Tuesday, June 30, 2009

4 Ways to Ease Symptoms Associated with Sciatica

Sciatica describes a cluster of symptoms rather than a true diagnosis and involves irritation of the sciatic nerve and/or it’s branches as they exit the spine. These symptoms can include back and/or leg pain (usually just one leg), abnormal sensory symptoms such as numbness and tingling and weakness or difficulty controlling the affected leg. Most people do not present with all of these symptoms, but in severe cases all may be found.

As stated, sciatica is really a set of symptoms and can be caused by several insults including: disc herniations (bulges), spinal stenosis, piriformis syndrome or some external source usually related to postural habits. All of these causes involve some form of compression on either the spinal nerve roots or on the sciatic nerve itself and can eventually lead to irritation and pain. So, it makes sense that the goal of conservative therapy would be to alleviate this pressure and restore normal mechanics to the spine and pelvic region in order to prevent the condition from returning. In cases where severe spinal stenosis or a large disc herniation is present, physical therapy may not be effective and surgery may be the only option.

The following techniques can be used to alleviate sciatica and should not cause increased symptoms. If increased pain, numbness or weakness is experienced, then a medical professional (orthopedic physical therapist or orthopedic medical doctor) should be consulted.

#1 - Lumbar Prone Press-up
The lumbar press-up stretches the spine into extension and is often useful in reducing pain associated with disc pathology. However, extension of the spine may make symptoms associated with stenosis worse, so be sure symptoms are not increased while in this position. Perform as needed to alleviate symptoms and hold 15-45 seconds.

#2 - Lumbar Flexion Stretch
This stretch will round the low back, which will reduce pressure over nerve roots associated with spinal stenosis. Perform as often as needed and hold 15-45 seconds.

#3 - Piriformis Stretch
This stretch helps to loosen the piriformis muscle which is a rotator of the hip and located under the gluteal (buttock) muscles. The sciatic nerve runs directly under this muscle, so when it is tight extra compression can be caused over the nerve. Hold the stretch 30 seconds to 1 minute. Start with the stretch on your back and move to the stomach down version if the first one is too easy. Both pictures show a stretch of the left piriformis and should be felt in the buttock region.

#4 - Piriformis Self Massage
Using a foam roller or tennis ball as shown in the picture can be a great tool for easing piriformis tightness and reducing pain. The right piriformis is being worked in the picture. Spend 2-3 minutes on the roller as needed to alleviate symptoms.

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