What is Sciatica?
The Sciatic Nerve is the largest nerve in the body. It runs from the lower back, though the pelvis and right down the leg. Understandably, any pain in the region is very difficult to manage and live with. Pain related to the Sciatic Nerve is called Sciatica (in non-medical language). Sciatica is typically caused by irritation or compression of the Sciatic Nerve. Normal painkillers may not always provide enough pain relief to treat Sciatica and often a combined treatment approach is required that incorporates specialist medications and regular focused exercises. Years ago bed rest was the treatment of choice, but research studies have shown that bed rest can hold back the recovery and that regular gentle exercise such as walking swimming and cycling as well as stretching and are best in combination with exercises to strengthen and stabilise the muscles around the lower back.
Here are a range of stretches and poses that someone experiencing pain may find helpful for both pain management and preventing further episodes.*
1. Reclining pigeon pose
There are a number of variations to the pigeon pose, which is often used within a yoga class. The reclining pigeon pose may be performed by laying down on your back, bringing up the right leg and bending at the knee, then grabbing the right ankle and placing it onto the left thigh just above the left knee. Then lift up your left leg and use your hands to hook around the left thigh to help pull your left leg towards you steadily. This has the effect of stretching the piriformis muscle in the right buttock area. The piriformis muscle can go into spasm following a strain or a small tear and this can ‘pinch’ or compress the sciatic nerve. This can be carried out for less than a minute initially, but then built up gradually over time to last several minutes or longer. The reclining pigeon is perhaps the easiest of the pigeon poses for beginners.
2. Sitting pigeon pose
A second variation of the pigeon pose is done sitting down with your legs stretched in front of you. Bend the right leg at the knee and then place the right ankle on top of left thigh just above the knee. Slowly lean your body forward to stretch the lower back. Hold the position for a period of time swap legs and repeat. This can be carried out for less than a minute each time initially, but then built up gradually over time to last several minutes or longer.
3. Forward pigeon pose
A third pigeon pose is the more advanced forward pose, which begins by starting in yoga’s downward dog position. Bend at the right hip, knee and ankle. Then place the right lower leg (outside of your shin) onto the floor so that the shin lies under and across your body. Depending on your flexibility this will mean that your right ankle comes to rest approximately under your left hip. Ensure that your right knee and ankle are both bent at right angles and gently lower your body to rest on top of your right leg, which is folded to the side underneath you. If you are able, rest your forehead on the floor and have your arms stretched gently out in front of you. Also, make sure that there is no pain or significant strain affecting the right knee. It would be best to avoid this pose if you have significant knee problems such as severe arthritis or instability. You should feel a deep stretch in the right buttock and hip. This is an advanced pose and if there are any concerns then it is recommended to seek professional advice and/or attend an accredited yoga class.
4. Knee to opposite shoulder
A simpler stretch is the knee to opposite shoulder. You should begin flat on your back, legs outstretched with toes pointing to the ceiling. Bend and bring your right knee to your abdomen, wrapping your left arm around the front of the knee. Move the right knee slowly towards your left shoulder only as far it will go naturally. If done properly, you will feel a reduction in pain on your lower back. If possible, at the same time turn the head to the left side and stretch the right arm out flat on the floor to the other side to maximise the stretch. Keep that position for about half a minute, do it three times before bringing the knee and leg back to your starting position and switching to left leg.
5. Sitting spinal stretch
Another important cause of Sciatic Nerve pain is when an intervertebral disc in the spine can push out and press on or irritate on the nerve. The sitting spinal stretch may reduce this pain by relieving the pressure on the nerve within the spine.
Start in a sitting position, legs outstretched with feet pointing upwards. Bend your right knee at right angles then cross the right leg over the left leg so that the sole of your right foot is flat on the ground from the other side of the left knee. Rest your left elbow on the right knee and slowly turn your body to the right. Hold for 30 seconds or longer and repeat on the other side.
6. Standing hamstring stretch
Sciatic nerve pain can also cause pain in the hamstrings located at the back of the thigh. The hamstring stretch is performed by bending at the hip and lifting your leg up and placing the heel on a raised surface such as a chair that is just below or at the same level as your hips. Make sure that your leg remains straight (although you can bend your knees slightly if they are susceptible to hyperextend).
Next, bend your body forward towards your foot, the more you bend the stronger the stretch. Do not go too far as that can cause pain. Release the hips of the raised leg in a downwards fashion. Hold for 30 seconds and repeat on the opposite side. When performed correctly you will feel a good but intense stretch down the back of the leg from the buttock to the knee.
An alternative version of this stretch is to do it from a seated position on the floor with both legs stretched straight out in front of you. A yoga strap or exercise band can be held in each hand and then hooked around the sole of the foot to assist with this, should you need it. One leg is stretched at a time while the other is bent at the hip and knee in a relaxed position.
*Please exercise care and caution
We all possess different bodies and abilities. Some may be able to bend and stretch more and have greater flexibility than others. It is important to exercise caution and take your time in performing these routines, starting with the simple stretches. Stop immediately, if the pose increases the pain. If you are unsure about these stretches it is recommended to seek professional advice. The information provided is meant only as a helpful guide and cannot replace a full clinical assessment.
If you are somebody experiencing sciatic pain for more than four weeks, consult a doctor or another expert in the field. If you have significant health problems it is recommended to seek professional advice before commencing a new exercise regime.
Expert care and pain relief treatment
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