Sciatica has a long (and painful!) history. As far back as the 5th century BCE, doctors and sciatica patients have tried a host of imaginative remedies, from leeches (yikes!) and hot coals in Roman times to 20th-century use of creams and injections.
SYMPTOMS OF SCIATICA
By definition, sciatica is tenderness and pain anywhere along the sciatic nerve, typically showing up on one side of the body. It might not be a chronic pain but can instead flare up in response to specific movement or activity. Sitting for long periods of time (especially driving!), bending over and even walking can irritate the nerve. Sometimes it’s as simple as tingling in your legs or weakness in your knees. Other symptoms can include:
- Pain anywhere along sciatic nerve pathway: lower back, buttock, back of the thigh, and/or calf
- Fatigue, numbness, or loss of feeling in your legs and/or feet
- An electric, tingling, burning, pinching, or pins-and-needles feeling known as paresthesia
- Weakness that can cause your knees to buckle when you stand up from sitting
- Foot drop: a condition in which you are not able to flex your ankles enough to walk on your heels
- Reduced reflexes in your Achilles tendon and knee
SOURCE OF SCIATICA
The presence of sciatic pain often leads doctors to look for a herniated disk in the lumbar spine, which may be pressing against the sciatic nerve. This is a significant problem, and it’s especially important to have your disks checked out by a doctor if you are experiencing painful electric shocks down your sciatic nerve, and/or tingling, burning weakness, or numbness in your legs or feet.
Alternatively, the source of your sciatica might be caused by a short, tight piriformis, which is very common in runners and other sports. In this case, it can be helpful to work with a physical therapist and take a gentle but progressive approach. Overworking the piriformis may lead to spasms and deep buttock pain, which may or may not be accompanied by sciatic pain.
Other causes of sciatica include hip imbalance during pregnancy, scar tissue build-up from old injuries, osteoarthritis, degenerative disc disease and more.
YOGA FOR SCIATICA
As you can see, there are many potential causes! Unfortunately, as yoga teachers, it’s impossible for us to know what is causing someone’s sciatic symptoms, and it is even more difficult for us to predict with any level of certainty the specific asana sequence that will make it better.
It’s important to note that there is a common disconnect when working with individuals suffering nerve pain specific to what is helping them and what is causing more aggravation. Working at a slow pace and not covering too many asanas in a session will give the student time to absorb the practice, develop interoception, and observe the physical and mental state after the practice. Open communication is extremely important.
Generally speaking, if tight piriformis, glutes, and hamstrings are the cause, postures that stretch out the back side of the body are recommended. With something like hip instability or lower back problem at the root of the sciatic pain, strengthening poses might be more beneficial. Regardless of the source of your or a student’s sciatic pain, a yoga practice will provide support and relief in most cases. Here is a description of yoga postures that you can start with to address the pain:
If tight legs and back body cause the problem…
Standing Separate Leg Stretching Pose
From a standing position spread your legs three to four feet apart. Keep your feet parallel to each other. Inhale, and then on the exhale bend forward from your waist with a flat back. At the same time, as you’re folding forward, reach out with your hands to grasp the outer sides of your feet. Without forcing it, let your head rest on the floor or as close to it as you can. If the pain in the back of the legs is too intense, keep a slight bend in the knees, hold on to the big toes instead of the sides of the feet. Or alternatively, place hands on the floor. Take five breaths in this pose.
Sitting Separate Leg Head-to-Knee Pose
This pose is typically performed while standing up, but in the case of sciatic pain, it’s best to do this pose on the floor. Sit on your yoga mat with legs stretched out in front of you. Spread your legs into a “v” shape, about four feet apart. Twisting at the waist to the right, square your hips towards your right foot. On your next exhale, fold forward from your waist and lay your torso against the stretched out length of your right leg with your head resting against your knee. Reach your arms forward and lay your hands on your right foot. as the stretch in the leg can be quite intense, bend the leg as much as needed.Spend five breaths here and then switch sides.
Lie face down on the floor atop a yoga mat or towel. Reach the crown of your head forward, lengthening the back of the neck. Hug your arms against your sides, palms on the floor. Activate your legs by tensing the muscles of the upper backs and fronts of your thighs. Point your toes. Lift your head and rest your chin on the floor. Exhale and while pressing down on the floor with your hands, lift both legs off the floor at the same time. Take up to five breaths and then lower back to the floor. You can start by doing one leg at the time first.
Legs up the wall
Sit sideways with your right side against the wall. Exhale and gently swing your legs up onto the wall and your shoulders and head lightly down onto the floor. Your sitting bones don’t need to be right against the wall, depending on the tightness of your hamstrings. Experiment with the position until you find the placement that works for you. You can even add a pillow, folded blanket or towel under your hips for greater comfort. This pose is not intended to stretch the backs of the legs, so if you feel pulling in the hamstrings move farther away from the wall. Keep the lower back grounded to the floor. Open your shoulder blades away from your spine and release your hands and arms out to your sides, palms up. Gently close and soften your eyes, then scan the body.
- For added core strength, which is also needed for sciatic pain relief, lift your chest off the mat and reach your hands toward your toes to the count of 3-5 breaths at a time.
If your lower back is the problem…
Kneel on your mat and place both hands on your hips. Your knees should be the same distance apart from each other as your hips, and your legs should be parallel. Tuck your chin in slightly, and then try to lengthen your tailbone towards the floor. Reach back with both arms to touch your heels with your hands. Keeping your toes tucked under is a great modification that can help make this pose a little easier to achieve. Aim to grab your heels with your palms so that your fingers are pointing towards the floor. If you can’t quite reach your heels, but you want to get a deeper stretch than you would by keeping your hands on your hips, place yoga blocks next to your feet and reach for those instead. At this point, you can release your head back and gaze at the ceiling or the wall behind you, but only if this feels good for your neck.
Half tortoise pose
Start sitting kneeling style, hips on the heels, sitting upright. Raise the arms overhead and clasp the palms together in prayer position with thumbs crossed. Keeping the hips down, bend forward from the hips bringing the forehead and little fingers to rest on the floor. Try to keep the hips on the heels. Stretch the arms as far forward as possible but then relax the shoulders and let your head rest on the floor. Press palms firmly together throughout the posture. Press arms firmly against the ears and squeeze the thighs together on the way down and up. Once you’re all the way in the posture you can mostly relax.
If hip instability is the problem…
Lying on your back, bend both knees and place the feet flat on the floor hip-width apart. Slide the arms alongside the body with the palms facing down. The fingertips should be lightly touching the heels. Press the feet into the floor, inhale and lift the hips up, rolling the spine off the floor. Lightly squeeze the knees together to keep the knees hip-width apart. Press down into the arms and shoulders to lift the chest up. Engage the legs, buttocks and mula bandha to lift the hips higher. Breathe and hold for 4-8 breaths. To release: exhale and slowly roll the spine back to the floor.
Awkward / Chair pose
Stand tall with both your feet next to each other, then move the right foot far enough for a 6-inch gap to occur between your knees. Extend your arms in front of you, and make sure they are not relaxed – keep them flexed and straight at the elbows. Slowly lower your hips so that your thighs become parallel to the floor, and hold the position. Go back up to a straight position, only make sure to stand on your toes this time.
Keep standing tall on your toes for a few seconds and then repeat the whole procedure above by bringing your hips down to where your thighs become parallel with the surface beneath you. This is the second iteration of the Awkward pose.
Go back up to straight position again, and this time instead of putting the entire weight of your body on your toes, simply lift your heels off the ground just a little bit as if you were trying to add just one inch to your height, and repeat the awkward pose, only this time going down with your buttocks as low as you can until they almost touch the back of your heels. This is the third, final, and most demanding iteration of this posture.