It's important for us to start with a huge DISCLAIMER here. Please see a physician before starting any kind of exercise regimen. What I am listing below is a very general outline of what usually works for patients after a thorough evaluation to confirm the cause of their symptoms. It may not work for everyone or every case and you should seek a formal evaluation and assessment of your concerns. In general, any time you feel numbness and/or tingling in your face, head or jaw, down your arms, or have an upset stomach, abnormal bowel/bladder movements, please discontinue the exercise and seek professional advice.
Sciatic pain occurs when there is pressure on the sciatic nerve which runs down both legs originating in the lower back. This pinch can cause pain that radiates down the leg. Below, I discuss what sciatica is, how it occurs and my favorite exercises to reduce symptoms and prevent flare ups!
Where does sciatica come from?
Funky mechanics at the pelvis and sacrum can begin to alter the alignment of your nerves as well as superior structures like the lumbar vertebrae or spine. The hip joint, specifically the femur, can migrate forward, or anteriorly when you sit for prolonged periods of time (like doing computer work or commuting).
Rehab and Revive likes to target the lumbar spine. This is because there are many different causes for the pain that radiates from the lower back/buttocks down into the leg. It can be a pinched nerve or herniated/bulging disc. Looking at the lower spine can pinpoint the cause of the pain.
I like to give the analogy of a kinked hose to describe how sciatic pain occurs and progresses. If you kink a hose by the spout then the flow (or signals in the case of our nerves) is less. But there is a significant decrease in “flow” that happens when there is a second kink. This "second kink" often around the sciatic notch of the sit bone (ischial tuberosity) or the piriformis.
Sciatica and Piriformis syndrome are often interchanged and confused, but both are labels or blanket diagnoses for symptoms of sciatic pain. They don't actually describe where the pinching/nerve inflammation is happening.
So what are the common symptoms of sciatica?
The indicative symptom of sciatica is pain in the buttock, especially pain that radiates down the back of the leg. Another very common symptom is pain accompanied by numbness and tingling or a buzzing/electric-like pain. Pain first thing in the morning, after prolonged sitting, or during the sit to stand motion is also a frequent symptom.
What would we do about it in-office?
Here at Rehab and Revive, we look at your mechanics, nervous system, and, of course, good old fashioned habits such as sleeping and postures.
We typically start by squaring away and realigning the nerves by going after the mechanics in the pelvis and sacrum. We also look at the lumbar spine in case there are disc issues that need to be addressed.
We then work on the nerve tracks by breaking up scar tissue around the nerves through the legs and stabilize with the exercises below!
Below are three of my favorite exercises for patients with sciatic pain!
The lift off exercise stabilizes the lower back by engaging the spine's strongest stabilizer, the multifidi. This is key to prevent the lumbar bones from shifting and sliding into your nerves.
The nerves can also get caught and inflamed in the hip joint. Hip holds gets the hips on-axis by realigning the hip point into the joint using the glute muscles. This exercise also gets your body warmed up so that you can more efficiently perform weight-bearing tasks such as walking and standing.
The hamstring muscles provide you with the power you need for your everyday tasks such as walking, sit to stand, and prolonged sitting. Heel slides helps isolate and strengthen the hamstring muscles while teaching your body to deactivate the overused quadricep muscles.
These are just a few of my favorite exercises for my patients suffering from sciatic pain. No single program works for everyone, so even if these don't work for you, there may be many others that do! If you find yourself struggling with symptoms of sciatica, it may be worth it to see your local PT and get it checked out!
Remember, we can and we will get better together!
Dr. Justin C. Lin