My mom recently discovered that she has sciatica. As a yoga teacher, I’ve been vaguely aware of sciatica for a long time, as I’ve had a number of students who suffer from it. With it striking so close to home (and as the world’s biggest mamma’s girl), I decided to take a bit of a dive into the workings of sciatica. And so for this week’s practice, I’m bringing you a yoga for sciatica (and low back pain) class.
But first, what is sciatica anyway?
What is Sciatica?
Sciatica is tenderness and pain anywhere along the sciatic nerve, of which there are two – one for each leg. Sciatica tends to show up on one side of the body; so affecting one of the sciatic nerves.
The sciatic nerves are the longest nerves in the human body. They originate at the spinal cord, thread through the sacrum, and then pass between layers of gluteus muscles, as well as through the deep muscles of the back of the thigh, and down through the outer edge of the lower leg, all the way to the foot.
These babies are long! Which means that the potential for pain is spread out – you can feel it anywhere along that nerve, from the low back, down into the lower leg.
Sciatica can flare up during a range of everyday movements, both passive and active. Bending over, running, and sitting (especially driving) are some examples that can cause sciatica to flare. Here are some possible symptoms:
- Pain anywhere along the sciatic nerve pathway: in the lower back, the glute, back of the thigh, and/or calf.
- Fatigue, numbness, or loss of feeling in your legs and/or feet.
- An electric, tingling, burning, pinching, or pins-and-needles feeling (paresthesia).
- Weakness that can cause your knees to buckle when you stand up from sitting.
- Foot drop: a condition where you can’t flex your ankles enough to walk on your heels.
- Reduced reflexes in your Achilles tendon and knee.
What Causes Sciatica?
There are two main causes of sciatica. The most common cause is piriformis syndrome.
The piriformis is a small muscle deep in your hips that externally rotates (turns out) your thighs. The sciatic nerve sits between the piriformis and the small tendons that lie against the bone of the sacrum and the pelvic bone.
If the piriformis is tight, which it often is, it can compress the sciatic nerve, leading to a literal pain in your butt (this is the aforementioned piriformis syndrome). Piriformis tightness often happens as a result of weak glutes. When we don’t properly recruit the glutes, the piriformis tends to get overworked and become tight. Strengthening the glutes will help take some of the load off of the piriformis.
Here are a few indicators of sciatica caused by the piriformis:
- Pain and a pins-and-needles sensation down the outside of your calf to the webbing between the little and fourth toes.
- Difficulty walking on your heels or on your toes.
- Burning in the back of your thigh and calf down to your heel, with stiffness in your legs. (In some cases this can signal a problem in the spine instead of the piriformis.)
- Pain from sitting, accompanied by a tingling sensation at the back of your thigh (the pain may be relieved by standing, but you still experience numbness in all of your toes even when standing)
- Gluteal and sciatic pain from exercising or sitting for long periods of time, with or without sensations of numbness, weakness, or tingling. The pain might appear during standing activities, but gets worse when you sit down
The second possible cause of sciatica is a herniated disc in the lumbar spine (lower back), which can press against the sciatic nerve. This is a serious problem that can cause any of the following:
- Pain in your mid-lower back.
- Painful electric shocks down your sciatic nerve.
- Tingling, burning, weakness, or numbness in your legs and feet.
If you’re experiencing any of these symptoms, it’s super important to have your spinal discs checked by a doctor.
Yoga for Sciatica
If the source of your sciatica is a herniated or bulging disk, you want a yoga practice that progresses from gentle poses to simple standing poses and downward-facing dog. This will help to align, lengthen, and strengthen your lower back.
It’s important to check with your doctor about the severity of herniation. Some herniated discs require surgery, while others do not.
If the source of your sciatica is pressure on the nerve due to a short, tight piriformis, you want to focus on stretching this muscle. You want to be gentle and progressive, since overworking the piriformis can lead to spasms and deep gluteal pain, which may or may not be accompanied by sciatic pain.
This practice has a little bit of both. It’s very gentle, with only one or two standing poses to bring some strength to the glutes. We bring a lot of stretching to the outer hips, targeting the piriformis, as well as work on a couple of back-strengthening, mild backbends.
It’s a great practice if you suffer from sciatica (duh), but also if you’re experiencing lower back pain in general, or if you feel that your outer hips and/or hamstrings are a bit tight.