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  • Writer's pictureKiley Holmes

I have sciatica and it happens when I...

Managing your Radiating Pain

Are you having pain that travels down your leg? And have you ever noticed a certain pattern to it? Does it bother you more when you stand or sit? Think about that for a couple of minutes. Is there a pattern to your discomfort? That's a huge clue as to going to make you feel better and what is going to make you feel worse - and how to fix it!

First of all, if you are having pain down your legs or, more likely one leg, then I'm sure that it is scary, and rightly so, so let's ask you a couple of questions:

  • Have you ever personally had cancer?

  • have you lost or gained a significant amount of weight in the last couple of months without meaning to?

  • Do you have full control of your bowel and bladder?

  • Are you suddenly tripping over your feet all the time and don't know why?

If you answered any of those questions with anything other than a no then stop reading this and call your doctor and see them ASAP.

If you answered no to all of those then stop stressing! You are going to be okay!

Now, your back pain and your leg pain/numbness need to be thought about separately. As you start to relieve the leg pain it's a sign that your back is actually healing even if your back pain may feel worse. Your back is just sending out a warning bell letting you know something's going on while your leg is actually telling you whether or not you are making progress towards getting better. You need to remember this for the next couple of weeks.

Also, back pain that travels down your leg is highly likely to come back at some point in your life, however, you are very likely to be able to manage your back pain with these simple tips.

So, are your symptoms more occurring when you are standing still or when you are sitting still? Well, let's find out!

First write down a piece of paper what level you would consider the pain in your back, and pain in your leg separately, and how far down your leg you can feel the symptoms.

Next you are going to go ahead and reach down towards your toes, as far as you can comfortably. Come straight back up and go straight back down or at least 10 times or until you're feeling any type of change. What change did you feel? Is the pain in your leg worse? Is it going down as far, or is it going down further? Write this down as well.

Now, if you're symptoms got better with bending forward, you temporarily need to sit more, I know you probably don't hear that often, but you have a flexion biased group. Remember that.

Now, if you are somewhere between the ages of 25 and 65 and you are not pregnant (I know, can you imagine being pregnant while having these symptoms?) you most likely feel worse after bending forward. I'm going to have you go ahead and put your hands on your hips and lean back eat least 10 times or until you feel the change. How have your symptoms changed? Are you feeling better, worse?

If you're feeling better you fit into an extension biased group, remember that because your exercises are going to be significantly different than a flexion biased group.

Did both directions make you feel worse? If this is the case, you are too flared up to be doing this, put some ice or heat on your back, whichever one makes you feel better (trust me on this, you are going to get a different answer from every single therapist as to what to do with heat or ice, but honestly whatever works for you no longer than 20 minutes at a time), and lay on your stomach with a pillow or two underneath your hips as long as you can, you should start to feel better. If that still doesn't work go ahead and lay on your back with your feet propped up as much as you can. When you start to feel better retest.

For someone with a flexion biased group you need to really work on bringing your knees to your chest. Every hour of every day that you are awake take time out and bring your knees to your chest, either holding them there or bring them up and down until your symptoms are relieved. You are also going to want to sleep with your knees up to take the pressure off of your back.

As you start to feel better you can add a hip flexor stretch and glut strengthening then start reincorporating standing activities while decreasing the amount of times that you do your double knee to chest.

Now, if you are an extension biased sciatica you need to focus on standing activities and extending your back. Start off by just laying on your stomach, if that feels okay go ahead and try and prop yourself up onto your elbows, if that feels pretty good go ahead and repeat that until your symptoms decrease. As that becomes easier you can prop up all the way onto your hands and lean back as far as you can. Enjoy this as you need to be doing these every hour that you are awake until your symptoms decrease.

As you start to feel better, add in a hip flexor stretch and glut strengthening as well as core strengthening as you back off of your stomach exercises, using them as needed to diminish any symptoms that may return as you heal. Finally, re-integrate the seated and forward bending activities that you enjoy slowly, using the extension exercise as needed to control your symptoms.

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