What is Sciatica?
Sciatica is the commonly used name for an irritated nerve in the lower back that causes pain in the leg. It can come with or without back pain and can present with other symptoms such as numbness, tingling and weakness in the leg.
Sciatica refers specifically to the LEG pain. Pain in the back or the buttock on their own, no matter how severe, are not sciatica. It is important to note that acute and chronic back pain can come with intermittent sciatica, on and off symptoms that travel into the leg.
What Causes Sciatica?
The most common cause of sciatica is a disc bulge or disc hernia (very similar and can be often used interchangeably) in the lumbar spine (lower back). These disc issues occur when the lower back bends forward more than it should.
Sitting for prolonged periods, repetitive forward bends during exercise or work are some of the most common causes of disc bulges and hernias which can lead to sciatica.
How Can We Treat Sciatica Conservatively (without surgery)?
Treatment for sciatica varies based on the severity of the irritation and the fitness level of the patient. We start by getting control of the sciatica with comfortable, pain-relieving positions like the Z-lying pose (lying on the back with the legs up on a chair or couch at 90 degrees at the hips and knees and a pillow under the buttock) or the prone on forearms position with a pillow under the pelvis.
Ultimately the goal of conservative treatment is to create a balance in the patient’s spinal movement between bending forward and backward. Bending the lower back backwards doing the sloppy push up (like in an upward dog yoga pose but without engaging the abdominal or buttock muscles) repetitively will balance the pressure on the disc and push the disc hernia or bulge back in. This will in turn alleviate the irritation of the nerve root and eliminate the leg symptoms.
Many patients struggle with that movement at first because it is new to them, and their spine is not able to bend backwards comfortably. This is NOT a sign that bending backwards will not work, it just means that it may take longer for this patient to respond.
Once the patient can bend backward comfortably it becomes important to make the movement habitual.
Disc bulges and hernias are NOT like simple bacterial infections that you treat with antibiotics and they go away. Sciatica tends to be a recurring problem because the underlying lifestyle issues that caused it are rarely addressed.
If you deal with rare or frequent bouts of low back pain that come with or without sciatica you should see a physiotherapist or chiropractor who is dedicated to teaching you how to manage it and resolve it.