Sciatica is the name given to a painful condition that originates in the lower back and triggers a “shooting” pain down the sciatic nerve. The sciatic nerve is the longest and largest nerve in the body1 and attaches at five points in the lower spine. It runs down the entire leg to the foot—and believe me, it is not a nerve you want to be playing up.
There are a few extremes in sciatica, ranging from a constant annoyance that ruins your life because you can’t think about anything but how sore your back or butt is, right up to not being able to put one foot to the floor without screaming in agonizing pain. In rare cases, both legs can have symptoms, and I cannot even comprehend how painful that would be.
If you have had a fall or recent lifting incident and this is your first experience with sciatica then I’d recommend getting a medical professional’s opinion to make sure there is nothing structurally wrong, but chances are if you are reading this you’re a long term battler of indomitable sciatica—and you’re getting pretty fed up with it!
What Are the Causes of Sciatica?
A lot of terms like degenerative disc diseases, compressed nerves, protrusions, and slips can be thrown about. They sound scary, but you really need to constantly remind yourself that pain usually will go away eventually. The body heals and adapts all the time. A major realization I had when studying this subject was that if someone can be in a car accident and have their spine smashed to bits and eventually be fine, then how is “a bit of nerve pain” not able to be fixed?
Super Secret Sciatica Tip 1: Belittling pain is a good place to start. Your attitude and the way you think about your pain is your first step. Don’t let it control you.
So, instead of resigning ourselves to it’s just part of our anatomy now and that’s that, how about these more workable reasons:
- Reason 1: Your hips are subtly twisted or misaligned.
- Reason 2: You’re overly dominant to one side.
Both these reasons could result in your discs or nerves being pissed off due to extra pressure on one side. Simply having a major imbalance in strength can trigger pain on the stronger or weaker side due to your spine being inadequately protected.
Yes, you could have a structural issue or internal damage, but you can’t change that. We now have two possible causes that we can be proactive about fixing. It has been estimated that up to 50% of 40-year-olds have “bulging discs” and feel no pain.2 Chances are that if you work on these imbalance issues you may get rid of your symptoms anyway, so why worry?
Super Secret Sciatica Tip 2: Getting stressed about things you can’t change just makes the pain worse.
How Do I Check For Imbalances?
First, stand up, put your feet together then close your eyes. Are you favoring one side? Do you find it easier to lean into one leg or one hip than the other?
It might be obvious, or quite subtle. Or potentially because you know you’re checking your balance you may subconsciously even yourself up, but you may find a shift to one side or the other.
Second, either in front of a mirror or record yourself on your phone, just move and down a few times to relax your body and hips… then stop and see where you stand. Does anything look off? Visually is one hip higher than the other? Or one side twisted more forward?
Both of these are “superficial” imbalances in the sense that you can easily fix them with some conscious movement. You can bring balance back into both legs or manually shift your hips so that they sit straight. The challenge is getting your body to exist like that naturally. This is a relatively easy, albeit potentially slow, fix. The combination of good side stretches for your obliques and core activation drills like the Copenhagen plank are a fantastic way to correct posture quirks.
The next thing to check is your single leg balance—a much more significant marker of unequal strength and potentially the cause of the above imbalances.
Provided you aren’t currently in a lot of pain, stand on one leg. Then stand on the other. See how each side feels. Can you easily stand on one side for a minute, but the other you’re wobbling around and barely lasting 10 seconds? If one side is performing significantly different from the other (note that the worse side won’t necessarily be the side of pain), then you are lacking a basic element of strength and stability which might not be the sole cause of your pain, but definitely won’t be helping.
Super Secret Sciatica Tip 3: Get excited when you find an imbalance or a “problem. This means you can actively work on fixing it!
So, What Do I Need to Do?
The very first step is to get to know your hips. We’ve already touched on this with the three tests above, but this drill will help strengthen your hips and increase your mobility. Watch the video below to see a drill we use called the 90/90 position. It gets one of your hips into internal rotation, and the other in external rotation.
You don’t need to know the names of muscles or any fancy terms to be able to do this, just sit on the floor and see if you can replicate it. While in the position sit up as tall as you can and see if you can take your hands off the ground and rotate your body side to side unsupported. Does it feel more challenging on one side than the other? If yes, then work on it! Spend a bit more time on that side. Does your tighter side correlate with the side with poor balance? Or the side you lean towards? Maybe it’s the opposite side? Experiment and take an active interest in what’s happening in your hips.
Hit this 90/90 position as often as you can a few times a day for 10-15 minutes until you notice an improvement. Not 5 minutes and say, “that’s quite hard.” Not a few reps and say, “I don’t notice any difference.” See if you can make yourself cramp, feel what’s different from side to side, and keep doing big deep relaxing breaths. At first, it may feel like you’re aggravating things, so be careful to not push it too far.
Working on your 90/90 and spending more time on one leg will begin to balance out your hips and build stability. If you dedicate real-time to this, you will find your sciatica symptoms reducing and even disappearing completely. Take it from someone who’s been there.
What About Seeing the Physiotherapist/Chiropractor?
A click can provide relief temporarily. If it is a recent injury and you’ve only just presented symptoms then that could be all you need to get everything back in the right place. However, if you have been suffering for a long time then your muscles are pulling your skeleton, any realignment could be undone by the time you get back to your car.
A good physiotherapist will look at your entire body and not just your back or the site of pain. They will do a good job of easing symptoms that you can get back to moving and working on your recovery.
The main issue with getting external help is you only have 30-60 minutes with this person, possibly once a week. So, what about the other 167 hours? You are living with your pain 24/7, and at the end of the day, you are the only one who can really fix it. Act. Don’t just accept sciatica as your fate.
Let us know if you struggle with sciatica and other things that have helped you along your journey!
References:
1. Yeomans, S. (2019). Sciatic Nerve Anatomy. [online] Spine Health.
2. Brinjikji, W, et al. (2015) Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. [online] AJNR. American Journal of Neuroradiology, U.S. National Library of Medicine.