Have you ever felt a sensation like a lightning bolt strike your lower back or down your legs?
Chances are you may be experiencing sciatica. Named for the sciatic nerve which originates in the lower back. Sciatica is experienced by at least 5 percent of the US adult population, and there is about a 40 percent chance an individual will experience the condition in their lifetime. Sciatic pain can also materialize as a dull soreness, numbness, tingling, or throbbing heat. Acute pain can make it nearly impossible to walk or stand, while the more chronic expression of the condition can cause an ache which makes it hard to sit and focus on daily activities. Bouts of sciatic pain can last anywhere from a few hours to several weeks (Keller, 2019).
Technically, sciatica is tenderness or pain anywhere along the sciatic nerve, which starts in the lower back then threads through the gluteus muscles, and down the back of the legs to the soles of the feet, ultimately terminating in the big toes. The sciatic nerves (one for each leg) are the two largest nerves in the human body(Cronkleton & Bubins, 2019). Sciatic pain is often a sharp, throbbing, even burning sensation which extends down the leg. It can be experienced on both or on only one side of the body. Pain occurs in the sciatic nerve when it becomes compressed, irritated, or injured (often in accidents which occur to the lower vertebra). However, accidents are not the only cause of sciatic pain– tight, overused, or injured muscles can also contribute to the condition (Solan, 2017).
Common Causes
In terms of injury, it is fairly common for sciatic pain to be related to a herniated disk (also known as a “ruptured disk”, “pinched nerve”, or “slipped disk”). This can be the result of injury or trauma or even extended periods of intense physical activity, or even years of consistent bending or sitting for long periods of time. However, there are other conditions which can contribute to sciatica including osteoarthritis, which can narrow the space through which the nerve exits the lower spine. This can in turn injure the nerve fibers in that area, causing inflammation. Additionally, conditions such as piriformis syndrome can also cause sciatic pain when the piriformis muscle in the buttock compresses the sciatic nerve. Piriformis syndrome can be caused by either under or overuse of the piriformis muscles, and can be caused by anything from sedentary activities like computer work to active practices like your daily yoga practice.
But don’t write yoga off just yet, because anecdotal experience of practitioners affected by the condition and research surrounding relief of the condition indicate that yoga can not only provide relief, but actually cure sciatica.
Treatment
Sciatic pain can be tracked as far back into history as the Roman empire, when treatments ranged from leeches to hot coals. In the 20th century, traditional medical treatment generally involves various creams, medications, and injections (Keller 2019).
But looking into the field of complementary and alternative medicines shows that perhaps one of the most effective treatments for sciatic pain may actually be yoga itself!
One study found that yoga poses including cobra and locust to effectively improve sciatic pain (Singh, & Singh, 2013). More recently, research has pointed to yoga’s ability to reduce chronic low back pain, improve limitations in activity and also to reduce the use of pain medication (Saper, et al. 2017). This is important given sciatica can be challenging to differentiate from other types of low back pain.
Whether the source of your sciatica is a herniated disk or pressure on the nerve due to piriformis tightness, yoga may be just the ticket not only to relief, but even to a possible cure. More than half of those affected by the condition can soothe and reduce sciatica flare-ups by engaging in some form of exercise, in particular yoga, to strengthen the back and help relieve the pressure on the root of the sciatic nerve root. However, this is not to say that more intense pain does not call for complementary treatment modalities such as medications to ease the inflammation, or to replace the advice of a doctor in cases severe or recalcitrant sciatica which may even require surgery to remove a portion of the disk that irritates the nerve root.
However, a yoga mat and a clear plan may be the most low-cost, effective, and accessible treatment modality for a sciatica sufferer (Solan, 2017).
In cases of a herniated disk, a yoga practice which builds steadily from gentle to basic foundational asana can align, lengthen, and strengthen the lower back and legs. Yoga can help reduce the effects of a herniation, at times this practice can even reduce the herniation itself. One study which evaluated both nonspecific low back pain and sciatica found that yoga was not only a safe but effective treatment for those with both conditions in the presence of spinal disc extrusions and bulges (Monro, et al., 2015).
In cases in which the piriformis is the culprit of sciatic pain, a gentle practice is required in order to ease the tight muscle and not overwork it causing further discomfort (Keller, D. 2019). One study found that paschimottanasana (seated forward fold) not only relieved sciatic pain, but did so with effects that lasted for two weeks, which was much longer than the relief from the Neurodynamic mobilisation technique, which is also a common treatment for nerve-related condition (Baxi, Mokashi, Borade, Palekar, & Panse, 2017).
But yoga may not only help sciatica suffers of all kinds manage their pain, it can also completely cure it in some cases. Candy Doran, a former sciatica sufferer speaks from experience when she says “You definitely can use [Yoga] to bring your sciatica under control and make flare-ups less and less common. But it is also possible to cure your sciatica with yoga.” Candy’s yoga practice is what she credits with her status as sciatic-pain-free for 11 years. This cure is no quick fix, given that nerve and spinal issues heal from injury slowly, but over time, practitioners typically learn what works for their body and on average can control their sciatic pain in 6 months to a year of regular practice (Solan, 2017).
The preventative practice of yoga becomes the cure because by addressing the issue before it becomes chronic and priming the body and it’s alignment to prevent future flare- ups. Yoga does this by stretching the muscles and bones, increasing and sustaining range of motion, sharpening focus, heightening self-awareness and initiating the relaxation response. One of the primary goals of yoga is the create space in the spine between each vertebrae which can decrease disk compression and herniation. By toning the body and promoting better postural habits, yoga can begin to undo and prevent physical aspects of sciatica, while working with the mind in yoga allows one to be more in tune with the body and more mindful of what it needs and when it needs it, while also decreasing tension that promotes inflammation and pain. Yoga does this all while being accessible anywhere with no equipment or special clothes, silently, without compromising one’s dogma (Fishman, & Ardman, 2005).
This makes yoga perhaps the MOST widely accessible and successful not only preventative but even possibly curative treatments for sciatic lower back pain!
References:
Keller, D. (2019). 7 Poses to Soothe Sciatica. Yoga International. Retrieved from: https://yogainternational.com/article/view/7-poses-to-soothe-sciatica
Cronkleton, E & Bubins, D. (2019). Yoga Poses for Sciatic Pain Relief. Healthline. Retrieved from: https://www.healthline.com/health/yoga-for-sciatica
Singh, A. K., & Singh, O. P. (2013). A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica. International journal of yoga, 6(1), 71.
Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., … & Roseen, E. J. (2017). Yoga, physical therapy, or education for chronic low back pain: a randomized noninferiority trial. Annals of internal medicine, 167(2), 85-94.
Solan, M. (2017). How One Cyclist Managed Sciatica with Yoga. Yoga Journal. Retrieved from: https://www.yogajournal.com/practice/easy-rider
Monro, R., Bhardwaj, A. K., Gupta, R. K., Telles, S., Allen, B., & Little, P. (2015). Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment. Journal of back and musculoskeletal rehabilitation, 28(2), 383-392.
Baxi, G. D., Mokashi, M. G., Borade, N. G., Palekar, T. J., & Panse, R. (2017). Yogasanas as a Neurodynamic Mobilisation Tool in the Treatment of Sciatica. National Journal of Integrated Research in Medicine, 8(4).
Fishman, L., & Ardman, C. (2005). Relief is in the stretch: End back pain through yoga. WW Norton & Company.