Sciatica is a pain caused by a nerve pain. There are many nerves
that originate in the lumbar spine, they exit the spinal cord through these small
holes, then they travel inside the buttock area, and here one of them is called “sciatic nerve”.
Then, the sciatic nerve travels down to the back of the tight,
and then it splits into two nerves, one that goes to the front of the leg (or tibial nerve) and
the other branch to the back of the leg (the peroneal nerve, also called fibular nerve).
When a nerve is inflamed or injured, it causes a typical pain that is more like a burning,
electrical shocks, or stabbing pain. If the nerve damage is severe, it will also cause
muscle atrophy and sensation loss. Low-back pain with nerve injury is
relatively rare. The most common condition that causes this is a lumbar disc herniation.
In this video, I’ll show you 3 resting positions to alleviate sciatica pain,
3 exercises that you can do for pain relief, and 4 activities that you should avoid.
Sciatica is usually self-limiting and resolves within a few weeks. Therefore, the purpose of this
3-3-4 method is to provide some pain relief while your body does the healing process.
Let’s talk about sciatica today
Last year I had a sciatica caused by herpes zoster virus, or shingles.
I know how bad this pain can be. I started having a dull deep pain in the inside of my
buttocks and radiating down the back of my thigh and leg. Two days after,
the skin rash erupted and I it was confirmed this was shingles.
The pain was constant, and I used the techniques that I’ll show you in this video to get some pain
relief and avoid pain medications. The sciatica lasted about 4 weeks and I don’t have any pain
now. I did another video where I tell the story of what happened with my varicela zoster disease.
But the most common cause of sciatica is not shingles, it is actually disc herniation.
First, let me explain what disk herniation is. The disc is a cushion of water between two
vertebraes. Its function is to act like a shock absorber. But this disc can degenerate and break
up, and the material that is supposed to stay inside the disc then gets out.
If these extruded content compresses a nerve that is going to the leg,
then we call this herniation > and the symptoms of pain going to the leg is known as sciatica.
The pain from sciatica will be different from the pain from the degenerated disc.
If it is just the degenerated disc, the pain will be referred to the lower back,
the buttocks, hips, and inguinal area. The pain from sciatica is felt in the thigh and
leg and it is because the disc is compressing the nerve that goes to the leg and foot.
It usually affects only one side. The diagnosis of sciatica is easy to be made.
You need to see a doctor. The doctor will do some tests with you, like
raising your leg like this. This test is called straight leg raising and it stretches
the sciatic nerve causing a specific pattern of electrical shock sensation.
That is why we avoid any exercise that stretches the sciatic nerve when it is inflamed. The doctor
will also examine if the nerve is functioning normally, like testing the reflexes with a hammer,
checking if there is muscle atrophy, and the sensations on the skin. If the doctor suspects
that there is a sciatic nerve injury, then the doctor may order a CT-scan or MRI, and sometimes
a electrodiagnostic test called electromyography. If you have low back pain caused by a disc problem
without pain radiating to the legs, you may watch my other video
for degenerative disc disease of the lumbar spine. Sometimes the disc herniation will affect the
nerves that control the bladder or bowels, and this is what we call cauda equina syndrome.
This is a medical emergency, and you need to go see a doctor immediately,
otherwise you may develop incontinence of bladder or bowels that may not be reversible.
First, I’ll show you the 3 relieving positions for sciatica:
So, this is the zed-lie position, what you do is you find a comfortable position on the floor. grab
a chair or it could be a couch, you're going to put your knees and legs on the top of the chair,
and pull until the knees are above your abdomen, put a pillow under your head, and
now try to find the position where the small of your back, here the lumbar spine is flat,
and you are not having the sciatic pain. you're not having the pain going down the back of your
legs anymore. you are relaxed if you can find this position of comfort. stay here for as long as you
can, five minutes, 10, or even 20, 30 minutes, because this is almost like taking a painkiller,
you will notice that this is the same position that i showed in the previous videos. if you
have a disc problem, a lumbar degenerative disc disease, and also if you have the facet joint
diseases. Now, if you have sciatica this is an excellent position, that's why we recommend
this zed lie position, a lot to our patients who have acute low back pain, because it relieves the
pressure in the vertebras, in the discs, the nerve roots, the facet joints, and if you stay
here for about 30 minutes, the pain is alleviated a lot, and then you can do a few more activities.
Now, this is the second resting position, if you want to alleviate the pressure on the disc and
the herniated disc, you're going to raise your trunk on your elbows, try to be 90 degrees here,
and if you can tolerate this position, so you just find a comfortable position that you're not having
the pressure going to down to your legs, and you stay here, then you can be reading a book,
watching a video, and see if you can stay in this position for about 5, 10, 20, 30 minutes,
because when you do this, you are releasing the pressure on the nerve root that is exiting from
your lumbar spine, and if you have a disc problem, this is excellent, because this is going to help
the disc to, if there's a disc prolapse to heal faster. Now, if you have facet joint pain,
which i explained in a previous video, this is going to aggravate your pain, so don't do this
if your pain is aggravated,, it may be because you also have facet joint osteoarthritis,
and this position will not relieve, but if you only have a sciatica from disc herniation,
or disc problem, you're going to feel a lot of relief from this position.
The third position of comfort is the prone lying position. so you're going to lie down on your
stomach with a pillow or cushion under your abdomen, and you're going to try to relax here,
lowering your head, and the key is to relax, and find a position that you don't have any pain,
so they try to move your legs, maybe put another two pillows, or three, and move your neck
and when you find that position that you have zero pain, you don't have any sciatic pain,
that's the position you can stay for five, ten, twenty minutes, because when you find
that position, you know that you are relieving the pressure on the nerve root, the sciatic nerve,
Now, i'll show you the three exercises that you can do to alleviate your pain.
The first and most important is to keep active, you should keep walking,
preferably on a flat surface, don't walk uphill or downhill, walk within your limits,
if you can only walk five minutes, then walk five minutes, many times during the day,
try to increase the amount of time that you walk, and also how many times you walk during the day.
So, this exercise is this sloppy push-up, you're going to get a mat or your carpet,
and you're going to start putting your arms in front of you, and you're going to
raise your trunk, and if this doesn't cause any pain, then what you're going to do is
raising and do this, two, three, keep your your hands in front of your body. Five, six,
seven, and eight. if this is okay, you can increase to 12 repetitions,
20 repetitions, and you can do this once a day, or two, or three times a day,
because this exercise should not be causing pain, so if you do this exercise and cause pain,
stop doing it. But if you do this sloppy push ups and you feel that your pain is alleviated,
then you can continue doing this exercise for your sciatica pain.
So, this exercise is similar to the one that we just did on the floor, but when you start getting
better, then you can do this exercise standing up, so if you are in line, waiting for something,
or at home, or at work, and you can't always find a floor to do this sloppy push-up exercise,
what you do is, you put your hands on your buttock areas, and just keep doing this, you don't need to
look up at the ceiling, if you have neck pain you can look in fron,t so you do one, two,
three, four, and you do this eight repetitions, 12, 20. if this aggravates your pain,
you don't need to do it,, but when you when you do this back extensions, if you feel pain relief,
then it means that it's helping your pain, and you can continue doing this exercise.
There is no need to start a specific routine of exercises, like going to the gym or
stretching, or strengthening, until the sciatic leg pain gets resolved,
gentle stretching can be done, but it should not increase the pain.
Now, I will show you the four activities that you should avoid.
So, it is important to learn how to get up from a chair, or a couch, or sofa, because if you just
simply do this,, then it's going to put a lot of pressure on your lumbar spine and aggravate
your pain, so what you need to do is, there is a right way of getting up, and this means that,
assuming that you are sitting upright, and sitting correctly, here when you get up,
you have to get close to the edge of the couch, or the chair, or even your bed in the morning,
when you're getting up from the bed, and even turning to the side a little bit,
and using your quadriceps, and your hips, so pay attention to my lumbar spine, i'm not going to
bend forward or backwards. I'm going to use my quadriceps, so this is how you get up.
So, this is important if you are doing the dishes, or ironing, or doing anything that you have to do
with standing up, because when you are doing the dishes, if you are like this, you are bending your
trunk all the time, or ironing, that you are ironing all the time like this, what we tell
the patients to do is get a box or a little stool, put on the floor, and one of your feet will be on
the on the top of the box, so when you do this you always, you're keeping your lumbar spine straight,
and it's hard for you to be bending, so then you remember that by keeping this the foot on the
stool, you have to be ironing or doing the dishes, without bending forward, so the higher this the
better, but if you don't have anything higher than this a box, a shoe box, or two shoe boxes,
should be okay, just be careful that they don't slip, and you don't fall, but you can get a stool,
and you can do this, and leave in the counter top, or leave close to the sink, where you are you're
doing most of your activities, that you have to stand up, and do activities standing up like this.
The other important thing is to use some sort of lumbar support, if you're sitting, if you
work with a computer, get something that you can put to support, to support your lumbar spine,
i got this for my car, so i used this in my car, i bought this 10 years ago when i had my episode of
acute low back pain, and i still love it, i use in the car, so this is how it works. you put in the
in there, and then it creates this support here for the lumber spine, but there are if you don't
have one of this you can have a towel, make a roll of a towel, or you can just get a piece of foam,
but you see it creates this nice curvature that supports the lumbar spine, and then you can relax,
but you can use this especially for people who spend many hours in the car,
it's really important that they have a support for the lumbar spine, if they have disc
pain, lumbar disc pain and they can use this, also for computer work, for desk work,
or even when they are watching tv, it's always nice to have a lumbar support that will give
this curvature of the lumbar spine, and the depth of the lumbar spine really depends on your size,
how much curvature you have, so you really need to try a couple of different
sizes, and depends on your body size, but for me, this one i really like to use this in the car,
and i'll put a link for this for you to find in the description of this video below,
Number four, avoid stretching your hamstrings for the first weeks. The nerve is inflamed,
and if you keep doing this, you will have more pain, give a few weeks, maybe six to
eight since the start of the sciatic pain, then, you can start doing some hamstring stretches.
Here, is an example of hamstring stretching, so if the person tries to do this, or stretching
the hamstring, it's going to stretch the sciatic nerve. Here, and it's going to shoot the pain,
so don't do this if you have sciatic pain. Now that you know what to do in the first
4 to 12 weeks, we call this the “acute phase”, I’ll tell you what you need to do
if your pain lingers beyond 3 months. In most cases of chronic low-back pain, I find
that muscle pain, or myofascial pain syndrome, is a very important factor that perpetuates the pain.
Well, what happens is that during the acute phase, the muscles were all tense and tight to
protect the lumbar discs. So, after 3 months, the disc herniation or zoster is resolved and
your body healed that acute problem. However, what may still be aching are the muscles. We
call this myofascial pain syndrome. I have a video about myofascial pain that you can watch.
Smoking accelerates the process of disc degeneration and weakens the bones. So,
if you smoke, and have low-back pain, this can be a good reason for you to think
seriously about quitting. Watch my other video about smoking and pain.
Take a look at this other video to find out if you have predisposition to develop chronic pain,
there are some factors that put a person at higher risk to develop fibromyalgia. Check here.
If you know someone with sciatic pain, press the share button below and send this video to them.
In the comments box below write down if you have sciatica and which positions and
exercises from this video worked best for you. Go to the description of this video below you may
find a summary of these positions and exercises that you can download and print to do at home.
There is a link to all products that I mentioned in this video if you want to purchase them.
Please, don’t forget that this video is for educational purpose only.
If you have a condition that needs medical advice, please talk to your doctor. And if there is an
emergency, go to the nearest emergency department. If you like this video, give a thumbs up here,
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Thank you for watching. Good bye.