Back pain and sciatic issues are one of the more common complaints I see in the clinic. In this article, we’ll learn a little anatomy and physiology so we can better understand why the sciatic nerve can get irritated, and what we can do to calm it down. The sciatic nerve can literally be a huge pain in the butt! It is the largest nerve in the body, which consists of a large bundle of smaller nerves that begin in the lumbar spine, travel down the buttocks, and down the leg. Technically, sciatica is not a disease, but a group of symptoms that affect the region of the sciatic nerve. Anything putting pressure on the sciatic nerve can elicit uncomfortable sensations from a shooting pain down parts of the back or leg, to numbness and tingling over the whole area. Pressure on the nerve can come from a whole host of things: a slipped or bulging disc, spinal stenosis, a tumor or just run of the mill muscle spasms. Sciatica can be stubborn so it’s best to prevent it from occurring and when confronted with an episode, have a comprehensive treatment strategy in place.
A herniated disc is a very common cause of low back pain which can lead to a variety of symptoms including sciatica. The vertebral discs are like little gel-filled cartilage cushions between the bones of the spine (vertebrae) that allow the spine to be both flexible and durable. When a disc is damaged it can bulge (called a protrusion or herniation, depending on the severity) out of place and put pressure on a nerve root, causing pain, numbness and/or tingling along the area supplied by that nerve. Herniated discs can occur anywhere along the spine but our low back is quite vulnerable due to poor posture, heavy lifting, and weak abdominal core muscles. Most herniated discs will heal in a few weeks if given proper rest, though severe cases may require further intervention. Spinal stenosis fits into this category as well, and is just a fancy way of saying that the holes in the spine that the nerves go through (called foramen) have narrowed which often occurs with older age. Bulging discs can cause this condition, as well as bone spurs and a few other conditions.
Muscle spasms are the most common and usually the easiest to treat, both at home and with acupuncture. When an irritated muscle is the culprit, it is usually a muscle smack dab in the middle of the butt called the piriformis. In addition to the piriformis, there are many other muscles along the sciatic nerve, all of which can cause the same symptoms.
It can be caused by an injury or sedentary lifestyles in people who don’t stretch or exercise. Particularly if you sit all day at a desk or computer, this can be a problem. Thankfully, there are stretches you can do at home that can help that I can show you when you come in for treatment.
Chinese medicine states that the body is interconnected; no one part can be separated from another. The diagnosis and treatment is based upon identifying specific imbalances in the muscles and the body as a whole. Correcting the imbalance does not just treat the symptoms or mask the condition, but rather corrects the root of the problem by encouraging self-healing of the body. It is best to approach sciatica using a combination style treatment. An effective therapy many include acupuncture, cupping, electric stimulation, and stretching. The back, hip, and pelvis are interconnected and the treatment should incorporate all of them. Overall, the treatment will relax and stretch the tendons and fascia while strengthening the muscles. This will help release the spastic muscles and strengthen them, allowing the back to naturally heal. It can even encourage an out of place disc to go back into place, depending on the severity. Acupuncture will help to reprogram the muscles to stay relaxed. In effect, this is working to help the body heal itself. Treatment works by releasing any extra tension in the fascia and connective tissue around the muscles. Acupuncture can help relieve pain, relax upset muscles, and help your body to heal itself without drugs or expensive and potentially risky surgery.
When a sore muscle is the root of the problem, stretching can be a simple and effective way of getting relief. Even in cases where a herniated disc is known to be the cause, these exercises can provide a good deal of pain relief, since disc herniation generally leads to sore muscles all over the low back. When doing any stretch, do it slow and gradual, no bouncing or quick stretching, or you risk aggravating the problem. There are stretches that I can show you how to do otherwise, if you have access to the internet, look up piriformis or sciatica stretches on www.Youtube.com which will give you videos on how to stretch effectively.
The absolute best thing you can do to prevent any spine-related problem is to maintain good posture. Poor posture puts uneven stress on the vertebral discs, making them weaker on one side and more likely to start bulging one day. Having a wallet in your back pocket fits into the “poor posture” category too, because constantly having your hips tilted to one side when you’re seated on your wallet does the same thing. We know you’ve probably heard it a thousand times, but when lifting anything, make sure you lift with your legs and not your back, and avoid turning at the waist while carrying anything heavy. Take core strengthening classes at the gym or with work out DVD’s because having a strong core (abdominal and back muscles) helps keep the spine stable and less susceptible to injury. Stretching is essential and will help keep the muscles healthy and relaxed. Also, doing tai chi, the Chinese exercise and meditation, is very effective to strengthen the lower back and relax it. After the pain is gone, it is important for you to maintain a healthy and strong back to prevent sciatica from coming back.
By Shawna Snyder, MOAM