Sciatica is a pain in the bum!

Sciatica is the name given to any sort of pain caused by irritation or compression of the sciatic nerve.

This is the definition as found on the NHS Choices website.

In my experience, it is a hugely common problem. I can safely say that around 70% of the people who come into my open yoga classes suffer from some form of sciatica. In the remedial yoga classes this is probably closer to 90%.

So what is sciatica?

Simply put, it is an inflammation of the sciatic nerve, which also happens to be the longest nerve in the body. It runs from the back of the pelvis, through the buttocks (and the piriformis), and all the way down both legs, ending at the feet. So the pain of sciatica can be felt anywhere along this line.

What does it feel like to have sciatica?

Usually, sciatica affects only one side of the lower body. The pain radiates from the lower back to the back of the thigh and down the leg.

Some combination of the following symptoms is most common:

• Constant pain in only one side of the buttock or leg, but rarely in both sides.
• Pain that originates in the low back or buttock and continues along the path of the sciatic nerve—down the back of the thigh and into the lower leg and foot
• Pain that feels better when you lie down or are walking, but worsens when standing or sitting
• Pain typically described as sharp or searing, rather than dull. It can literally feel like a knife stabbing into the deep flesh of the buttock, a red hot searing pain which at it’s worst can be quite debilitating.
• A “pins-and-needles” sensation, numbness or weakness, or a prickling sensation down the leg or shin in some cases
• Weakness or numbness when moving the leg or foot
• Severe or shooting pain in one leg, maybe even making it difficult to stand up or walk
• Pain and other symptoms in the toes, depending on where the sciatic nerve is affected
• Lower back pain that, if experienced at all, is not as severe as leg pain
• Symptoms may intensify during sudden movements, such as a sneeze or cough, or when changing positions, such as when moving from a sitting position to standing up.

For some people it goes away naturally within a few weeks, although some cases can last for a year or more.

What causes sciatica?

Sciatica can be caused by a number of medical issues like herniated or degenerated discs, structural problems in hips and bone structure of the legs and pelvis, or other spinal problems. In these cases, the sciatica is a symptom of a far more serious problem which has to be handled appropriately by medical intervention.

However, as a yoga teacher I believe that the common occurence of sciatica symptoms is due to unhealthy or repetitive moment patterns in the body. Sitting too much, weakness in the legs, hips, lumbar spine and pelvic floor muscles, overuse due to sports like cycling or running, general stiffness and immobility are common causes I see every day. These are not medically derived, but rather down to over- or under-use of the body.

Especially in runners and cyclists, tightness around the piriformis can create pressure on the sciatic nerve which causes extreme discomfort.

How can yoga help?

Yoga is a gentle way to access the stiff, sore and inflamed muscles that cause pressure on the sciatic nerve. Gentle somatic movement, alternating between active and passive stretches, twists that allow the piriformis to release, standing postures to build strength and balances that encourage core stability and pelvic floor engagement all help to relieve the pressure.

There is no quick fix. After tearing my hamstring, I suffered from extreme sciatica as my body responded to the injury by overusing the other muscles around my hip to compensate. From my own experience, I know that continuing my yoga practice eventually brought not only pain relief, but a total recovery. I have also seen the same results in my remedial yoga students, who felt immediate relief directly after class. With sustained and regular practice, the symptoms disappeared entirely.

Do you want to know more?

There is no need to suffer pain from sciatica. Find a remedial yoga teacher who understands anatomy, and who takes care to work with your particular physical needs. Sciatica shows up differently for every body. So a one-size-fits-all approach is unlikely to give you the lasting pain relief that you deserve. Twists and lunges are particulary useful to release the piriformis, but take care of poses that may create torque on the SI joint. Take the legs out to the side in wide-legged postures ( Seated or standing) to work the muscles responsible for abduction. I frequently use straps and blocks as props to help my students get into the right position for their body. it also helps to hold the poses yin-style forlonger, allowing the deeper connective tisuues (ligaments and tendons) to stretch as well.

Also work to increase the strength, activation and mobility of the psoas and QL, ITB and hamstrings. Strong core muscles help us to lift out of the hips with a long spine and this means that stronger obliques (Especially in runners) can help bring the balance and space to release pressure on the sciatic nerve. The best bit of advice though, for anyone pained by sciatica is this: Don’t stop moving! Sitting and slumping is the worst thing to do for sciatic pain, although your entire body may be screaming out for it. It may sound counter-intuitive, but moving keeps the muscles supple and engaged. Moving in the right way, with lazer-focussed yoga postures to target the cause of the pain instead of treat the symptoms, will give you long-term relief. But it requires consistency and patience. Good luck!

Article written by Cathy Richardson,  Diversity Yoga www.diversityyoga.co.uk