Sciatica is the term used for any lower back pain that radiates down into your bum and/or legs. This can also be felt as tingling or numbness in a leg or foot. The pain is caused when the sciatic nerve is compressed or pinched either by a disk (disk herniating/stenosis) or by the piriformis muscle.
Usually with sciatica you only get pain down one leg. You will need to see a physio or osteopath to diagnose sciatica but once you have a diagnosis there is a lot you can do in Pilates to help combat the symptoms and feel better. The key with sciatica is knowing the cause so the treatment can reflect the underlying issue.
What causes sciatica?
There are many potential causes for sciatica, knowing what causes yours can help you when getting treatment as different causes will need different Pilates exercises to help support your treatment.
The most common cause of sciatica is disk herniation or a bulge. The herniated disk presses against the nerve root causing pain and discomfort. The other type of disk issue which can cause sciatica is disk degeneration, as the disk degenerates it releases inflammatory protein which aggravates the nerve.
Spinal stenosis can also cause sciatica. Spinal stenosis happens when the spaces within your spine become narrower and compress the nerves running through the spine. It is most common in the neck and lower back.
Both spinal stenosis and disk degeneration can not be ‘undone’ however with the correct Pilates exercises you can maintain a healthy lifestyle and stay pain free. The key is remembering movement without impact is going to benefit you greatly.
The other condition which can cause sciatica is piriformis syndrome where the sciatic nerve either runs through or is compressed by a tight piriformis. If you find it painful to sit or walk-up stairs this could be your issue but please see a physio for formal diagnosis.
How to treat sciatica?
It is important to remember that inactivity will not cure sciatica and in some cases makes it prolonged and worse. The trouble is when you have pain walking or standing, sitting probably feels like a good idea, but the more you can add gentle non load bearing exercises, like the ones we do in Pilates into your routine the better it will become.
Hot and cold therapy can really help with swelling as can painkillers like ibuprofen but check with your GP that you can have these first.
With a disk herniation or compression, you should avoid flexion of the spine (bending forward) as this just exacerbates the problem. Instead try gentle back extension work like swan dive and exercises to release tension in the upper back and neck area. Avoid Pilates moves that involve rolling forward like roll down, roll up, spine twist etc. With disk herniation it would be good to work on a one to one basis with a Pilates instructor in order to get a specialised program for your specific needs. Contact me to book.
If you have spinal stenosis flexion is okay and you can do a variety of Pilates moves to help with maintaining spinal health and mobility. With piriformis syndrome it is also okay to add in flexion of the spine but avoid any activities where you activate the glutes, no leg resistance band works, clams, or glute presses, plenty of gentle stretching to elevate the pressure and tightness caused by the muscle on the nerve. With piriformis syndrome or stenosis, you could join a regular Pilates class with me, please make sure you have seen a physio or osteopath prior to joining a class and have your diagnosis so we can talk through beneficial moves before attending class.