Sciatica is a very complicated condition.
And there's so many different causes to it.
In this video, I'm going to cover 10 treatment mistakes that people often make when trying
to help their sciatica problem.
But let me just preface it with this thought so that you can understand why you might be
getting certain treatments from different individuals, different healthcare professionals,
or you may be looking them up online to wrap your head around why some of these things
are helpful, but harmful.
At other times, well, there's different intensities of sciatica that you might go through.
And there's also different causes of sciatica, it might be coming from the low back could
be coming from the pelvis, or even the way that you're moving, or muscles can also affect
this too, because there's so many different causes.
There's different treatments for each of those causes.
And they may be even happening at the same time, you might have a low back problem and
a pelvis shift and a muscle problem all happening simultaneously.
So it matters what treatment you're doing, and when you're doing it in the course of
sciatica because a certain treatment might be great when static is very intense, but
it might be useless when it's relatively mild, and another treatment might be great for sciatica
that's coming from a herniated disc problem, but might actually make things worse, if it's
coming from a shifted pelvis problem.
I'm going to explain why all 10 of these problems might hurt your sciatica problem.
But before you go through all 10 of these problems and possibly get more discouraged
about your sciatica issue, I want you to know that I've got a full playlist, tons of videos
on how to help sciatica.
It's linked in the description below.
Once you're done with this video, go check that out so that you can begin to find the
right things to do to help your sciatica problem.
And at the right times, of course.
So let's get into the top 10 Number one is resting for too long, that you might even
be following doctor's orders with this, your doctor may have told you go do bed rest go
sit on the couch goes to the recliner go lie in bed until the problem goes away.
Or very often, what I hear patients tell me is my doctor just said to go rest.
They didn't say how long they just said until it's better.
But after a week, or even just a few days or even several weeks of being in bed rest.
What the patients are saying is they're getting up and feeling worse when they move around.
Oftentimes even the pain gets worse when just resting.
Now this is good advice for very intense sciatica.
Because the nerves are irritated and getting the irritation to come down means you have
to move less temporarily.
But once the irritation has gone down a certain amount, then it's time to incorporate some
movement and bedrest is no longer a good idea.
And there's no set timeframe.
It's not like it's going to be, you know, one day for everybody or one week for everybody,
you have to have a good handle on when you're able to begin to move without making the problem
worse, you might only tolerate a minute of movement or maybe 10 minutes of movement.
Before it starts to get worse, you have to move within the amount of time that you can
tolerate movement without making the problem any worse.
And number two is exercising back muscles.
This exercise is often given to patients in a variety of different ways.
Sometimes, you're lying face down and you're picking up your upper body.
And the goal is to exercise these back muscles that are right here.
Other times you're just standing up putting your hands on your waist and leaning backwards
like this.
Whenever you exercise those back muscles, it usually adds more compression to the spine.
And if your sciatica problem is coming from a herniated disc in the lower part of the
spine, then you're going to add more compression to that disc and possibly directly to the
nerve.
And over time because it may not be an instant pain like you do the motion.
You do the exercise and you right away feel pain.
It may be that it comes on worse as the days go by of doing this exercise.
Definitely as the weeks and months go by of doing back exercises, it tends to get worse
in every case of sciatica that I've ever seen in my career and that I've trained with patients
on and that I trained as a as a mentee with my mentors.
Weak abdominals is part of the root problem.
And exercising the back muscles that are on the other side of the spine tends to feed
the problem because when you exercise the abdominal muscles, it corrects the imbalance.
Now exercising abdominal muscles is probably not the best idea early on when it's severe.
But as the symptoms calmed down, then you need to begin to get those ab muscles active
again.
Problem number three is exercising through pain.
Now even though there's good exercises to do for sciatica at certain times for certain
types of sciatica, if you're hurting, it's not a good idea, even if it's a good thing.
Your nerves, your sciatic nerve especially is telling you it doesn't like what you're
doing.
So don't force it because you're going to further irritate the problem.
And sometimes there's healthcare professionals out there fitness professionals, friends family
that might tell you Oh, it's okay.
This is going to help it just go through it because it helped them.
And if it helped them, they're assuming that it's going to help everybody but if your sciatica
problem is from a different source than their sciatica problem and he might not help you
might actually make the problem worse, you should be able to recover from your sciatica
problem.
By doing exercise that feels good to do, maybe you get tired, but it doesn't make your sciatica
worse.
That's how it should be.
Number four is hamstring stretches for sciatica, anything where you're putting your foot up
like this, where you might be sitting on the floor and your legs up and you're reaching
towards your foot, and it puts a stretch through this area of the leg.
This tends to be a bad idea for sciatica, because the sciatic nerve is right between
those hamstring muscles, just like I've gotten the skeleton right here.
And whenever you add a stretch to this area of the body, you're stretching the entire
sciatic nerve pathway, in addition to the muscles, and you could be irritating and already
irritated sciatic nerve.
Now the hamstring muscles will usually shorten as well because they're innervated by the
sciatic nerve, and their response is to stiffen up and tighten up.
So you might actually feel relief in the moment when you're doing stretching.
But if you're repeatedly doing hamstring stretches, in an effort to fix a sciatica problem, you're
going to tend to keep that nerve irritated.
And it's not going to go away for the long term stretching is also not correcting the
root problem.
But it might bring you some short term relief.
As long as you're not aggravating the sciatic nerve, which is really difficult to do on
a hamstring stretch, you're probably going to get the nerve to the number five is a figure
for stretch.
So what this is, is when you take your leg and you bend the knee, and you move your leg
in this position right here, and it puts a big stretch through the glute, the back of
the hip, the butt area.
And because this the sciatic nerve, as depicted here with this green strap is right there
and there's muscles in the area too, you can stretch everything in the area.
And it may feel good because the muscles get tight there like with the hamstrings, but
long term, you're adding a lot of stretch to that nerve.
And it's going to stay irritated just like with the hamstring stretch idea.
Number six is massage for sciatica, because the sciatic nerve tends to be buried in muscle
on the back of the hip and the back of the thigh, it's often tempting to start to massage
the area.
And if you find a stiff muscle massage, it actually kind of helps.
The problem is when you find the nerve, and people typically know it when you push on
a certain spot, and it starts to radiate out a bit.
It even hurts so good.
That kind of sensation, it typically is a nerve.
And if you rub on that area, you're just rubbing an irritated nerve.
It's the equivalent of if you had a cut on your skin, and you just rub it, it's hurting
it and it's irritating it more and you're going to make that injury worse, it's going
to take longer to heal.
Now there's not an actual cut on the nerve.
And it's not bleeding necessarily, but there's irritation to the sciatic nerve.
And if you rub it out, it's going to make it worse.
There's some people do this with a tennis ball, they'll sit in a ball, a foam roller,
they'll get a professional massage, or they'll get one of those massage guns and stick it
right where the nerve is, and do vibration massage, percussion massage, all of these
forms of massage are typically going to irritate the nerve more than you have to be careful
with this and full transparency.
When I see a patient here in the clinic for sciatica problems, I do massage on them.
But I can tell the difference between a nerve and a muscle when I'm feeling somebody.
And I'd make sure to stay only on the muscles in my touch tends to be significantly lighter,
but way more effective, because I'm very strategic with where I go in.
If you don't have that kind of sense.
Many people do actually they can kind of tell when they're in a muscle versus a nerve.
But if you aren't certain you're not sure.
And then you've tried to massage and it's made things worse, I'd back off of it and
not do it.
And this is especially the case with a very irritated sciatic nerve.
You don't want to be rubbing it out because everything's going to hurt at that point.
Rest tends to be the best thing for an extreme irritation.
But then you got to get moving, you got to start doing other things.
Massage could be an option, but use extreme caution that you're not on the nerve.
Number seven is relying on braces.
Sometimes people wear a brace, especially around their low back their waist area to
get stability for their vertebrae in their back.
This is helpful if you've got a disc herniation that's contributing to the sciatic nerve problem.
There's also braces that go around your legs to try to get the nerve, the sciatic nerve
going down the leg.
These braces might all be helpful, but only in the short term.
They're not addressing the root problem of sciatica, the muscle imbalances that shifted
pelvis, there's other things that are causing sciatica, and these braces aren't going to
fix it, they're going to buy some short term relief, and it's natural.
It's not taking pain medications, which of course can cause other issues side effects,
but relying on braces to solve the problem like putting it on and saying oh is going
to fix my sciatica problem.
You can't do that you have to tell yourself; I'm putting this brace on to buy myself some
time to reduce the irritation so that I can work on the right exercises that are going
to take the problem away for the long term.
That's often the case that people will wear braces feel pretty good really if they have
relief because they're not always effective with everyone, and after a few days, at most
a few weeks, the relief that they got from the brace starts to wear off and the symptoms
come on just as intense as they were before the brace and now the brace feels ineffective.
Now doctors will often recommend braces to patients, and there'll be happy when they
feel relief.
And then doctors will present in the step by step process, they'll say, well try the
brace out the brace didn't work.
Let's try the next thing and the next thing and eventually it goes down to surgery.
So let's go down that pathway next.
That takes me to number eight, a doctor's typically going to recommend a medication.
If you haven't tried over the counter medications for your sciatica problem, the doctor might
recommend prescription strength medications.
Now all of these medications, whether the prescription or over the counter, they're
just masking the pain symptoms.
Some are more focused on nerve some are more focused on other stuff like the ligaments,
the tendons, the bones, other tissues, non nerve tissues.
Basically, the purpose of these medications is to buy you some time to reduce the symptoms
so that you might sleep better.
So you might tolerate walking and doing normal things that you have to do being able to not
be so grumpy when you're in pain medications have their place in treating sciatica, but
they're not curing sciatica for the long term, they're not addressing the root problem, they're
merely buying you some short term relief.
And you have to understand that there's side effects to taking all these medications that
can affect your liver, your kidneys and other organs in your body.
If you're relying on them for the long term, it's just not appropriate for you to take
a medication and assume that it's going to fix a sciatica problem.
There's some sort of mechanical issue in your body that setting up the sciatica issue.
And that mechanical problem needs to be addressed and medicine does not address it.
It's usually a strength imbalance that will address a mechanical issue.
And if the painkillers don't work brings me to number nine, a doctor is going to recommend
injections and relying on injected pain medication is very similar to taking medications by mouth
except this time, there are certain medications that are injected directly into the area they
suspect is the root of the problem.
Sometimes they use it as diagnostic like they'll say, well, let me inject your spine at this
specific place to see if that's the main cause of the sciatica or Let's inject a little bit
lower in the SI joint.
That's another common place that gets injected for sciatica, because the SI joint can get
affected when the pelvis gets shifted, and they'll test to see if you get relief or not.
But even if you do get relief, you have to understand that this isn't going to fix the
problem.
It's just pain medication in that area, it's causing a decrease in inflammation, and it's
helping the pain temporarily, you need to use that time to go fix the muscle imbalance
so that you can then have long lasting improvement from your sciatica problem.
Plus, one of the dangers of using steroid medications that are injected is that it breaks
down connective tissue over time.
Connective tissues are things like tendons and ligaments, and even the discs in your
spine are made of connective tissue.
And these can all be damaged over time if you get repeated cortisone or steroid shots
for pain relief.
And number 10 is the last step that a doctor might take you through, it's getting surgery
too soon, because surgery has its place as well.
And it might be beneficial for you, especially if you know that the MRI shows a massively
herniated disc that's directly compressing a nerve.
And it's consistent with the symptoms that you have like it's on the same side that you
have your sciatica problem like the left for instance.
And it's at the nerve root level that is consistent with the way that your weakness and your pain
shows up.
That's another thing weakness.
Because if you have intense pain, but not necessarily a ton of weakness, you might not
actually need a surgery because the nerves working at least to the muscles you have strengthen
the muscles in use of those muscles.
It's only when there's debilitating pain and debilitating weakness, that a surgery is going
to be highly recommended to solve a sciatica problem.
Now, I've seen tons of patients that have had mild disc herniations that are pushing
a nerve, even moderate disc herniations pushing on the nerve, and they've done just fine with
natural treatments like what we do here in our office guiding on proper exercise, fixing
the root muscle imbalance so that they can get the pressure off the nerve off the disk
and give the disc a chance to heal and the nerve to operate.
Normally, they'll do just fine without having surgery.
We've even seen patients with severely herniated discs that are obviously pressing on the nerve.
And we've told them, you might need surgery.
Let's give this a go see how you do and they've actually gotten better just fine.
Because it turns out the main root of the problem wasn't coming from the spine even
though the MRI showed a severe disc herniation with apparent pressure on the nerve.
The main issue was actually the pelvis had shifted which we treat here naturally just
fine.
And that relieve the sciatic nerve pressure.
We still educate and coach and treat on taking pressure off the disc in the spine so that
that doesn't become the main reason and lead to an unnecessary surgery potentially because
it could have prevented it by treating them muscle imbalances to relieve the pressure
on the disk and heal the disk and allow the nerve to operate well.
But sadly, I've seen tons of patients that ended up getting this surgery, whether it's
a diskectomy procedure or micro diskectomy procedure, or fusion surgery where they put
rods and screws into the spine to hold the spacing in the spine, well off the disk and
off the nerves, and they have a relapse of their back issue, they have another distance
herniated above or below and that can cause sciatica symptoms as well, when it relapses
that's just dreadful for me, because I have to tell my patients that the root problem
was never fixed.
And then they come to the realization that they might have had a surgery when they didn't
need to, because now they go down the pathway of fixing the root problem.
And if they improve, which they usually do, then they start to say, so I didn't need that
surgery.
And I have to tell them, Hey, I didn't see you at the beginning when you had all this
problem.
I don't know what you look like at that point.
But what I know now is the problems better, it's maybe even gone.
And at least you don't need a second surgery.
And that's good news.
So use caution when signing up for surgery, make sure you go after treating the root problem.
And again, there's a playlist down below in the description where I lay out all the root
problems and how to fix them.
In our playlists on YouTube here, go check out that link.
It's called sciatica pain help.
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I hope to see you in the next video.
Bye