Sciatica Q&A

“Thou cold sciatica, cripple our senators, that their limbs may halt as lamely as their manners.” – William Shakespeare 1564.

A friend of mine - JuJu - asked about her sciatica and what I could possibly recommend for it from a yogic point of view. She participates in the MS 150s; Houston to Austin. I looked through all my texts and have consulted several times over - both past and present - with various medical and holistic professionals on this subject. Here is what I have for her and hopefully anyone else with the same question. Before you read on, PLEASE MAKE ALL YOUR MOVEMENTS DELIBERATE, SLOW AND CAREFUL. Fast movements and jerking can only increase physical problems. Besides, no one wants to be a jerk.

Sciatica is defined as pain caused by irritation, compression or inflammation anywhere along the sciatic nerve. The sciatic nerves are the largest and longest nerves in the body, reaching about the size of your thumb in diameter, and running down the back of each leg. Each sciatic nerve is composed of five smaller nerves that leave the spinal cord from the lower spinal column, join together and then travel down each leg. It then divides into smaller nerves that travel to the thigh, knee, calf, ankle, foot and toes.

Sciatic pain can usually be linked to two types of irritation:

One cause of sciatica is piriformis syndrome. The piriformis muscle extends from the side of the sacrum to the top of the thigh bone at the hip joint, passing by the sciatic nerve en route. When a short/tight piriformis is stretched, it can compress and irritate the sciatic nerve. People who stand pigeon toed - with their toes turned out - often develop piriformis syndrome, as do runners and cyclists, who overuse and understretch the piriformis muscle.

Also, sciatic pain is often the cause from compression of the L4-S1 nerve roots affecting the sciatic distribution. Occasionally irritation of any part on the branch of the sciatic nerve in the legs can be so severe it can set up a reflex pain reaction involving the entire length of the nerve. For example, if the nerve is pinched or irritated near the knee, you may feel the pain in the hip and buttock.

If a tight piriformis muscle is the problem, then it must be gently stretched. Do not overstretch or more spasm can result. Remember what you do to one side, do to the other to keep a proper balance of strength and stretch (limberness). Focus on improving posture and body mechanics in daily activities. Yoga practice should be modified so that the pain is neither created nor intensified.

Standing Poses:

The easiest is to start in Tadasana (mountain pose or standing position), ground your left leg and bring your right leg up onto a platform; a step, a chair, a box. 90* degrees is good. Feel the stretch in your hamstring, groin, glutes and lower back. If your body allows, hinge at the hips, don't round your back, and lean forward into the pose keeping your hands either on your hips or knees. Come back up, bring your leg down and switch sides.

Trikonasana (triangle pose). Use bolsters or supports if needed.

Parivrtta Trikonasana (revolved triangle pose) with the support of a table or countertop can also help.

Virabhadrasan (warrior I pose)

Virabhadrasana II (warrior II pose)

Utthita Parsvakonasana (side angle pose)

Parivrtta Parsvakonasana (revolved side angle pose)

Forward Lunge

Seated Poses:

Seated Half Lotus. Sit upright on your sit bones, not your tailbone, in a comfortable chair with a flat seat. Pass on the lay-z-boy and try something more like an office chair or dining room chair. Bring your rib cage up and out to straighten your back and create a good strong base for your pose. Up and out, not puffed out. Feet flat on the floor, legs hip width apart, knees over ankles, hands on either your knees or thighs.
Bring your right ankle (not foot) up ontop of your left knee. Now is a great time to bring in your Pranayama practice and take steady deep breaths while holding this pose for up to 2-3 minutes. If your right knee is up, press down gently with your right hand to ulitmately bring your chin parallel to the floor. Then switch.
IF THIS HURTS, DO NOT DO IT. A good rule of thumb I pass along in all my classes is, "If it hurts, stop. This is 'find the enlightenment', not 'feel the burn'."
If your body can go further then with keeping your back straight, hinge at the hips and lean forward. Do not round your back, this will not help you no matter how far you go! The woman in the picture almost has it, but remember not to round your back and also, I prefer to keep my hands on my knees rather than increase the intensity of the stretch by reaching for the floor since this only increases the desire to round the back. If your sciatica is really acting up, this will be near impossible anyway.

Bharadvajasana

Agnistambhasana

Pasasana (noose pose or wall twist)

Baddha Konasana

Marichyasana III

Dandasana (staff pose or seated pose). If your sciatica is not as severe or not present at all, you will be able to do this. This and the next one are great poses for building strength in the lower back, glutes, abs and legs to forego any future nerve problems. However, if your sciatica is acting up, these next two will be near to impossible.

Paschimottanasana (forward bend)

If these are too difficult it is suggested to isolate the muscles more with:

Janu Sirsanan (head to knee pose)

Reclining Poses:

Viparita Karani (legs-up-the-wall pose) with or without a bolster. Many believe this to be the ulitmate pose. Restorative, cleansing, it takes all the weight off your lower back while letting gravity work its magic. I use Viparita Karani, Balasana (child's pose) and Savasana (corps pose) as restorative poses. During class I make a point of reminding everyone - including myself - that if at anytime they feel fatigued, short of breath, or dizzy to go into one of these poses.
It is always good to end with one of these poses, especially Viparita Karani or Savasana, after a full workout; whether aerobics, cycling, running, yoga or any other strenuous activity. It gives the body a chance to relax and assimilate all the channels you just opened in your system.

As far as yoga is concerned, there are a million, billion different poses and sequences to perform to help with sciatic pain (along with every other aspect of your life). This is just one sequential suggestion. Any and all of these poses can be worked into a regular Surya Namaskar (Sun Salutation) practice.

For more information with a medical slant try here. Remember to always speak with a physician before beginning any type of physical exercise.

Live long and prosper my fellow yogis.
Om Shanti Shanti Shanti