Yoga for Sciatica
Sciatica is not a cause but a symptom.
Bill Reif, physical therapist
Sciatica is a condition that more and more people seem to experience. Sometimes, movement and daily activities are impeded by sciatica. But why do people experience it throughout life and how can we soften or make the condition milder, especially when it comes to Yoga?
The sciatic nerve, the longest and widest in the body, starts at the base of the spine and extends through the pelvis and along the back of the thighs. When the sciatic nerve is compressed or irritated, the pain can travel from the lower back all the way to the buttocks and legs. Sciatica can manifest itself as intermittent pain, usually increasing when sitting or standing for long periods of time or while making a sudden movement. Sciatica is actually a symptom rather than a condition itself. It occurs when a nerve in the lower back is pinched, often due to wear and tear from repetitive forward bending or lifting heavy objects with a rounded back.
Yoga can be a highly effective tool for relieving sciatica by decompressing the spine and stretching tight muscles (like the piriformis and hamstrings) that press on the sciatic nerve. Moreover, Yoga helps with regaining a lost range of motion, since sciatica can actually limit in time the natural range of motion in an individual. Yoga for sciatica can lead to improvements in many areas, for example improving hip and hamstrings mobility, restoring the lumbar spine, improving circulation and releasing tension in the glutes. However, to avoid worsening the nerve compression, ideally one should turn to more gentle Yoga practices. Ashtanga for instance might not be recommended in case of an advanced level of sciatica, due to the high number of forward folding and deep hamstring stretches. Sciatica-relief Yoga as well as low-impact activities (spinning, swimming, walking) can help alleviate pain and discomfort, so people can start practising with more confidence and body awareness.
In the case of sciatica, it is best to talk to the healthcare provider always before attempting any Yoga practice, whether more gentle or dynamic. Some of the poses to best be avoided in case of sciatica are: Deep twists, Forwards fold, Backbends and squatting. On the other hand, some of the poses recommended for sciatica that can reduce tension in the hips and create more space in the lower back include: Child's pose, Bridge, Locust, Cat-Cow with one leg extended on the floor, Legs up the wall, Gate pose, Reclined pigeon, Seated twist, Shoelace and Sphynx (Yin Yoga). Many postures can alleviate and reduce the pain caused by sciatica, however we should always be mindful not to overstretch because this can lead to further injury, so ideally staying with a feeling of a nice stretch or minor discomfort but no sharp pain. Further tips for a sustainable Yoga practice are spinal realignment, always trying to maintain a neutral spine, pelvic tilts and focus on both gentle internal and external hip rotations. It is crucial to simultaneously strengthen the supportive muscles, like the core, the pelvis and the back muscles. Last but not least, understand and apply pain management through meditation and mindfulness techniques, that we can apply in our everyday practice. Restorative Yoga is great for sciatica, helping to quiet the nervous system, allowing the body to rest and heal faster. Slowing down the breath activates the vagus nerve and helps reducing inflammation of the fascia.
There are many factors that cause sciatica, for example the most common one is herniated disc (which is a disc that has slipped out of place between the vertebrae in the spine which then puts pressure on the sciatic nerve), osteoarthritis, degenerative disc disease, but also less suspected factors such as smoking, obesity and prolonged periods of sitting or standing. It can also appear sometimes during pregnancy. Tightness in the hamstrings, glutes and hip rotators can also influence the position of the pelvis and place additional strain on the lower back, thus leading to sciatica in time. It is important to keep in mind that we should not step out of our role as Yoga teachers and assume that only one of the factors apply for sciatica, in a student. Sometimes, it could be a myriad of factors involved or other seemingly unrelated conditions and it is not up to us to give a certain diagnosis or assess that some of the postures are better than others 100%. It is more a matter of the teacher and student openly communicating about the condition and the options available. It is all about guiding the student to deepen interoception in their body and discover a more gentle movement with fewer asanas and more of a gentle pace, moving without pain or discomfort, but with a sense of discovery and care for themselves.
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