Pain in the Butte II: Sciatica

Back pain is a complex issue in the medical field.  As we’ve already discussed, imaging doesn’t normally help identify sources of back pain, and pain medication (especially for back pain) doesn’t always lead to relief.  When it comes to issues like back pain there are a surprising number of symptoms that tend to occur, which is part of the reason why it can be so tricky to treat.  One common symptom is known as radicular pain, which is basically pain that “radiates” from a nerve as it exits the spinal column.  A common example of this is from a herniated (bulging) disc, where the irritated nerve can cause pain to radiate down the leg, sometimes all the way down to the foot.  Numbness/tingling or muscle weakness can also occur.  Radicular pain isn’t always caused by a herniated disc, but that is one of the more common causes.

To make things more confusing, there’s a condition called sciatica, which also tends to present with shooting pain, typically starting in the buttock or back of the thigh.  The difference between sciatica and radicular pain is the location where the nerve is being affected.  In sciatica, the sciatic nerve exists outside of the spine.  With radicular pain, however, the nerve is still inside of or just exiting the spine, so the area with symptoms will usually be different depending on the where in the spine the affected nerve is located.  This may seem like we’re just splitting hairs, but these differences do matter, particularly with how they’re treated.

When it comes to sciatica, the problem is usually considered an issue with the sciatic nerve.  This could be from a muscle around the nerve being too tight, the nerve being “stuck” or pinched, or different positional stress that a person has in their day to day life.

Treating sciatica will usually involve some sort of professional examination, but there are some things that you can try at home to see if they clear up.

  • Sciatic nerve glides – Just like muscles, nerves can also be tensed with movement.  Unlike muscles, nerves don’t have much ability to stretch.  If a nerve is being pulled, it tends to cause a bit of pain and discomfort.  Nerves are very sensitive.  If you’ve ever hit your “funny bone” on your elbow and had pain shoot down into your hand, you know how it feels to hit your ulnar nerve.  Here’s how to do nerve glides.
  • Piriformis Stretching – The sciatic nerve tends to be right near a muscle in the buttock called the piriformis.  There are anatomical variations from this where the nerve may go through the muscle, but they’re relatively rare.  There are instances where the piriformis can apply excessive pressure to the sciatic nerve, and this can often be alleviated with simple stretching.  DO NOT LEAN INTO PAIN.  Aim for 2-3 reps of 15-30 second holds, making sure to focus on steady breathing and maintaining some light abdominal activation.
  • Bridging – The bridge is an easy way to get the glutes working properly, which can take stress off of the sciatic nerve.  If a standard bridge is too easy, try a single leg bridge for some additional strengthening benefits.  Try working at 2-4 sets of 10-15 reps, holding at the top position for 2-3 seconds.  Make sure that you don’t over-arch your back – keep your stomach engaged the whole time.  You should still be able to talk, so don’t hold your breath!

It’s important to note that these exercises are likely to help with radicular pain as well, however the emphasis with this article is on sciatica given its prevalence.  If these exercises are not providing any relief or are causing more pain, don’t hesitate to contact a physical therapist for a full examination of your symptoms.

Got questions?  Feel limited in what you’re able to do?  The staff at Limitless Physical Therapy in Eugene, OR can show you how to be limitless. Contact us to connect with on of our PTs. Or follow us on Facebook.

***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice.  Please contact a certified healthcare professional or your primary physician for any personal concerns.

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