Question: I have painful sciatica. Is there anything I can do at home to lessen the pain?
Rebeccah T. Getz, RN, CMT
The sciatic nerve begins at the base of the spine, shoots through the center of each buttock, edges by the boney pelvis, wraps around the deep hip muscles, and stretches down both legs. Inflammation often presents with painful restricted muscle and connective tissue along the pathway of the nerve. Swedish massage uses effleurage (long sweeping motions), petrissage (kneeding and compression), friction, and vibration to increase circulation, decrease muscle tension, and break the pain cycle.
At home try these techniques:
Apply cool compresses to the sacral area and buttocks to decrease inflammation.
Place your fists, knuckle side down, on each hip, with your thumbs out, pointing toward your spine. Using gentle pressure and circular motions with your thumbs, outline the ridges of your hip bones. Inch your thumbs toward the center of your back, hold to the count of 25 when your thumbs meet. Use the same circular motion with your thumb to the center of each buttock. The 'sweet' spot will be sensitive, so be easy.
Deep tissue massage is great for long-term relief, but it may be more appropriate to use a gentler touch initially.
Visit www.AMTAmassage.org to locate a qualified massage therapist in your area.
Judith Hanson Lasater, Ph.D., PT
Sciatica feels like a bolt of lightening shooting through your buttock and down your leg. It is an irritation of the large-as-your-index-finger sciatic nerve that exits the pelvis at the
mid-buttock and continues down the back of the thigh and into the lower leg, both side and front. Irritation of the nerve is due to compression that stems from one of two main causes. The first is a tight external rotator muscle in the buttock called the piriformis. In piriformis syndrome, this muscle is contracted and pressed down against the sciatic nerve lying below it, causing pain and irritation to the nerve. This type of sciatica can be found in athletic types, especially runners and bicyclists who tend to have tight rotators. The second main cause of sciatica is more serious; in this case, the intervertebral disc in the back is pressing on the sciatic nerve roots as they exit the vertebral column. In either case, you should consult a health professional to obtain a diagnosis if you believe you have sciatica.
Two things can help. One is an upright posture, whether sitting or standing. Good posture keeps the whole back in its natural curves. Flattening your lower back either when sitting or standing actually puts more pressure on the discs and may exacerbate their pressure against the nerve roots, thus increasing symptoms in the leg. A simple yoga asana may also help, especially if the cause is known to be piriformis syndrome.
Cautions: practice this very gently at first to make sure that it does not exacerbate your symptoms.
Benefits: stretches the piriformis and other external rotators, opens the hips.
Sit on your yoga mat with your legs in front of you. Bend your left knee and place that lower leg across the mat so your shin is perfectly parallel to the end of your mat, with your foot in line with your knee. Place your right leg on top so that your right foot is exactly on top of your left knee and your right knee is over your left foot. Be careful not to bring your lower leg in toward your body; keep it out and parallel to the end of your mat. Breathe normally. If possible, bend forward; note the stretch in the rotators of your right outer buttock. Hold for several breaths, and repeat before practicing on the other side. Try to do this pose at least twice a day.
Judith Hanson Lasater, Ph.D., PT, has taught yoga since 1971, and is the author of five books including 30 Essential Yoga Poses: For Beginning Students and Their Teachers (Rodmell Press, 2003).