Q: What are some strategies to “cure” sciatic problems and to provide preventive maintenance?
A: The sciatic nerve cord is the body’s largest bundle of nerves, branching out from three vertebrae in the lumbar region of the lower back.
Because it runs beneath the buttocks and down the legs, inflammation or compression at any point can cause pain all the way from the lower back to the feet, in just a few spots, or in any spot along the way.
The radiating pain down the butt and legs distinguishes sciatica from plain-old low back pain. Diagnosis by an orthopedic professional is highly recommended before you proceed with any physical activities.
Poor muscle conditioning, poor posture, excess weight, tight hamstrings (sometimes caused by sitting too long), and overusage of the hip muscles are often culpable for sciatica.
If you are a golfer or a tennis player, the twisting-while-flexing motion inherent in these sports can also cause sciatic inflammation.
Men often develop sciatica because they carry (and, therefore, often sit on) a wallet in their back pocket. Osteoporosis, spinal stenosis, pregnancy and degenerative disks must also be considered as culprits.
Another common complaint is called “periformis syndrome,” where the periformis muscle — which lies under the gluteal muscle, and is involved in hip extension and leg movements away from the body — becomes tight or swollen from an injury.
What to do? The Agency for Health Care Policy and Research recommends the following:
1. Use pain as your guide. Control discomfort with over-the-counter pain medications that contain acetaminophen, ibuprofen or aspirin as recommended on the bottle.
2. Gentle stretching can relieve pain. “Stretching,” by Bob Anderson, is an excellent book with suggestions for what to do for sciatica.
3. Rest, but not for more than two days. Dr. Robert Gamburd, an orthopedic physician at Sports, Orthopedic and Rehabilitation in Menlo Park, Calif., says, “Two days of rest is the point of diminishing returns. Beyond that, deconditioning issues become important.”
4. Check posture and alignment throughout all your daily activities.
5. Begin walking for exercise as soon as possible. Avoid high-impact exercises and stop exercising if doing so creates sharp, shooting pain or numbness.
6. Work into strengthening exercises for the abdominal and back area gradually.
Preventing sciatica involves stretching the muscles involved with spine and leg flexibility (those of the hips, butt, hamstrings, and lower back), and strengthening the core muscles of the back, lower back and abdominal area (particularly the oblique and transverse muscles) that assist in maintaining good posture. Also: lift properly, pushing instead of pulling (whenever possible), and control your weight.
Many problems can be avoided simply by taking inventory of the things you use every day and checking them for wear, specifically, your mattress and your shoes.
If your mattress dates back to the Carter administration, it is time to go shopping! While you are at it, pick up a new pair of workout shoes. They are generally only good for four to six months of regular use before breaking down, at which point the “breaking down” can travel to your back, since most of the shoe’s support is gone.
It is always wise to get a proper medical diagnosis before self-treating. Check with your regular physician for a referral to an orthopedic specialist or physiatrist. Many people find relief through chiropractic manipulation and acupuncture. A few sessions with a physical therapist would also be helpful.
Linda J. Buch (linda@ljbalance.com) is a certified fitness trainer in Denver.
