Sciatica, a very common condition among Americans today, affects about 40% of people in the U.S. during their lifetime. Sciatica is a condition that occurs from a pinched sciatic nerve. It causes pain to radiate along the sciatic nerve which has its roots in your lower back, and goes through the hips and buttocks, all the way down to each leg. In a normal case of the condition, this pain occurs only on one side of the body. The Sciatic nerve is the longest and thickest (almost a finger-width) nerve in the body.
It is made up of five nerve roots. Two are from the lower back region, called the lumbar spine, and three from the final section of the spine called the sacrum. The five nerve roots meet to form the right and left sciatic nerve. On each side of the body, one sciatic nerve runs through the hips, buttocks and down the leg, ending just below the knee. The sciatic nerve then branches into other nerves and continues down the leg and into the foot and toes.
How does Sciatica start
Sciatica usually occurs when a herniated disk, bone spur on the spine or the narrowing of the spine (known as spinal stenosis) compresses or pinches part of the nerve. This results in inflammation, pain and numbness in the affected area or the entire leg. It can also cause an unpleasant tingling pins-and-needles sensation in your leg, foot and toes.
Causes of Sciatica
Sciatica is caused by a herniated disc in the spine or an overgrowth of bone on the vertebrae. Sometimes, Sciatica is also a result of a nerve compression caused by a tumor or due to another condition such as diabetes. Trauma injury to the lumbar spine or sciatic nerve can also cause Sciatica. Osteoarthritis can cause bone spurs which can age spines and compress lower back nerves. Lumbar spinal stenosis (narrowing of the spinal canal in your lower back), Degenerative disk disease (breakdown of disks, which act as cushions between the vertebrae) and Spondylolisthesis (a condition in which one vertebra slips forward over another one) are all disorders or conditions that can cause Sciatica.
Lack of regular exercise, wearing high heels, being overweight or having a job that requires a lot of driving for long periods of time, twisting your back, or carrying heavy things are examples of everyday activities that can also cause Sciatica.
Signs and Symptoms of Sciatica
The most common sign of Sciatica is pain that radiates from the lower back to the buttocks and all the way down the back of your leg. It might start as a feeling of discomfort anywhere along the nerve pathway. However, it is more likely to be anywhere between your lower back to buttocks and the back of your thigh and calf.
The pain that you feel might vary from a mild ache to a sharp, burning sensation or even unbearable pain. It could also come as a sudden shock, throbbing or shooting pain, and might feel worse when you cough, sneeze or sit for a long time.
Another indication could be numbness, tingling or muscle weakness in the affected area (leg or foot). You might also feel pain in one part and numbness in the other. This is basically along the same nerve, but a different sensation or feeling at different parts of the nerve.
How Can Yoga Help You Manage Sciatica
A Harvard Medical School article states that practicing yoga for sciatica pain, as a preventive measure itself, is a good idea. A study conducted in 2018 showed that 76.8 percent of people practicing yoga for one month experienced pain relief. 8 percent also reported reduced levels of stiffness and 79.5 percent reported lesser symptoms of prickling, throbbing or jolts of pain.
Regular yoga practice strengthens and stabilizes the core, back and gluteus muscles, increases flexibility in the spine and hips, and relieves lower back pain as well as sciatica. Apart from strengthening the muscles, spinal twists can help relieve pain caused due to the compression or pressing of the sciatic nerve. Stretches can lengthen the spine, again providing relief caused by the compressing of the spinal cord on the sciatic nerve. The hips and gluteus muscles also take a hit due to the same pressure on the nerve. Yoga asanas for hip flexibility will help loosen tight hips. Thus, yoga for lower back pain and sciatica are an impactful therapy.
Yoga provides the necessary movement and counter-movements for those leading sedentary lifestyles, involved in jobs that require you to be in a certain posture for hours together or are already struggling with sciatica.
Furthermore, unlike most other treatments, yoga is a non-invasive, personalized method of managing symptoms. Once you have a regular routine in place, the benefits are profound. Yoga practices like breathwork and meditation will help you relax, become more mindful and manage pain in a better way as well.
Yoga Poses for Sciatica
The principles that should be employed to manage Sciatic are backbends, hip mobility, upper back mobility, core strengthening and inverting gravity Asanas. A good combination of these asanas, with the help of props like bolsters, will ensure that sciatic pain is managed and parallelly the pinching of the sciatic nerve is reduced. It should be kept in mind there are certain yoga poses to avoid with sciatica. An experienced teacher will guide you and tell you what you should and should not practice. These yoga stretches for sciatica are helpful when practiced in the right way.
Setu Bandhasana (Bridge Pose)
This asana strengthens the lower back, hips and thighs. It also opens up the hip flexors and relieves back pain.
How to practice Setu Bandhasana:
- Lie down on your back with both knees bent and feet flat on the floor. Keep your arms straight by the side of your body with your palms close to the feet.
- As you inhale, slowly raise your hips up. Ideally, your knees, hips and shoulders should be in a straight line at an angle. You can also support your back by holding your waist on both sides.
- Stay here and keep breathing deeply.
- Slowly, release the position by coming back down vertebrae by vertebrae.
Marjariasana (Cat-cow pose)
This is a great asana for back pain. It relieves tightness, improves back flexibility, and provides relief to stiffness and pain in the lower back.
How to practice Marjariasana:
- Come onto all fours with the palms directly under the shoulders and knees underneath your hips. Ensure your weight is equally distributed on all fours.
- Inhale and fill your abdomen with air as you let your belly drop towards the mat. There will be an arch in your back as you do this. Look up towards the ceiling and lengthen your neck and throat.
- As you exhale, pull the naval towards the spine, curve your back and tuck your chin into your chest as you lift up.
- Continue this movement for a few breaths. Let your breath guide you through the movements.
- After a few rounds, release and come into child’s pose.
Adho Mukha Svanasana (Downward-facing Dog Pose)
This asana has a lengthening effect on the back, while also stretching and strengthening the back muscles. It also strengthens all the parts of the legs - thighs, calves and feet.
How to practice Adho Mukha Svanasana:
- First come into the starting position of Marjariasana (on your palms and knees). From here, push back through your hands and lift your hips. Straighten your legs.
- Keep the palms firmly on the mat with the fingers spread. The feet will be on the mat. If you find this difficult, you can also only place your toes on the mat.
- Keep the shoulders away from the ears. Look towards your abdomen.
- Engage your thighs and core to hold the posture. Keep taking slow deep breaths.
- To release the posture, exhale and bend your knees. Come down to the child's pose.
Eka Pada Raja Kapotasana (One-legged Pigeon Pose)
This asana has a wonderful effect on the lower back and hips. It opens up the hip region, promotes better posture and releases tight muscles.
How to practice Eka Pada Raja Kapotasana:
- Start by coming to the Downward Facing Dog. From here, take the right leg forward and fold the leg placing your knee between your palms. Your foot will be pointing outwards towards the left side.
- Your right shin might be at an angle back towards the left hip or be more parallel to the front of your mat. This will depend on your flexibility and range of motion.
- Keep your palms on the mat beside the thighs. If comfortable, you can try to look up and arch your back. This will give your back a slight backbend as well.
- Stay here for a few long breaths.
- To come out of the posture, first bring the back to a neutral position. Now take the support of your palms, raise your hips and right leg. Bring your right leg back and come back to the downward facing dog.
- Repeat this with the other leg.
Ardha Matsyendrasana (Sitting Half Spinal Twist)
This spinal twist provides relief for lower back pain caused due to compression of the sciatic nerve. The asana strengthens the back, spinal nerves and releases stiffness in the hips.
How to practice Ardha Matsyendrasana:
- Sit in Dandasana with your feet together and spine straight.
- Now bend the left leg and place the left foot flat beside the right hip.
- Take the right leg over the left knee and place the left hand on the right knee and the right hand behind you.
- Now slowly twist the waist, shoulders and neck to the right and look over the right shoulder.
- Ensure your spine is straight.
- Now look over the right shoulder while taking slow deep breaths.
- To release the posture, breathe out and slowly release the right hand (the hand that is behind you) and turn the waist, chest and neck. Sit up straight and relax.
- Now repeat this on the other side.
Viparita Karani (Legs up on the wall pose)
This is a relaxing asana that alleviates tension from the back and legs. Staying here for a few minutes improves blood circulation from the legs back up to the circulatory system, which often gets affected due to the imbalance in the nerves. Furthermore, it helps you relax and rejuvenate which is often difficult for one to do when dealing with chronic pain.
How to practice Viparita Karani:
- Lie down with your buttocks close to a wall and legs falling to one side. Now slowly lift the legs up along the wall. Adjust your position to make sure you are as close to the wall as possible. Make sure you are comfortable.
- Now relax the throat and head. Keep the arms on the side of the body or above your head - whichever is comfortable for you.
- Stay here for a couple of minutes. Try to take slow, deep breaths.
- To come out of the posture, slowly drop the legs to one side and push yourself away from the wall.
Other yoga practices for Sciatica
A 2019 study was conducted to find the difference in results of those who only practiced yoga and those who combined yoga with massages like an Ayurvedic deep tissue massage. The study found the group who practiced yoga and got massages experienced greater pain relief than the yoga-only group.
Other yoga practices one can do include breathing practices like alternate nostril breathing to relax and balance the system. Meditation is a practice that greatly helps one relieve stress and improve mindfulness. Improved mindfulness goes a long way in correcting lifestyle choices, making better decisions and relieving stress, which is often the cause of all problems or is also a result of pain experienced with Sciatica. Adding positive habits to one’s lifestyle such as getting some amount of exercise everyday, taking time out to do something positive for your mind and body can also be very helpful in correcting all problems.
It might be difficult to start practicing asanas initially due to the pain. Practicing with a teacher is helpful as they will guide you as to what will suit you and what won’t. Start slowly, hold only as long as possible and comfortably, and do as much as you can. As the pain begins to release you will slowly start seeing a difference which will motivate you to come back on the mat.