Sciatica is a common condition that impacts many people. Sciatica occurs when the
sciatic nerve gets irritated. It is a symptom of another problem that causes the nerve to
be compressed. The symptoms often associated with sciatica can include pain,
weakness, numbness or tingling that travels into the buttocks or down the back of the
leg.
As I mentioned, there are multiple reasons that someone can experience sciatica. A few
common examples are:
-A disc pathology: When a spinal disc bulges or ruptures, it can place pressure on the
nerve where it exits the spine. This is more likely to occur in younger and more active
populations.
-Spinal stenosis: A narrowing of the spinal canal. This is more likely to occur in older
populations.
-Degenerative disc disease: A gradual compression and breakdown of the discs that
live between the boney vertebra. A scary sounding term, but something that is very
common and normal to find in imaging with age.
-Spondylolisthesis: A condition where one vertebra slips forward over another. This is
associated with instability in a certain area of the spine and can contribute to sciatica
symptoms.
-Bone spurs: An overgrowth of bone that can put pressure on the sciatic nerve.
Determining the root cause of your sciatica is something that is addressed in physical
therapy. I also help folks determine if they need imaging or not. Many times imaging is
not needed for successful physical therapy treatment of your sciatica.
Regardless of the root cause of your sciatica, flare-ups can often be prevented with
consistent effort and healthy habits. Your lifestyle such as how active you are, your
occupation, and more can significantly impact your back pain.
Here are some tips to help keep sciatica at bay:
1. Perform Consistent Cardiovascular Exercise:
o Engage in consistent activities like walking, swimming, or biking, etc.
o Which type of exercise that is best for you depends on the type of
lower back pain you are dealing with. Find a position that feels good
for your back and a movement that you enjoy.
2. Participate in Consistent Strength Training:
o Strength train 2-3 times a week, especially focusing on the legs and
trunk. You don’t have to lift with a barbell or free weights. Machine
based work can be a good fit for some people.
o Lift with good form including proper breathing. Seek out guidance
from a performance physical therapist if you aren’t sure about your
lifting form.
3. Stretch/Move Regularly:
o Again, there isn’t a one size fits all mold for people since everyones
back pain is different. But I encourage you to work with a performance
physical therapist to help you find the areas you need to stretch
regularly.
o However, avoiding stretching your hamstrings while your sciatic pain
is flared up is important for everyone!! Don’t stretch through nerve
pain.
4. Think About Your Position During Your Day:
o There is no right or wrong. Your posture doesn’t cause your pain
exclusively. But you should consider the position you are spending
most of your day in.
o I encourage most people to stand more, but if standing for extended
periods of time flares up your back then you may need to set timers
periodically to sit.
o Avoiding or modifying positions that have triggered your sciatic pain in
the past is important. If driving for 5 hours straight is a position you
don’t tolerate well, then consider how you can avoid or modify the
situation in the future.
5. Manage Body Weight:
o Maintaining a healthy weight reduces pressure on the lower back and
sciatic nerve.
How Physical Therapy Can Help Sciatica Flare-Ups:
Physical therapy is highly effective for managing and preventing sciatica. We do this at
Outshine Physical Therapy in Asheville, NC first by evaluating you with a full body
assessment. We need to find the root cause of your sciatica so we can treat it
effectively.
Here are some common tools I use to help people relieve their sciatic pain and prevent it:
-Education: If you don’t understand what keeps flaring up your symptoms, then you will
never overcome it. Education is the most important early on in a plan of care.
-Manual Work: I use tools like dry needling, cupping, soft tissue work, joint
mobilizations/manipulations, and more to help improve your pain and mobility.
-Positioning Techniques: We can use specific positions to help alleviate your symptoms
(as well as avoiding certain positions).
-Strength Training: Introductory strength training with a gradual progression to more
gym-based movements. We have to gain strength to build resiliency to prevent issues in
the future. And you need to build confidence with lifting and higher-level activities so you
can get back to the things you love!
If you have been dealing with repeated sciatica flare-ups, then try some of these
suggestions. I also recommend you set up a free call with me so we can discuss what’s
going on and get you scheduled for your initial evaluation. That is where we will perform
an in-depth evaluation to determine the root source of your pain, and set a game plan to
get you to your goals!
As always, I hope that was helpful.
Sincerely,
Dr. Sieara