Sciatica
Do you have a recurring back problem? Does lifting a grocery bag, a misstep, or bending cause you pain? When you cough or sneeze, does a sharp pain tear through your body? Do you have to change positions often to get rest? Do your legs ache painfully at the end of a long day? Do your toes or feet ever feel tingly for seemingly no reason?
If the answer was yes to any or all of these questions, you may be the victim of SCIATICA.
The sciatic nerves are the largest in the body, beginning in the lower spine, running down the back of the leg all the way down to the toes. Each branch is about the diameter of a finger. As with any other nerve in the body, when this nerve gets pinched or compressed, pain will probably be evident, and by comparing its size and length with other nerves in the body, it is very clear why so many people are troubled by this nerve.
Compression of the sciatic nerve usually occurs between spinal vertebrae or the passageway within the vertebrae through which the sciatic nerve emerges in its route to the feet. This compression can be the result of a bulging disc, a sprained ligament in the area, arthritis, or an abscess, blood clot, or growth may push on the nerve. Pain may be felt in the lower back, buttock, thigh, lower leg or foot, or sometimes in a combination of or all of these areas. For many sufferers the pain is a sharp shooting pain in any of the regions, or it may shoot directly down the leg to the toes. Sciatica also causes weakness in the muscles, numbness and a loss of reflex in the knee or ankle.
The most frequent cause of sciatica is a degenerative disc (DD), which may occur when a damaged, bulging or completely ruptured (herniated) vertebral disc pinches a nerve at the root of the sciatic nerve. This type of damage may occur suddenly from a fall or accident, or more commonly may be a result of normal age related wear and tear. By the age of 30, nearly everyone has experienced some degree of degeneration in their vertebral discs. Spinal Stenosis (SS), another cause of sciatica, results from a narrowing of the spinal canal in the lumbar vertebrae. Nerve space is lessened in the spinal canal because of the formation of bony enlargements developing around discs and facet joints.
"The lunges and squats that we do during our sessions help when walking and climbing on iron beams at work. My work requires using the same muscle groups that we exercise, making my job easier."
- Matt Kondrat.
Spondylolisthesis is a condition caused by the excessive forward movement of one lumber vertebra into another. This also occurs as an age related change in adults but may be caused through contact sports. Another cause of sciatica is Piriformis Syndrome. The piriformis muscle is a short, thick, pear-shaped muscle located deep underneath the gluteal muscles. In 85 percent of people, the sciatic nerve passes just underneath this muscle, but in the remaining few the nerve travels through the muscle. If this muscle is tight or swells from injury or aggravation, pain can be felt on one or both sides of the body, deep in the buttock or hip.
Pregnancy can be a major cause of sciatica, many times becoming a recurring condition in women. Half of all pregnant women experience back pain as a result of the narrowing of sciatic nerve exit sites. As the abdomen protrudes and weight is shifted forward, the normal lumbar curve is exaggerated, curving the spinal column and pinching the nerves.
For severe episodes, rest is mandatory. Lying flat on the back is the most comfortable for many sciatica sufferers, and many find a seated position highly uncomfortable. Gentle stretching can be beneficial when severe pain lessens, lengthening the muscles surrounding the area of pain. If pain persists for more than a day or two, medical attention may be necessary. Exercise can provide effective therapy for many experiencing acute symptoms, although high-impact activities should be avoided and trunk strengthening (abdominals and back) exercises should be delayed for several days after the onset of pain.
Sciatica is unfortunately most times recurring and incurable although strengthening and stretching may decrease the degree of pain and chance of further injury. Tips on avoiding sciatica include:
- When lifting an object (no matter how much it weighs), keep it close to your chest, lifting with your hips and legs.
- Strengthen abdominal and back muscles- which support your spine-by swimming, walking, performing weight bearing strength training and other exercising muscles important in torso stabilization. Include these muscle groups: abdominal obliques, transversus abdominis, gluteal muscles, latissimus dorsi and spinal extensors.
- Practice good posture at all times. This will relieve pressure on your spinal column.
- Avoid sitting for long periods of time.
- Stretch the muscles and joints that are important for spine and leg flexibility and good spinal alignment. These include the hip rotators, hip flexors, gluteus muscles, hamstrings, hip extensors and low-back extensors.
By following these guidelines, back pain caused by sciatica can be lessened or controlled. Consult a doctor if back pain is persistent or severe. Look to a Physical Therapist if needed, or a Certified Personal Trainer in designing a personal healthy-back care program.
Karen Schutters, MA,
ACE Personal Trainer
Owner- Priority Fitness