Do you have sciatica? Here is a simple way to start your treatment at home.
Everyone will have low back pain at some point in their life. This is just a fact of life and is what research tells us as a human race. Now, a portion of us will also get leg pain that may or may not be associated with this low back pain. This is called “sciatica”. I am sure that many of you reading this have heard this diagnosis before from any number of us in the medical field. The real question is, what is sciatica? How does it happen? Does it heal? And, what is the right treatment for the so-called “sciatica”?
To begin, sciatica is an irritation of a bundle of nerves that travel from the low back down through the leg and branch off to many other parts of the lower leg. Think of the sciatic nerve as the trunk of a tree, and the roots of that tree are the many places in your leg that the pain can manifest and present itself. So how does this irritation occur? It can happen in many ways and yes, one of the ways is from a disc that is pressing on it in the low back (lumbar spine). Imagine you’re trying to unwind your water hose to water your garden and it gets kinked. Then it gets trapped under another part of the hose, followed by getting caught going through your kids jungle gym, then over the fence. Then, just about the time you reach your destination of the garden, you forgot to turn the water on! AHHHH! I think we have all been there at one time or another.
This is very similar to how the sciatic nerve can operate. It can get caught, trapped, pinched, twisted and compressed at any point where it exits the spine, and travels down to the final destination, which is somewhere in the foot. This means that NOT everyone who has low back pain has sciatica, and NOT everyone with sciatica has low back pain, BUT it can be both.
The most up-to-date research tells us that the nerve itself can actually create and self generate pain! What? That is right, our nerves (which send signals about the body to the spinal cord, and thus to the brain) actually have nerves within them that can also create pain. Speaking of which, nerve problems don’t always present as pain. They can show up as numbness or tingling, heat, cold, swelling, puffiness, heaviness. Some have reported ants crawling, lightness, and fire! The other aspect of a nerve, kind of like that garden hose,is that it does get compressed. These nerves coming from the spinal cord can be cut off by as little pressure as it takes to blanch your fingernail bed! Nerve pain could present in any combination of these ways and can change from person to person.
Now, how do we treat this “sciatica” issue? Traditionally, traction (also called distraction, decompression, or unloading) are advocated and acceptable ways, as well as joint mobilization/manipulation, massage, McKenzie exercises, and “core strengthening”. These are all utilized and the research supports their use in general, but we don’t often treat the NERVE directly. The treatment of the nerve is very specific and very effective for staving off leg symptoms if understood and performed well at home. This is why we are here. We are going to take you through how to identify, perform and give the proper treatment for your leg pain/symptoms.
First, we have to recognize where the symptoms exist. Whether it is back of the thigh, outside of the thigh, outside of the lower leg, back of the calf, heel or lateral foot/ankle the technique may vary, and in the following video I will demonstrate how to change your position to address each area. Second, it is important to know that nerves are like muscles, and they need to be stretched, but overstretching can also result in an angry nerve. So it is VERY important to know that when treating a nerve, to NEVER push into any pain or symptoms and yes, this does include the feeling of stretching as a symptom. Third, the dosage for the right amount of treatment is VERY important. I refer to this as the angry mother-in-law approach. We all know of one, or have one in our lives, and the one truth we know is that they can be very passive aggressive. You may be making them upset without even knowing it and you may feel the wrath of that at a later date. This is the same with nerves, and if you work them/stretch them too much, even just into symptoms, then you may have more difficulty later and even trying to get comfortable at night. There are times where you have pain when you are in a relaxed position and you may actually have to use the other leg to calm the nerve down on your affected side.
The system I use involves lying on your back with both legs straight (now if this is painful, then lie flat on your back with both knees bent). Then, if there is no pain on your affected leg, take that leg behind the knee and pull up to 90 degrees and hold in that position. Once here, then point your toe towards your face (this position will affect symptoms that run down the back of thigh and back of calf) and start to kick (or extend) the lower leg upwards until you feel any symptoms (stretching, pulling, pain, numbness, tingling or just anything other than the normal). Once you reach that point, bend the knee slightly (lower the leg) until you DO NOT feel symptoms anymore, and then pump the ankle towards and away from your face. Now, the repetitions can vary, but I like anything from 10-15 reps, then resting the leg back down for 30 seconds, and repeat this process up to 10 times/day if needed. For most people I am happy with 2-3 times a day. The last thing I will say about the actual exercise is that the angle of the leg may change (higher or lower) in between each set of the exercise depending on where you notice symptoms and that is OK! It means that you are affecting that bugger of a sciatic nerve, and anyway we are affecting this nerve is a sign of starting the healing process.
So there you have it! A simple way to address the sciatic nerve itself, in a very systematic, practical and easy way at home during these difficult times. We here at Curnyn Physical Therapy strive to address the needs of our patients on every level, and believe in the importance of keeping you moving and healthy, and this is a simple way to avoid those leg and sciatic nerve pains. This being said, if this treatment does not seem to be helping, then it may be beneficial to stop in for a FREE 15-minute screen to make sure that you are treating the correct injury. Please do not hesitate to contact us via our website www.curnynphysicaltherapy.com or phone 817.923.9000, and make sure to check out our video for more details on how to properly perform these treatments at home!