The last few months I’ve seen what seems like a plague of clients coming in saying they’ve been diagnosed with sciatica. They way they tell me about their diagnosis it sounds like they’ve been diagnosed with a terminal condition never to be reversed. This is far from the reality when it comes to sciatica.
While sciatica is a common complaint, it is often overdiagnosed. Unfortunately it seems to now be a catch all for physicians to diagnose Sciatica when there is any complaint of pain in the hip and leg, without giving any true solutions outside of pain masking.
Sciatica symptoms include shooting pain or numbness/tingling down the leg stemming from deep in the hip. It is often combined with low back pain. The sciatic nerve runs deep in our hip, and sciatica symptoms often begin when muscles in the same area tighten, or the area become compressed due to poor movement patterns and muscle deactivation (this is why symptoms often begin during long periods of sitting or standing, and are common in manual labourers and desk workers alike).
The root cause behind sciatica is quite simple (in my mind, anyway). It is usually a manifestation of less noticeable messages from our body adding up over years- finally reaching a point where the body is sending us a message we can not ignore.
More importantly, with some consistency and effort, sciatica should not be a long term problem for people. When a client sees me for sciatica, our first step is to calm the nervous system down in the area. This is done through a combination of soft tissue work (massage/tissue release) and movement prescription. Many people with sciatica often present with pelvic misalignments. Soft tissue work can help to correct the baseline alignment passively- but if we are going to make this correction long lasting we need to layer some activation tactics on top of that. This is where patient participation comes in!
My favourite movements to prescribe for sciatica are similar to those I would give for low back pain. Here are three of my top ones for the beginning stages of treating sciatica.
- Bridges- laying on the floor, placing both feet below the knees and inline with the hips. Activate through the butt muscles to press the hips up towards the ceiling, forming a diagonal line through your body. Make sure the entire foot is pressing into the ground, and both hips are active so that the back is not arching in this movement. Hold at the top for 5-10seconds, slowly lower down, and repeat for three sets of ten.
- Figure 4 Stretch: Laying on the floor, your bed, or seated, cross one ankle over the opposite thigh. Grip behind the non-crossed leg (if laying) and pull the thigh towards your chest for a stretch in the hip of the crossed leg. If seated, gently press down on the crossed leg for a stretch through the hip. Hold for 20 deep breaths, repeat on each side for 4-5 rounds/day.
- Clamshells- Laying on your side with knees bent to approx. 90deg, hips and ankles stacked- clamshell the knee open lifting from the hip. Do not let your hips fall backwards, they should remain stacked and level throughout the movement. Hold the clam at the top range of motion (wherever you can raise to without your hip sliding back!) for 10seconds, slowly return back to the start position.Repeat 3 sets of 10-15 routinely in your day. The more you activate the muscles properly, the more the brain makes it automatic.
If sciatica symptoms are something you’re currently stuck with, remember that anything that prevents you from living pain free is not a normal part of life. Checking in with your movement based professional to find out what’s causing the root of the problem can be a valuable asset to regaining pain free function!
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