Sciatica is a pain caused by a
nerve pain. There are many nerves that originate in the lumbar spine, they
exit the spinal cord through these small holes, then they travel inside the buttock area,
and here one of them is called “sciatic nerve”. Then, the sciatic nerve travels
down to the back of the tight, and then it splits into two nerves, one that goes
to the front of the leg (or tibial nerve) and the other branch to the back of the leg (the
peroneal nerve, also called fibular nerve). When a nerve is inflamed or injured, it causes
a typical pain that is more like a burning, electrical shocks, or stabbing pain. If the
nerve damage is severe, it will also cause muscle atrophy and sensation loss.
Low-back pain with nerve injury is relatively rare. The most common condition
that causes this is a lumbar disc herniation. In this video, I’ll show you 3 resting
positions to alleviate sciatica pain, 3 exercises that you can do for pain relief,
and 4 activities that you should avoid. Sciatica is usually self-limiting and resolves
within a few weeks. Therefore, the purpose of this 3-3-4 method is to provide some pain relief
while your body does the healing process. Let’s talk about sciatica today Last year I had a sciatica caused
by herpes zoster virus, or shingles. I know how bad this pain can be. I started
having a dull deep pain in the inside of my buttocks and radiating down the back
of my thigh and leg. Two days after, the skin rash erupted and I it
was confirmed this was shingles. The pain was constant, and I used the techniques
that I’ll show you in this video to get some pain relief and avoid pain medications. The sciatica
lasted about 4 weeks and I don’t have any pain now. I did another video where I tell the story
of what happened with my varicela zoster disease. But the most common cause of sciatica is not
shingles, it is actually disc herniation. First, let me explain what disk herniation is.
The disc is a cushion of water between two vertebraes. Its function is to act like a shock
absorber. But this disc can degenerate and break up, and the material that is supposed
to stay inside the disc then gets out. If these extruded content compresses
a nerve that is going to the leg, then we call this herniation > and the symptoms
of pain going to the leg is known as sciatica. The pain from sciatica will be different
from the pain from the degenerated disc. If it is just the degenerated disc, the
pain will be referred to the lower back, the buttocks, hips, and inguinal area.
The pain from sciatica is felt in the thigh and leg and it is because the disc is compressing
the nerve that goes to the leg and foot. It usually affects only one side.
The diagnosis of sciatica is easy to be made. You need to see a doctor. The doctor
will do some tests with you, like raising your leg like this. This test is
called straight leg raising and it stretches the sciatic nerve causing a specific
pattern of electrical shock sensation. That is why we avoid any exercise that stretches
the sciatic nerve when it is inflamed. The doctor will also examine if the nerve is functioning
normally, like testing the reflexes with a hammer, checking if there is muscle atrophy, and the
sensations on the skin. If the doctor suspects that there is a sciatic nerve injury, then the
doctor may order a CT-scan or MRI, and sometimes a electrodiagnostic test called electromyography.
If you have low back pain caused by a disc problem without pain radiating to the
legs, you may watch my other video for degenerative disc disease of the lumbar spine.
Sometimes the disc herniation will affect the nerves that control the bladder or bowels, and
this is what we call cauda equina syndrome. This is a medical emergency, and you
need to go see a doctor immediately, otherwise you may develop incontinence of
bladder or bowels that may not be reversible. First, I’ll show you the 3
relieving positions for sciatica: So, this is the zed-lie position, what you do is
you find a comfortable position on the floor. grab a chair or it could be a couch, you're going to
put your knees and legs on the top of the chair, and pull until the knees are above your
abdomen, put a pillow under your head, and now try to find the position where the small
of your back, here the lumbar spine is flat, and you are not having the sciatic pain. you're
not having the pain going down the back of your legs anymore. you are relaxed if you can find this
position of comfort. stay here for as long as you can, five minutes, 10, or even 20, 30 minutes,
because this is almost like taking a painkiller, you will notice that this is the same position
that i showed in the previous videos. if you have a disc problem, a lumbar degenerative disc
disease, and also if you have the facet joint diseases. Now, if you have sciatica this is
an excellent position, that's why we recommend this zed lie position, a lot to our patients who
have acute low back pain, because it relieves the pressure in the vertebras, in the discs, the
nerve roots, the facet joints, and if you stay here for about 30 minutes, the pain is alleviated
a lot, and then you can do a few more activities. Now, this is the second resting position, if you
want to alleviate the pressure on the disc and the herniated disc, you're going to raise your
trunk on your elbows, try to be 90 degrees here, and if you can tolerate this position, so you just
find a comfortable position that you're not having the pressure going to down to your legs, and
you stay here, then you can be reading a book, watching a video, and see if you can stay in
this position for about 5, 10, 20, 30 minutes, because when you do this, you are releasing the
pressure on the nerve root that is exiting from your lumbar spine, and if you have a disc problem,
this is excellent, because this is going to help the disc to, if there's a disc prolapse to
heal faster. Now, if you have facet joint pain, which i explained in a previous video, this is
going to aggravate your pain, so don't do this if your pain is aggravated,, it may be because
you also have facet joint osteoarthritis, and this position will not relieve, but if
you only have a sciatica from disc herniation, or disc problem, you're going to feel
a lot of relief from this position. The third position of comfort is the prone lying
position. so you're going to lie down on your stomach with a pillow or cushion under your
abdomen, and you're going to try to relax here, lowering your head, and the key is to relax, and
find a position that you don't have any pain, so they try to move your legs, maybe put another
two pillows, or three, and move your neck and when you find that position that you have
zero pain, you don't have any sciatic pain, that's the position you can stay for five,
ten, twenty minutes, because when you find that position, you know that you are relieving
the pressure on the nerve root, the sciatic nerve, Now, i'll show you the three exercises
that you can do to alleviate your pain. The first and most important is to
keep active, you should keep walking, preferably on a flat surface, don't walk
uphill or downhill, walk within your limits, if you can only walk five minutes, then walk
five minutes, many times during the day, try to increase the amount of time that you walk,
and also how many times you walk during the day. So, this exercise is this sloppy push-up,
you're going to get a mat or your carpet, and you're going to start putting your
arms in front of you, and you're going to raise your trunk, and if this doesn't cause
any pain, then what you're going to do is raising and do this, two, three, keep your
your hands in front of your body. Five, six, seven, and eight. if this is okay,
you can increase to 12 repetitions, 20 repetitions, and you can do this once
a day, or two, or three times a day, because this exercise should not be causing
pain, so if you do this exercise and cause pain, stop doing it. But if you do this sloppy push
ups and you feel that your pain is alleviated, then you can continue doing this
exercise for your sciatica pain. So, this exercise is similar to the one that we
just did on the floor, but when you start getting better, then you can do this exercise standing
up, so if you are in line, waiting for something, or at home, or at work, and you can't always
find a floor to do this sloppy push-up exercise, what you do is, you put your hands on your buttock
areas, and just keep doing this, you don't need to look up at the ceiling, if you have neck pain
you can look in fron,t so you do one, two, three, four, and you do this eight repetitions,
12, 20. if this aggravates your pain, you don't need to do it,, but when you when you
do this back extensions, if you feel pain relief, then it means that it's helping your pain,
and you can continue doing this exercise. There is no need to start a specific routine
of exercises, like going to the gym or stretching, or strengthening, until
the sciatic leg pain gets resolved, gentle stretching can be done, but
it should not increase the pain. Now, I will show you the four
activities that you should avoid. So, it is important to learn how to get up from
a chair, or a couch, or sofa, because if you just simply do this,, then it's going to put a lot
of pressure on your lumbar spine and aggravate your pain, so what you need to do is, there is
a right way of getting up, and this means that, assuming that you are sitting upright, and
sitting correctly, here when you get up, you have to get close to the edge of the couch,
or the chair, or even your bed in the morning, when you're getting up from the bed, and
even turning to the side a little bit, and using your quadriceps, and your hips, so pay
attention to my lumbar spine, i'm not going to bend forward or backwards. I'm going to use
my quadriceps, so this is how you get up. So, this is important if you are doing the dishes,
or ironing, or doing anything that you have to do with standing up, because when you are doing the
dishes, if you are like this, you are bending your trunk all the time, or ironing, that you are
ironing all the time like this, what we tell the patients to do is get a box or a little stool,
put on the floor, and one of your feet will be on the on the top of the box, so when you do this you
always, you're keeping your lumbar spine straight, and it's hard for you to be bending, so then you
remember that by keeping this the foot on the stool, you have to be ironing or doing the dishes,
without bending forward, so the higher this the better, but if you don't have anything higher
than this a box, a shoe box, or two shoe boxes, should be okay, just be careful that they don't
slip, and you don't fall, but you can get a stool, and you can do this, and leave in the counter top,
or leave close to the sink, where you are you're doing most of your activities, that you have to
stand up, and do activities standing up like this. The other important thing is to use some sort
of lumbar support, if you're sitting, if you work with a computer, get something that you can
put to support, to support your lumbar spine, i got this for my car, so i used this in my car, i
bought this 10 years ago when i had my episode of acute low back pain, and i still love it, i use in
the car, so this is how it works. you put in the in there, and then it creates this support here
for the lumber spine, but there are if you don't have one of this you can have a towel, make a roll
of a towel, or you can just get a piece of foam, but you see it creates this nice curvature that
supports the lumbar spine, and then you can relax, but you can use this especially for
people who spend many hours in the car, it's really important that they have a support
for the lumbar spine, if they have disc pain, lumbar disc pain and they can use
this, also for computer work, for desk work, or even when they are watching tv, it's always
nice to have a lumbar support that will give this curvature of the lumbar spine, and the depth
of the lumbar spine really depends on your size, how much curvature you have, so you
really need to try a couple of different sizes, and depends on your body size, but for me,
this one i really like to use this in the car, and i'll put a link for this for you to
find in the description of this video below, Number four, avoid stretching your hamstrings
for the first weeks. The nerve is inflamed, and if you keep doing this, you will have
more pain, give a few weeks, maybe six to eight since the start of the sciatic pain, then,
you can start doing some hamstring stretches. Here, is an example of hamstring stretching, so
if the person tries to do this, or stretching the hamstring, it's going to stretch the sciatic
nerve. Here, and it's going to shoot the pain, so don't do this if you have sciatic pain.
Now that you know what to do in the first 4 to 12 weeks, we call this the “acute
phase”, I’ll tell you what you need to do if your pain lingers beyond 3 months.
In most cases of chronic low-back pain, I find that muscle pain, or myofascial pain syndrome, is
a very important factor that perpetuates the pain. Well, what happens is that during the acute
phase, the muscles were all tense and tight to protect the lumbar discs. So, after 3 months,
the disc herniation or zoster is resolved and your body healed that acute problem. However,
what may still be aching are the muscles. We call this myofascial pain syndrome. I have a
video about myofascial pain that you can watch. Smoking accelerates the process of disc
degeneration and weakens the bones. So, if you smoke, and have low-back pain,
this can be a good reason for you to think seriously about quitting. Watch my
other video about smoking and pain. Take a look at this other video to find out if
you have predisposition to develop chronic pain, there are some factors that put a person at
higher risk to develop fibromyalgia. Check here. If you know someone with sciatic pain, press the
share button below and send this video to them. In the comments box below write down if
you have sciatica and which positions and exercises from this video worked best for you.
Go to the description of this video below you may find a summary of these positions and exercises
that you can download and print to do at home. There is a link to all products that I mentioned
in this video if you want to purchase them. Please, don’t forget that this video
is for educational purpose only. If you have a condition that needs medical advice,
please talk to your doctor. And if there is an emergency, go to the nearest emergency department.
If you like this video, give a thumbs up here, turn on the notifications and don’t
forget to subscribe to this channel. You can also find me on
twitter, facebook and Instagram. Thank you for watching.
Good bye.
