Posted 02.08.2024

Did you know that nearly four out of five people will suffer from a debilitating back pain episode at some point in their lives and that it can result in sciatica?
“Sciatica” is a term used to describe severe pain, burning, or numbness that runs from your back into your butt and down your leg; typically below your knee and sometimes into your foot. It occurs because something in your lower back is causing the nerve to be irritated and inflamed that sends signals to your leg. It can be caused by anything that puts pressure on your sciatic nerve – such as bulging disc.

What a lot of people don’t know is that you can have sciatic symptoms without actually having any low back pain. Sciatic symptoms can occur just in one place like in your leg, your knee and/or foot, or run down the whole leg as described above. Regardless of how your sciatica is presenting, there are some general “best practices” that almost all versions of sciatica will respond well to.

What to Avoid:

1. Soft Beds and Couches
Lying in soft beds or couches will aggravate your sciatica so try to lie on a more firm bed if able. When you lie in a soft bed or couch it forces you into a slouched posture putting unwanted pressure on your already irritated nerves. What’s tricky is that you often won’t notice the aggravation at the time. It won’t be until you get up to walk or move around, that you’ll feel worse. Because of this, people mistakenly attribute the aggravation of their sciatica to the activity they just did instead of the prolonged, slouched position they were assuming perhaps just minutes or hours before.

2. Flexion Based Exercises (ex. Child's Pose)
Just because a stretch feels good, doesn’t mean it is good. Since sciatica is often caused by a bulging or herniated disc that is putting pressure on your nerve, you want to avoid anything that is going to increase that pressure. When you stretch forward or bend forward, like in child’s pose, you’re opening up the space in between your vertebrae. In between each vertebrae lies your discs. Although it feels good “in the moment” when you’re stretching forward this relief won’t last and may actually make it worse. By opening up your intervertebral space you’re making it easier for your discs to protrude out and put more pressure on your nerves.

3. Getting an MRI Right Away
Just because a stretch feels good, doesn’t mean it is good. Since sciatica is often caused by a bulging or herniated disc that is putting pressure on your nerve, you want to avoid anything that is going to increase that pressure. When you stretch forward or bend forward, like in child’s pose, you’re opening up the space in between your vertebrae. In between each vertebrae lies your discs. Although it feels good “in the moment” when you’re stretching forward this relief won’t last and may actually make it worse. By opening up your intervertebral space you’re making it easier for your discs to protrude out and put more pressure on your nerves.

So What Can I Do?

1. Move!

Movement is one of the best things you can do for back pain; even though it may seem counterintuitive to do so when you’ve got pain running down your leg. Walking is an upright activity that is generally good for sciatica versus the slouched, curved posture you have when sitting. When you walk, pay close attention to what happens in your leg. Do your symptoms worsen or start to get better? Try it even for just 10 minutes. If they worsen, certainly stop and seek professional guidance. But if your leg starts feeling better, then the walking is likely good for your sciatica. We typically see those that sit on the couch and wait out their symptoms actually get worse. Keep moving!!

2. Pay Attention to Your Posture

This may seem trivial but maintaining good posture is critical when you’re suffering from sciatica. When your sciatic nerve is irritated, it becomes very sensitive to postural changes in your lower back (especially slouched postures). Whether you’re sitting or standing, you want to maintain the natural S-curve of your spine as best as you can. We recommend to our patients they use a lumbar roll whenever they are sitting to make maintaining this posture easier. Correcting your posture alone is often not enough to get rid of your sciatica, but it can keep you from getting worse, and prevent it from coming back if you’ve successfully eliminated your sciatic symptoms.

3. Talk to a Physical Therapist

Did you know that 70-80% of all musculoskeletal pain is mechanical in nature? Both back pain and sciatica can fall into this “mechanical pain” category, which is caused by slowly developing movement problems or habits that eventually result in stiffness and mobility restrictions in your spine. These restrictions can lead to irritated structures, such as nerves. So if your sciatica is due to a mechanical problem, it’s not going to permanently improve with pills, injections or surgery. You’ll need to find a mechanical pain specialist, a physical therapist, who can help correct and restore your movement patterns for a long-term solution you can maintain on your own without needing injections.