Discover how yoga therapy offers a gentle and effective alternative to traditional medical treatments for sciatica, promoting holistic healing and long-term relief.
Our medical community currently communicates that the prognosis for sciatica is not very positive. I am using this uplifting, positive image to suggest that this is not true and healing is very possible for you or your loved one. The first and most important step in your healing process is to believe that a strong complete recovery is possible for you and that surgery is not your only option.
The sciatic nerve begins in the lumbar part of the spine; it crosses the buttock, thigh and leg and goes down to the foot. The main symptom for sciatica is pain radiating down the leg and 90% of cases of sciatica are said to be caused by nerve root compression in the lumbar region. Some individuals also report low back pain that is less severe than the leg pain. Others report numbness and paraesthesia (tingling in the extremities).
Sciatica is also referred to as lumbosacral radicular syndrome, ischias, nerve root pain, and nerve root entrapment. The management of this condition varies and surgery is a common approach, particularly in certain countries- the USA without a doubt being one of them. Conservative treatment for sciatica is limited to analgesics or by reducing pressure on the nerve root. And research has found that conservative treatments do not clearly improve the natural course of sciatica in most patients or reduce symptoms. One review states that “Analgesics, non-steroidal anti-inflammatory drugs, and muscle relaxants do not seem to be more effective than placebo in reducing symptoms.” Our contemporary medical system is not very creative, in other words. And I would prefer the placebo, personally. Because conservative treatments are not alleviating pain and primary care physicians are not aware of alternative approaches, patients have been recommended surgery. Surgical intervention is quite invasive, as well, involving the removal of the disc herniation (and eventually part of the disc) or correcting a foraminal stenosis (a case of bone compressing the nerve). Surgery can alleviate leg pain, but is not guaranteed to help with back pain.
It is also worth clarifying that a herniated disc does not guarantee pain. G. Lorimer Moseley and David S. Butler, the authors of Explain Pain, share that “At least 30% of people who have no low back pain, have LAFTs (living adaptable force transducers, or intervertebral discs) bulging into their spinal canal, sometimes markedly.” Here are some things you should know about these discs (shared by G. Lorimer Moseley and David S. Butler):
As shown in image 1, these discs are firmly integrated with adjacent vertebrae, have shock absorbing rings, and are surrounded by lots of ligaments and muscle. They do not look like loose frisbees in reality, as depicted in most medical illustrations (see image 2)
The outer layers of the disc as well as the surrounding structures have nerve innervation. The spinal column is very important for our body’s proper functioning and so any damage will understandably set off danger signals.
An injured disc may result in delayed pain, sometimes as long as 8–12 hours post injury.
Degeneration of the intervertebral discs is natural and does not need to result in pain. If the degeneration is gradual, the nervous system is not likely to react.
Intervertebrals discs do not slip. They “age, bulge, sometimes herniate, and sometimes squeeze onto a nerve or release chemicals that irritate a nerve.” These changes are not guaranteed to result in pain.
These discs heal slowly and aged discs may resemble injured discs, yet result in no pain.
The intervertebral discs are resilient structures. Imagine football players being tackled and coming out of this with no pain.
Image 1: An more realistic portrayal of an intervertebral disc
Image 2: How intervertebral disks are normally depicted. This is not a realistic portrayal of this structures.
Seeing Sciatica from a Metaphysical Perspective
To provide another perspective on this condition: The following is metaphysical explanation for sciatica from Le grand dictionnaire des malaises et des maladies by Jacques Martel.
“The pain I feel paralyzes me. The pain may occur more in one leg than the other. So I’m worried financially. If my right leg is in question, it may be because I am afraid of running out of money and not being able to meet my responsibilities in what is coming for me. If the pain is in my left leg, my lack of money may intensify my feeling of not being able to give everything, materially, to the people I love. I fear that their love for me will be affected. I delude myself, I believe myself to be very spiritual and detached from material goods (a kind of hypocrisy). However, the fear of running out of money haunts me and makes me very anxious. I work very hard, I have great responsibilities and, despite all my efforts, I still experience some financial problems. My body stiffens: I feel stuck. I constantly question myself. What am I not doing? Do I have the knowledge and talent to deal with a new situation? My insecurity leads me to rebel, I resent life and have come to develop a feeling of inferiority. I can refuse to “bow” to a person or a situation. Insidiously, aggression sets in and my communication with others suffers. I better calm my nerves because, at the moment, I feel like my nerves are on edge. I become aware of my inner confusion and pain (both internal and external) regarding the direction(s) of my life, here and now. This pain often results from my stubbornness in wanting to cling to my old ideas instead of opening myself to change and newness. This situation is common among pregnant women who experience inner confusion and pain regarding the direction now taken in their life: doubts, fears and worries can surface…I don’t have to judge myself, but accept myself as I am. I accept that the source of my true security is in myself and not in the things I own. I let go and trust the universe, because it is abundance for all on all levels: physical, mental and spiritual. By trusting the universe, I trust life. I discover true wealth, that which I have inside me. The true value of a being is measured by his greatness of soul. I accept my limits, I become aware of my fears, I integrate them. I decide to move forward in life, I let myself be guided in complete safety for my greatest good.”
If you have sciatica, notice if there is anything here that resonates with you. It may shed light on how your personal fears and belief systems could be contributing to your condition. Begin with this acknowledgement and don’t put pressure on yourself to resolve this now. Simply set the intention of healing this and surrender to the process.
Yoga Therapy for Sciatica
In the meantime, I have a yogic approach to this condition that should help you manage the symptoms. These practices were shared by Richard C. Miller, PhD,a clinical psychologist, author, yoga scholar and advocate of yoga as therapy. He is the founding president of the Integrative Restoration Institute, co-founder of The International Association of Yoga Therapists and founding editor of the professional Journal of IAYT.
Yoga Practice 1 (Image 3)
Do this practice daily for 1–3 weeks and be mindful not to strain yourself when you are doing the postures. Trust that you can do less and still experience a large benefit. Listen to your body and focus on how you feel when you are doing the exercises.
Before starting your practice, consider sitting comfortably and briefly taking note of how you feel in your mind and body. Observe the quality of your breath (how you are breathing, where you are breathing- in the chest? ribcage? abdomen?, at which rate). Observe how you feel in the body and do a quick body scan of the head, neck and shoulders, chest and abdomen, arms, hips, and legs. Note where there is tension, pain, or discomfort. Observe the state of your mind- is it still? body? what are you thinking about? There is no need for judgment. You just want to be aware of how you are doing on the level of the body and mind at this time. Also consider observing your emotional state and note to yourself how you are feeling emotionally.
Start your practice with diaphragmatic breathing: While lying on your back, place a book on your stomach and as your breathe, be aware of the movement of the book (the movement of your abdomen). Lengthen your exhalations and pause very briefly after each exhale. The idea here is to develop mindfulness of your breath. Be sure to expand the ribcage to engage the vagus nerve and parasympathetic nervous system and therefore promote relaxation.
Lie on your back and raise your arms dynamically from your sides to over your head while keeping one leg stretched out and the other leg bent with the foot on the floor. This practice gently massages the lower back.
Lie on your stomach and alternatively lift one foot at a time, bending the leg at the knee while keeping the thigh on the ground. This is preparation for the next movement.
Dynamically bend one knee as before while simultaneously lifting your chest. This develops the extension in your low back to help ease any pressure away from your sciatica nerve.
Rest on your back and observe the effects of the practice on your body and mind.
Lie on your side and dynamically raise and lower your top leg, keeping the lower leg bent on the ground to provide support and stability. Keep the front of the active leg turned in and your thigh and leg rotated medially (inward and downward) throughout the exercise. This massages and strengthens a number of muscles around the low back and buttocks including the piriformis and gluteus medius; all muscles which are suspected to contribute to your sciatica and low back discomfort.
7. Rest and observe the effects of the practice on your body and mind.
8–9. Repeat Asanas given in the beginning of the Vinyasa as a way of counterposing, balancing, and strengthening.
10. Visualize the abdominal diaphragm moving up and down with each inhale and exhale. It lowers on the inhale and lifts on the exhale. This video and this video show how the diaphragm moves with respiration.
11. Repeat #5: Rest and observe the effects of the practice on your body.
Image 3: Practice 1
Yoga Practice 2 (Image 4)
When you notice an improvement in your pain with the first practice, continue with the following practice. Modify this practice as you desire, incorporating exercises from Practice 1 if they brought great benefit to you.
Practice Shitali Pranayama as a way of calming your mind and preparing the mind, body and breath for upcoming sequence. This practice can help with sleep and contribute to pain reduction.
Dynamically bring one knee into your chest while bringing the arms down by your side. Then return the arms over your head and place the bent leg back on the floor.
While on your stomach, dynamically bend one knee while simultaneously lifting your chest. We did this movement in the first practice to remove the sciatica and strengthen the low back.
Lift your head as your lift one leg, keeping it extended and engaged. The intensity of this pose should be in your lower back. Be sure not to strain your neck as you practice this. This exercise further strengthens the back and supports the removal of sciatic pain.
Raise your chest off the floor on the inhale while keeping the hands clasped behind the back. On the exhale, while keeping upright in the backbend, twist your spine over your shoulder and look at the opposite foot while keeping both hips firmly anchored on the floor.
Rest and observe the effects of the practice on your body and mind.
Image 4: Practice 2
Regular practice should strengthen and stabilize the back and gluteus muscles, increase flexibility in the spine and hips, and relieve lower back pain as well as sciatica. Focus on consistency for now and keep it simple. As you progress, you sould be able to incorporate more dynamic and advanced postures. If the Shitali Pranayama does not feel right to you (if you do not feel calmer after the practice), replace it with the Viloma Krama Pranayama from Practice 1 (#10).
Practice with mindfulness and avoid exercises that exacerbate the pain and discomfort. Make a habit of incorporating time for rest intermittently so that you can develop awareness of how the exercises are impacting your mind and body. If the effects are not desirable, trust your intuition and only do practices that are clearly beneficial for you. Some exercises may not be beneficial now but may be more suitable later. A mindful, slow practice will allow you to conclude for yourself what is appropriate for you.
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