Tips for Sciatica

Hi, everybody. It's Amy here talking to you and us today about sciatica. And as Pilates teachers, we will often encounter clients and students that come in to us privately or in classes that say, oh, I'm dealing with sciatica. And I'd say forty percent of us human beings are probably going to have a bout of sciatic at some point in our life, not something to be too afraid of and fearful of, but definitely to pay attention to it. So we Pilates teachers can really help our clients and our students get through the pain and the discomfort, but there are a few things we should talk about first with that, with sciatica. So the general characteristics of in the definition or description is pain, numbness, tingling, pins and needles, weakness down from your lower back, anywhere lower back through the buttocks, down the leg, and in extreme cases all the way down to the foot. Now that's a pretty long territory. It's a lot of territory to be having pain in.

And those of us that have had sciatica, it's a real thing. It's uncomfortable. It's nagging you might be afraid of the sensations rightly so. It can come on suddenly from maybe a trip, a twist, bending down to pick something up and quickly picking it up too heavy of a load. Things that overload your lumbar spine and your sacrum, this wonderful territory here. Right?

And it can come on gradually. Also, like a slow build to suddenly having a a a bunch of pain here. So the true way to know if it's sciatica is to go to a physical therapist, go to a spine doc, go get an MRI, go get a scan, an x-ray, some kind of imaging that's gonna detect for sure. Yes. It is sciatica. What is sciatica? It's the compressive force from lumbar vertebra through sacrum. And the the compression can be things like a disc herniation.

The jelly like substance inside that that disc spilling out because of poor posture or overload, and it can really vary that disc can push sideways. It can be pushed forward. It can be pushed backward. Any of those forces though are going to put pressure on the nerves that are trunking out these yellow nerve roots here and causing extreme pain down where they travel, which is down through the buttock and down the leg. That's a herniation.

It can be assist that develop somewhere on one of the facet joints or one of these transverse processes. Again, anything that's not going to allow congruence for the nerves to flow through. So if there's assist there pushing on those nerves, it's gonna send that signal of pain, the temp, the numbness, the tingling all the way down. The set joint problems, which, again, imbalance out of alignment, spondylolosthesis, which is that shifting of the vertebra one above it, one below it sideways. So any and all of those, which are the main examples, are gonna push on those nerve roots and cause pain coming down through your butt and your leg.

So when you go to an a scan and imaging, they're gonna do a few things. They're gonna do manual tests, but they're also gonna get in there and look and see. And if they can detect that and see for sure if there's a compromised space, a compression happening causing that pain, they'll tell you, and they'll say, oh, you absolutely have sciatica and ways to treat it might be. And you'll get your choices. It's an extreme case.

Sometimes they'll suggest surgery. We Pilates people are always gonna suggest to hold off on that and as long as you can because we can we can get through that without surgery. But sometimes an epidural into the nerve root will calm that down. Sometimes some cortisone will calm that down. Sometimes a laminectomy to clean out some of the arthritis that's been built up in there causing that joint space to be compromised and compressed can help.

Those are the extreme cases. But what if the scan shows no compromised compression? We might be then dealing with something known as referred pain and referred pain coming down from the buttocks low back through the buttocks down the legs is also real and very uncomfortable. And the referred pain can be coming from, again, the set joint imbalance or shifting. It can be coming from the wonderful sacraliliac joint, which is right here where our sacrum and Illium meet together.

This is probably what I've seen the most with my clients over my time is the sacrum sacraliliac joint being out of balance, out of alignment. One ilium might be higher than the other one, causing a slip up compression. One ilium might be forward and up could be back and down. Anium all can be causing that compressive force again in and around those nerves that trunk out and all the way down. It can be from hip joint dysfunction.

Maybe one of your hip joints is stiffer than the other one. Compromised hip joint arena pain in the back and around the buttocks. It can also be probably the other one we've heard the most is piriformis syndrome. That's real. And it's in the buttock. Right? It's one of our external rotators that allows our leg to turn out and move back in. It turns it out.

Well, if that nerve or that muscle is pressing on the sciatic nerve, which the skeleton doesn't show, but our sciatic nerve runs right out of that sacrum and right over to the trochanter. If that nerve is getting pushed on because of a tight and often weak piriformis, that's gonna shoot pain down your leg, and you're gonna know it. And we can get afraid, of moving, and we can stop moving. So some people will say, oh, just rest. Rest and wait till the pain goes away.

I think we would most likely say, please don't rest for too long. We need to keep moving, but moving wisely. Right? So when when sciatic is coming up, are these symptoms of sciatic are coming up, whether it's a true diagnosis by the scan, or the referred pain, it can be from sitting too long. What if you're a sitter like this and you're sitting on the back edge of your pelvis for hours and hours and hours. Right? I'm gonna it's just look at all that force that's going back to the back of the spine.

Could be pushing that bulge and that herniated disc even farther back, more compression. You could be a sitter that sits too far forward, like that with your lower back. In standing, that would be something maybe like that. That big, big, big arch there, and living your life with this big arch and doing tasks and lifting things with that big arch. At some point, that could really push in the wrong direction and cause a significant amount of compression down there.

Ouch. Right? Of course. Driving for a long time. People who work with machinery that have vibration to it. That is treachery for the lumbar spine and the pelvis. All of this gets the brunt of it.

In our work in Pilates, of course, when we're lying on our back, the most common place where we feel at ease is lying on our back with our or with our pelvis slightly tilted posterior. That can really help calm that pain down and create the space we're looking for in these joints. So it's a phrase and word decompression. We want to decompress So in our world and Pilates, we we stand such a great chance of helping our sciatica people because we're always looking to decompress our spine. That lift from the stomach in and out, the lift of the spine in upward and our hamstrings and our pelvis rooted down.

Right? So when we're prone, facing down, we would most likely like you to actually slightly take your tailbone. I'm gonna get out of the way here. And reach the tail longer down the back of your legs to create more space again in these joints. If I could pull on my skeleton and make it longer, you'd see what I was doing there. Anything to create more space to decompress.

So things to do. Again, if you think this is you and you're having sciatica and you're not sure if it's coming from an injury or a a slow build up of maybe poor posture or things, go to a doctor. Go get a a PT check you out. MRI or some kind of scan. If you've gotten your results back from your doctor, and they've said, no, you actually your scan shows clear. You don't have an actual compression. Your spine looks fine.

And you might be having more of the referred pain symptoms. Things you might be able to do. And I just filmed a Pilates math class here for sciatica relief, and I would love for you to check that out. I go it's about a forty minute class, so it starts nice and slow. And we build from release work all the way into some strength work because with sciatica, you may be hearing people say, oh, you need to stretch. You need to stretch, stretch, stretch, stretch, stretch, that hip, that tightness.

And while that's effective and useful and yes, we should. We also need to strengthen. So because sciatica typically is a one-sided thing or an event, meaning one side of your hip is having the pain. One side is not. It could be coming from another thing. One side being too bound and compressed. One side being too slack.

So we need to strengthen and get balance in both sides of the pelvis to make it as harmonious and congruent as possible. Gentle things lying on your back, bringing your knees to your chest. You can bring a knee to the chest and knee to the opposite shoulder. You'll see your figure four stretches. You're gonna see things that require a lot of lift in through the abdominals.

I've been doing a lot of this lately, just having people sit and push their fists into their chair and lift themselves up to offload the pressure that they're feeling in their lower back. Of things face down to strengthen your buttocks because, again, we want strong muscles and glutes to help lift on show them again if this is my rear and a rear The stronger those muscles are, the more they can help lift and unload what's being compressed downward. That's gonna include your erector spinae, your big back muscles. That's gonna include your obliques that are part of your corset in the front. Of course, it's gonna include your abdominals in the front. So if you're dealing with some sciatica, whether it's diagnosed or the referred pain that we're is talking about here, be gentle with yourself.

You can heal yourself. It could take usually four to six weeks. If you're doing a nice easy program that's targeted with some of the exercises that we've shown, and I've talked about, and then they've seen in my math class, be patient with yourself, It's gonna be a progressive relief. Usually, rarely does it just go away overnight. So be gentle, be patient.

Ungroup your glutes. Try to ungroup the tuck that you might be living in. Just relax. Breathe. I do believe that the more relaxed we are, the pain will subside and trust yourself and do some smart exercise.

So thank you for joining me today here. This brief discussion about sciatica, and let us know what questions you might have.