Everything You Need to Know About Sciatica
"Over 40% of the population will experience sciatica at some time... but research shows it's preventable."
We’ve got a couple myths to dispel surrounding sciatica! In this installment of her series on back pain, Dr. Nancy, PhD, holistic nutritionist, talks about what sciatica is, and the most common causes of the condition.
Plus, learn the best tips and recommendations to treat and prevent sciatic pain!
- 02:55: Sciatica: what is it?
- 07:56: The most common contributing factor is a pinched nerve caused by a herniated or slipped disc
- 08:52: Other common causes of sciatica
- 10:35: How inflammation makes it worse
- 11:04: Acute vs. chronic inflammation
- 15:29: Common myths about sciatica
- 16:02: Myth 1: All leg pain is sciatica
- 17:00: Myth 2: We don't know what causes sciatica
- 18:18: Myth 3: If you have sciatica, stay in bed and rest
- 19:24: Tips for dealing with sciatica
- 19:42: Bromelain from pineapple
- 20:31: Anti-inflammatory diet
- 23:29: Hydration
- 24:28: Daily supplementation
- 25:05: Frequent movement
- 26:02: Top sciatica relief and prevention stretches
- 28:07: Reclined pigeon pose
- 32:02: Sitting pigeon pose
- 34:09: Forward pigeon pose
- 34:33: Modified forward pigeon pose
- 40:51: Pigeon windshield
- 43:25: Seated spinal twists
- 45:24: Supine spinal twist
- 47:17: Three additional things
Sciatica: What is it?
The sciatic nerve is the largest nerve in your body. It's about the width of your little finger, and it branches from the lower back through your hips and glutes, down each leg and to your feet.
Sciatica is the term that we use to describe any pain or symptom, such as tingling or numbness, that travels down the path of the sciatic nerve. Just like the word "headache", sciatica is not an actual diagnosis of a specific condition, just an accurate description of the location of your pain.
There are several conditions that cause low back pain and hip pain, but the pain associated with sciatica is very unique. It's often described as a shooting or searing pain, that is felt deep in the buttocks and radiates down the side of the leg. Sometimes numbness, tingling, or burning is also felt along the nerve.
Sciatica affects each person differently. Some people describe the nerve pain as an electric shock, shooting through their lower back, buttocks, and legs. Others describe their sciatica symptoms as more of a constant, dull, aching, throbbing pain.
There are a series of nerve roots that exit from your lower spine, and when any of these nerve roots become irritated or pinched, it can cause radiating pain from the nerve root, down the sciatic nerve, down the back of the leg, and even into your feet or toes. While sciatica can affect both sides of the body, it typically occurs only on one side of the body.
Sciatica is among the most common types of back pain. Over 40% of the population will experience sciatica at some time, and while it can affect anyone at any age, the most common age for the first developing sciatica is between 40 and 50 years old.
Common Causes of Sciatica
There are a number of factors contributing to sciatica, the most common being a pinched nerve caused by a herniated or slipped disc, that results in pressure on the nerve root.
Other common causes include:
- Spinal Degeneration
- Spinal movement loss. This is the loss of normal spinal movement, and is usually associated with an injury, like a car accident, or a fall, or aging.
- Sedentary lifestyle. If you do not use your body regularly, or are nursing an injury that makes you immobile, or if your job requires that you stay stationary for long periods of time, that can bring it about
- Injury. This is often a job-related injury caused by repetitive motion or heavy lifting.
- Excess weight. Obesity is a major contributor to sciatica
- Inflammation. Of course, inflammation is a huge contributing factor to these issues
Inflammation and Sciatica
All of these causes are pretty self explanatory, but let's take a closer look at inflammation. Even if the initial cause or trigger of the sciatica was something else, the inflammation will make it worse.
Inflammation is part of our body's natural healing process. You may not know this, but there is a difference between a normal, healthy inflammatory response in the body, and an unhealthy one.
Acute vs. chronic inflammation
When our bodies are injured or require some type of healing, inflammation occurs to localize and remove the problematic agent. This is totally normal. It's good! Inflammation also allows damaged cells and tissues to be cleared from the site. It brings healthy, white blood cells, proteins, and other components to the site of the injury to continue the healing process. This is called acute inflammation, which is healthy and normal, and should only last a short amount of time, such as a few days. Anything longer than that is considered to be chronic inflammation, and is a sign of the body not healing properly. Sciatic pain, or inflammation of the sciatic nerve, can occur as a result of chronic inflammation. This is one of the reasons we focus so regularly on our inflammatory equation:
Less Inflammation In + More Inflammation Out = A Healthier You
As part of this equation, it's important to deal with environmental factors, the foods you eat, the people you surround yourself with, your stressors, environmental toxins, food allergens, poor exercise, and anything else that may contribute to your inflammatory load. You really want to make sure the things you expose yourself to do not increase the inflammation in your body. Things that trigger a stress or adrenaline response in your body increase inflammation!
The good news is, all of these can be addressed through simple lifestyle changes and forming healthy habits.
Common Myths Associate with Sciatica
Like most health conditions, sciatica has a number of urban legends associated with it. For example:
- All leg pain qualifies as sciatica. Sometimes talk about sciatica can be confusing, because different types of leg pain are frequently included under the category "sciatica," but they should not be. Leg pain can be caused by a number of issues, including vascular issues, muscle strains, cellulitis, or nerve irritation. Irritation of the femeral nerve, for instance, can cause pain in the front of the leg. A true case of sciatica runs from the mid-buttocks down the back of the leg, on one side of the body. Most commonly, it runs past the knee, and down the calf.
- We don't know what actually causes sciatica. As we've already discussed, sciatica occurs when the sciatic nerve becomes pinched or compressed, and that typically is caused by a bulging or herniated disc between the vertebrae in the lower spine. It can also be caused by a bone spur or a bony growth on the spine itself, or by spinal stenosis, a narrowing of the spinal canal, work-related injuries, obesity, and inflammation.
- If you have sciatica, stay in bed and rest. This is a very common myth. People who develop sciatica often think they need to stay in bed and wait it out. The truth is, most people do better if they remain active and avoid excess rest. In fact, numerous studies have found that there is little to no benefit in staying in bed, compared with staying active, for people who have sciatica. Being immobile and staying still for a long time is actually worse for you.
Tips for dealing with sciatica
First, you want to reduce chronic inflammation levels. This is an important first step for dealing with sciatica, or any chronic health issue.
Pineapple. If you find your sciatic nerve inflamed, try loading up on pineapple. Bromelain is a powerful enzyme that has been shown again and again to reduce the swelling and inflammation in the body, and pineapple is loaded with Bromelain. In a worst-case scenario you could even supplement with Bromelain for a while, until the sciatic inflammation passes.
Anti-inflammatory diet. Diet is essential to fighting inflammation long-term. Cutting out foods with added sugar, and processed foods, is a great start. Some of the most amazing anti-inflammatory foods include:
- Extra virgin olive oil
- Organic berries
- Dark, leafy greens like kale, spinach, and swiss chard
- Sweet potatoes
- Cruciferous vegetables like Brussels sprouts, cauliflower, cabbage, and broccoli
- Citrus foods: grapefruit, lemons, limes
- Healthy fats: chia seeds, almonds, olive oil, avocado, pumpkin seeds, sunflower seeds, and brazil nuts
These are the foods you should always be buying when you grocery shop!
Hydration. drink as much good-for-you liquids as you can! Remember that your body is 70% water. The more water you drink the better. In addition to helping every single cell in your body function properly, staying hydrated helps you flush harmful chemicals and toxins from your body. So drink up!
Daily supplementation. You should also supplement daily to help create a more normal inflammatory response in the body. Curcumin, the bioactive ingredient inside turmeric root, is a great way to do this. Take your Smarter Curcumin supplement daily to combat free radical damage and lower your inflammatory load.
Frequent movement. Sitting in one spot for extended periods of time will make your sciatica worse. Take short walks to loosen up the areas in your back, hips and legs to decrease sciatica and improve recovery time.
Stretching and strengthening muscles in your joints, lower back, and hips are essential for the treatment and prevention of sciatica. Here are the top relief and prevention stretches targeted for sciatica.
Top Sciatica Relief and Prevention Stretches
A good physical therapist should be able to help you determine whether sciatica can be relieved through simple methods such as chiropractic adjustments, static stretching, active stretching, or cold therapy. Most people respond really well to simple techniques and are pain-free within a few weeks if they are consistent.
Chiropractic adjustments and massage therapy may also help improve the alignment of your spine and address other underlying conditions while also improving circulation and muscle relaxation. Minor pain can also be treated with the application of heat and cold. But one of the best ways to relieve sciatic pain is to do stretches that can externally and internally rotate your hip, to encourage proper 360-degree rotation. The following stretches increase range of motion and flexibility in joint muscles.
Reclined pigeon pose
Lay down on your back, with your knees up, and bring one leg up crossing it over your other knee. Then bring the bent leg up, so that your crossed leg is coming toward your chest. Hold your foot with one hand, and press the crossed knee away from you with the other. With every breath, bring your bent leg closer to your face. Breathe there for a minute or two, then relax. Take a deep inhale and release both feet on the ground, then repeat on the other side.
Sitting pigeon pose
Sitting up with legs straight out in front of you, cross one leg so the ankle rests on the opposite knee. Then just walk your hands and your torso forward, til you are leaning over your knee. Lean until you feel a warm stretch in your hip area. Breathe there for 10 breaths or so, then switch to the other side. For a slightly deeper stretch, use your hand to press your knee down. Inhale back to neutral.
Forward pigeon pose
For a forward pigeon pose, sit with one leg in front of you at a 90-degree angle, and your other leg straight out behind you. This can be difficult to do if you're experiencing sciatica, so you can modify it.
Modified pigeon pose (90-90)
For this pose, your front leg should be at a 90-degree angle to your body, with the front of your leg parallel to the top of your mat. Your back leg should also be bent at a 90-degree angle. Don't let your heel turn in too much toward your body as it may naturally want to do. Sit as tall as possible without letting your torso lean toward the side. Straighten your spine, and align yourself as well as possible, activating your glutes and legs. When you're perfectly aligned, lift one arm, and then the other.
If you're able to hold this for 10-15 seconds with no trouble, then move on by bringing your torso forward on an exhale, keeping everything activated, keeping your alignment straight and your hands off the ground, so you're unassisted. Then come back up and lean back, before returning to neutral. When you're ready, repeat on the other side.
Control Articular Rotation (C.A.R.s)
While in the 90-90 position, elongate the back leg, keeping your torso straight and aligned. Then very slowly, wave hello with your toes, so that your leg is rotating 180 degrees in each direction (or as much as your range of motion will allow). Wave about 20 times, then repeat on the other side. If you feel too much pain, stop, back off, and stay in the spot you are for 2 minutes.
Seated spinal twists
Star with your legs straight out in front of you, and bring one leg up, crossing your foot over to the other side of your thigh. Then bring your torso toward the bent leg, placing your arm on the outside of the thigh and sitting up tall so you're hugging your leg to yourself. Repeat on the other side.
If that's too hard, you can cross your legs and turn your torso from there. Then bring up your leg and hug it to yourself. Repeat on the other side.
Supine spinal twist
Lay back on the ground, bring one knee up toward your chest, then cross it over in front of you, hugging it toward your body, and breathe. You can extend one arm out to the the other side for a deeper stretch.
Return to neutral, hug your knees, do a little crunch, and then twist to the other side.
Additional recommendations to prevent reoccurring bouts of sciatica
1. Exercise regularly! This is super important. Move your body. Find something you love you do and do it consistently. To keep your back strong, pay special attention to your core muscles. Always activate these and keep them tight. A weak lower back and weak hips, means a weak core and weak hamstrings. The muscles in your abdomen and lower back are essential for proper posture and alignment.
2. Proper posture. Maintain proper posture when you are sitting and standing. Choose a chair with good lower lumbar support, or roll up a towel and put it under the part where your back curves. Consider placing a pillow or rolled up towel in your car as well when you're driving or sleeping. Keep your knees and your hips level, and wear flat shoes with good arch support whenever possible.
3. Use good body mechanics. If you stand for long periods of time, rest one foot on a stool or small box, and use an anti-fatigue mat. When you lift something heavy, lift from lower extremities, letting your legs do the work. Bend, squat down, and then move straight up. Don't dome your back when you lift. Avoid lifting and twisting simultaneously as well, and find a lifting partner if the object is too heavy.
In summary, sciatica is a very painful condition. If you've had it or are experiencing it, you know! But research has shown it is preventable. We can also reduce the intensity of the symptoms and speed up recovery with the tips we've discussed today. Healthy lifestyle choices and regular body movement are the best things you can do to prevent reoccurring bouts of sciatica.