilage. This cartilage acts as a shock absorber for spinal movement. If the disc becomes damaged, or the spine is misaligned, the disc may bulge out to one side, and can even rupture. When there is a herniated disc near the sciatic nerve, the bulge of the disc can compress the sciatic nerve, leading to sciatica pain.
Other conditions that can lead to sciatica include:
•Degenerative disc disease
This disease causes excessive weakening of the discs between each vertebra. With weakened discs, the lower back becomes hyper-mobile, and friction between the bones of the spine causes inflammation. This inflammation can irritate the sciatic nerve.
The piriformis muscle is an outward rotator deep in the buttock. If it becomes inflamed or spasms, it can compress the sciatic nerve.
•Lumbar spinal stenosis
Lumbar spinal stenosis causes a narrowing of the spinal canal. This narrowing, along with the spinal arthritis that typically accompanies lumbar spinal stenosis, puts pressure on the sciatic nerve, leading to sciatica pain.
This is a condition in which a stress fracture causes the lumbar vertebrae to slip out of alignment. One vertebra will typically slip forward of the others, causing compression of the discs and pinching of the sciatic nerve.
Sciatica is fairly common during pregnancy. The sudden weight gain causes a woman’s center of gravity to shift. This dramatic change in how a woman carries her weight can affect her alignment, putting undue pressure on her lower back. On top of that, a hormone called elastin, released during pregnancy, causes the ligaments throughout a woman’s body to become flexible and weak to prepare the birth canal for childbirth. But it also makes the woman’s joints less stable and more prone to injury. This combination of factors can contribute to compression of the sciatic nerve, and consequently, sciatica pain.
This is quite rare. But certain types of infections can affect the root of the sciatic nerve and cause pain to radiate down the leg.
- Stand tall. A tall, upright posture translates to a lengthened spine with a healthy amount of space between each vertebra. While standing, create equal pressure on the left and right foot. Now, find optimal alignment by stacking the knees over the ankles, the hips over the knees, and the shoulders over the hips. Align the head atop the spine by pulling the chin back as if to make triple chins. Finally, engage the abdominals by lengthening the side body—the space between the hips and ribs—and pulling the belly in toward the spine and up toward the ribs, which provides stability and strength for the lower back. Maintaining length and strength in the spine reduces the risk of developing a herniated disc, lumbar spinal stenosis, piriformis syndrome, and other alignment-related conditions that can lead to sciatica.
- Boost calcium and vitamin D intake. The health of the vertebrae is critical to maintaining a strong spine and decreasing chances for lumbar spinal stenosis, degenerative disc disease, and bone fractures. Consume a healthy dose of vitamins and minerals from whole foods, specifically food rich in calcium and vitamin D—this can make a huge difference in maintaining bone strength and staving off sciatica pain. To increase your calcium intake, try adding dairy, such as milk, yogurt, and cheese, to your diet. If you prefer to stay away from dairy, add dark leafy greens (such as broccoli, bok choy, kale, and turnip greens), sardines, salmon, calcium-fortified foods, and only if necessary, a calcium supplement. To increase your vitamin D intake, add salmon, mackerel, tuna, sardines, vitamin D-fortified foods, and a daily supplement.
- Lift with care. When lifting a heavy object, place your body directly in front of the object, bend your knees, engage the abdominals, and lift slowly. Avoid simultaneously bending and twisting the spine, especially when lifting an item off the ground. Lifting things carefully reduces the risk of spinal injury and thus the risk of sciatica.
1. Ground the Feet. If your weight is disproportionately shifted toward the outer edge of the feet, the risk of misalignment throughout the rest of the body increases. This can result in excess pressure on the piriformis muscle of the left hip versus the right, or improper hip alignment, leading to greater likelihood of developing a herniated disc. Grounding the feet ensures equal distribution of weight on each foot, essentially removing the potential for favoritism toward the inside or outside of the foot and therefore setting up the foundation for good alignment in the rest of the body. To Ground the Feet, first create equal pressure on the left and right foot. Then, imagine points at the base of your big toes, pinky toes, outer heels, and inner heels. Pull the toe stems long and push all four points of the soles into the ground. In everyday life, you can Ground the Feet when you stand in line at the grocery store, brush your teeth, or sit at your desk at work. No matter if you’re seated or standing, connect to the ground beneath you by simply pressurizing through the four points of the soles (with equal weight on both feet) and reaching long through the toes.
2. Anchor the Hips. Sciatica pain may start in the lower back for most people, but typically, misalignment in the lower back is directly linked to weak or misaligned hips. Anchoring the hips ensures proper engagement in the abdominals, which protects the lower back from injury and reduces strain on the glutes (butt muscles) to decrease the risk of developing piriformis syndrome. To Anchor the Hips, make “L” Mudra with your hands. Place your thumbs on your ribs and your index fingers on your hips. The space between the thumbs and the index finger is called the side body. This area shortens when you slump or slouch. Increase the space between the index fingers and thumbs to lengthen the side body. Now, draw the lower belly—the space between the belly button and the pubic bone—back toward the spine and up toward the ribcage to engage the deepest layer of abdominal muscle (transverse abdominis). Finally, release the glutes. To learn to release your glutes, it may help to understand what it feels like to do the opposite—grip the glutes. To grip the glutes, squeeze them together. Now release. In everyday life, you can Anchor the Hips when standing from a chair. Before rising, lengthen the side body. On an exhale, Ground the Feet, and simultaneously pull the belly in toward the back and up toward the ribcage and release the glutes to stand.
3. Stimulate the Spine. The lower portion of the spine is at increased risk of injury due to compression from the weight of the upper body and the incredible mobility in the spine. To reduce this risk, minimize spinal compression, and curb conditions like lumbar spinal stenosis, try stimulating the spine. To Stimulate the Spine, set your gaze slightly above the horizon, and pull the chin back as if making double, triple, even quadruple chins! This aligns the head atop the spine. Now, lengthen the spine to reverse the compressing effect of gravity by increasing the space between the tail and the head. To do this, create opposition by pushing your feet down and pulling the crown of your head up. In everyday life, you can Stimulate the Spine while waiting for the bus or train. First, align the head atop the spine. Now, exhale to push the feet down. Keep the feet pushing down toward the earth, and now inhale and reach the crown up toward the sky.
See a doctor. The only way to fix sciatica pain is to address the condition causing it. A doctor will listen to your description of symptoms, ask you questions about your family history, and run x-rays, MRIs, and CT scans to determine the cause of your pain. Once you know the cause, you can begin to treat the problem. While you’re waiting for your appointment or results, you can alleviate symptoms by resting and icing the affected area to cut down on inflammation.