5 Things You Can Do to Reduce the Pain of Sciatica
If you are suffering from sciatica, you know that it can be a real pain in the butt, literally and figuratively; if you are a yoga teacher and have students dealing with sciatic pain, these techniques can be the difference between helping their bodies heal and causing more harm.
First, a quick anatomy overview. Sciatica is the inflammation, irritation, or compression of the sciatic nerve, the largest (it is as thick as your pinky finger!) and longest nerve in the body that has five roots emanating from the lumbar and sacral vertebrae that join and travel down the back of the body from the buttocks, leg, knee and into the foot. Depending on which root of the nerve is irritated, you will feel it in different places along the leg.
Ayurveda classifies sciatica as a nervous disorder and falls under the category of Vata diseases.
If you are experiencing sensations of electrical pain, excruciating pain, muscle weakness, or numbness in any of the areas mentioned above, please seek medical help. Diagnostic imaging can diagnose true sciatica, which in most cases is caused by a herniated disc or a spinal canal narrowing that also puts pressure on the nerves. In some instances, called pseudo-sciatica, the nerve gets impinged lower down either as it passes under the gluteal muscles or the piriformis, a deep external rotator of the hip joint that connects the sacrum to the thigh bone; the physical treatment is the same.
Many mild to moderate sciatica cases resolve after a month or so with proper self-care. The following tools and techniques can speed up your healing and stop future episodes from occurring. Once you have had a bout of sciatica, you are more prone to a second and a third. In Ayurveda, this is known as a kavaigunya, a weak spot in the body prone to imbalance or chronic disease. Remember that the best way to manage any disease is to prevent it from happening. Read on to find relief.
1. Tadasana in Every Pose - We want to take the load off of the lower back while sitting and standing. Compression of the vertebral discs, and thus sciatic pain, increases when the lumbar spine is stuck in flexion. Chronic sitting in what I call "slumpasana" collapses the chest, sinks the upper body into the lower back, and reverses the lumbar curve. By practicing proper posture while sitting, standing, and bending over, you will find extension through the lower back, help bring space back to the spine, and allow the irritation, inflammation, and compression to reduce.
When standing, find the weight evenly distributed through the right and left sides and the whole foot. Much back pain is caused when people stand with all their weight in their heels. Instead, think that you are standing on the tripod of the foot, consisting of the center and front of the heel, the balls of the big toe, and the little toe. Next, frame your pelvis with your hands, keeping your thumbs in the back, and press your pelvis down towards your legs. This will activate the legs and ground the lower body. Keeping this activation and rooting down, move your hands to your ribcage and lift your ribs up and off your waist. You should feel a spontaneous inhalation as you free the diaphragm and make more room to take in more air. More air = more space. More space means less compression and less pain.
Do this when seated, which may mean sitting more forward so you don't collapse into the back of the chair. Imagine a string connected to the top of your head, lengthening up. This will elongate the spine and lift you out of your lower back. Ideally, sitting well means that your pelvis is higher than your knees and your feet are making contact with the floor.
2. Increase mobility in the hip joints—Often, when we have pain somewhere in the body, where the pain shows up isn't the source of the problem. In sciatica, pain down the leg can be traced back to the root of the sciatic nerve, where the impingement occurs. Additionally, if we pull back the lens, we can see that a lack of mobility in the hip joints may cause constant over-flexion in the lumbar spine, leading to disc bulging and herniation over time. Working the internal and external rotation of the hip joints through a pain-free range of motion may relieve the sensations of sciatica and go a long way toward preventing further episodes.
3. Stretch the glutes, piriformis, and hamstrings - This will go a long way when you have "pseudo-sciatica," and the root cause is the compression of the nerve as it passes under or even through the glutes or piriformis muscles.
Supta Padangustasana sequence, or reclined foot in a strap pose, will slowly lengthen the hamstrings over time and stop their pull on the pelvis into a posterior tilt, further creating flexion in the lumbar spine. This easy sequence also targets the outer hip and glute muscles and can be very helpful in bringing relief to symptoms. If your hamstrings are very tight, bend the knee of the leg in the strap. Ideally, your hip joint angle should be 90 degrees or less. You can also keep the bottom leg bent with the foot on the floor to make it more accessible.
Figure four stretch is like a pigeon pose on your back. It targets the first fold at the pelvis, bringing a stretch to the piriformis muscle without allowing the lower back to round into flexion. Remember, it is more important to do the movements properly than to find a greater range of motion. If sciatic pain prevents you from getting a good night's sleep, try this sequence before bed.
4. Be Smart - You know your body best. Could you listen to the signals it is giving you? Rest and ice may be the best protocol if you are in an acute phase of sciatica and inflammation is involved. Some people find relief by alternating ice for the inflammation several times a day for up to twenty minutes and then using heat in the form of warm medicated oils, heating pads, or other sports ointments to increase circulation and help speed healing. Do not perform any movement where you feel increased pain, tingling, or a radiating sensation. The same therapeutic poses supposed to bring relief can be detrimental when done incorrectly. It is key to work with a yoga therapist or teacher trained in good biomechanics and who understands sciatic protocols. You will know you are on the right path when the sensations move from the periphery back to the root and decrease in severity.
Tingling and numbness are prodromal signs of sciatica, so if you are feeling any of those in your hip, butt, or down the back of your leg, get on this protocol. Prevention is vital to management.
5. Ayurveda works—Ayurveda is a holistic approach to health. You can help lessen sciatica by incorporating diet and lifestyle tips that help manage Vata; the dosha made up of the air and space elements. Warm oil applied on the sacrum, hip, and down the leg can soothe and relieve the nerves. Pitta pacifying protocols can ease inflammation. Consulting with an Ayurvedic Practitioner can give targeted recommendations for your unique constitution and herbal remedies to tone the nervous system. By targeting the root cause from the inside and outside, you will have greater success with faster and lasting results.
