Sciatica – just what’s it all about?

Sciatica – just what’s it all about?

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Good evening
Hope you’ve had a great weekend and are getting ready for the week ahead. I’m about to live stream on my Viva Pilates Essex facebook page at 7pm if you are interesting in joining me chatting about the week ahead.
Sciatica just what is it all about?
I thought this week, I’d start a chat about sciatica as I know a number of people who are experiencing this and I wanted to promote a useful discussion that might give some tips, ideas, useful information to help you reduce sciatica if you experience it, or get rid of it completely.
Definition:
Pain affecting the back, hip, and outer side of the leg, caused by compression of a spinal nerve root in the lower back, often owing to degeneration of an intervertebral disc.
If you have experienced sciatica then you will know how very unpleasant it can be and it seems that sciatica seems to linger. Perhaps you did have a trauma at some point that caused you to alter your movement pattern which now seems to impinge the sciatic nerve, but whatever did cause it, we need to find a solution to get rid of it.
Causes of sciatica (NHS)
In the vast majority of cases sciatica is caused by a slipped disc. A slipped disc occurs when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves.
It’s not always clear what causes the damage, although as you get older your discs become less flexible and more likely to rupture.
Less common causes include:
spinal stenosis narrowing of the nerve passages in the spine
spondylolisthesis when a vertebra slips out of position
a spinal injury or infection 
a growth within the spine such as a tumour
cauda equina syndrome is rare but serious condition caused by compressed and damaged nerves in the spinal cord.
What would be my first steps in dealing with sciatica?
For me it is determining just what movements are aggravating the condition as these need to stop for the time being.
I don’t believe in targeting the site of pain as we know now that if an area of your body is in pain, then you will have muscular tension and no-one should be stretching a deliberately tense part of your body!
We also know that the body is completely interconnected therefore it might be a tight ankle that is affecting the hip.
If you have pain when turning in bed or deep in your lower back the Quadratus Lumborum or QL, this muscle could also be part of the problem.
Having said that, if you spend a lot of time seated your hip flexors might be weak and a little tight through always staying in a shortened position. This area too can affect your sciatic nerve.
You begin to see that it is very difficult to know exactly what might cause sciatica or to be honest any back pain, therefore an assessment system needs to look at the whole body when trying to help you move away from pain.
The assessment system I use is based on biomechanics which does start with the pelvis as this is the centre of our bodies where force has to be transmitted from lower to upper and vice versa. If the pelvis is not functioning correctly, this could easily affect the lower back, cause sciatica or other painful conditions. However I am also a big believer that if your feet are not working problems this will impact into the hip.
Be careful with stretching. Consider this if sciatica is the result of too much tension on the nerve then if you try to stretch the area, you may well be trying to stretch a tight nerve which is not the way to help you ditch sciatica. You need to encourage the nerve to move as it should.
Exercises I would avoid:-
Sit ups and leg raises as these over activate your hip flexors which as mentioned can further aggravate sciatica.
Superman laying flat on your stomach because it is a high load exercise that compresses the lower back causing hyper-extension of the spine which transfers load onto the facets crushing your interspinous ligament.
Exercises I would do:
Side bridges to help your body learn to resist twisting.
Bird dog on all 4s where you are in the CAT stretch position and try to lift one hand off floor without moving rest of body, then the other, then the knee. This helps the spine to try to stabilise.
CAT/camel stretch should be about mobility not stretch and not too big a flexion (curve) of the spine.
Flexing your back may cause sciatica so NO roll downs, roll ups, ab curls.
Hope this information is useful and feel free to get in touch. I am now able to do biomechanic assessments on Tuesdays 12pm to 2pm, Wednesdays11.30am to 2pm and Fridays 12pm to 2pm.
Have a great week.