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Yoga for Sciatica
As a yoga teacher I have found that sciatica may be the most common health problem driving people to practice yoga. The word is out--yoga cures sciatica!
Having recovered from two bouts of sciatic pain primarily using yoga asana, I can testify that it does work, but only if you are consistent, persistent and do all the other right things when you are off the mat. Here are some tips for healing sciatica with yoga that I learned while working on my own sciatica..
The initiating factor in the attack from which I recently recovered was a freak lifting injury affecting my left sacroiliac joint. I went straight to work, applying yoga and body awareness to the problem and I was healed (or so I thought) in six weeks. Two days later, in parsvottanasana (pyramid pose) during my morning sadhana (daily practice), I heard the sound of cracking ice emanating from my right hip and a cold, yellow, stabbing pain radiated down my leg into my foot. Not good. The instability in my SI joint had shifted to the right!
Interestingly, the character of the discomfort (a euphemism for agony) that I experienced on the right side was quite distinct from the left. The left had been heavy, dull and reddish. It had responded to many of the postures that had been effective for me the first time I had had sciatica some years ago. But now on the right side, many of those same poses seemed to only aggravate the pain, which was sharper, more electric and sulfuric. Forward folding was now completely impossible whereas the sciatic pain on the right side had not prevented poses such as uttanasana (standing forward fold) or paschimottanasana (seated forward fold).
Having also recently worked with many students and clients suffering from this condition, I have observed that different individuals may experience the discomfort of sciatica distinctly and respond in substantially different ways to the same yoga posture. Each individual’s unique pattern of holding in the body seems to shape the character of their experience of sciatic nerve pain. While some general rules of thumb exist, working through sciatica is a tricky, dynamic process requiring diagnosis, patience, some experimentation and deep mindfulness of body.
The sciatic nerve is the largest and longest single nerve in the human body, about as big around as a thumb at its largest point. The nerve originates in the lower spine where nerve roots exit the spinal cord and it extends all the way down the back of the leg to the toes.
Sciatica occurs when a nerve root in the lower spine is pinched or irritated. Usually, sciatica only affects one side of the lower body and the pain will often radiate from the lower back all the way through the back of the thigh and down through the leg. Often a particular event or injury does not cause sciatica, but rather sciatic pain may develop as a result of general wear and tear on the structures of the lower spine. The vast majority of people who experience it get better with time (usually a few weeks or months) and find relief with non-surgical treatments such as yoga.
Any condition that causes irritation or impingement on the sciatic nerve can cause the pain associated with sciatica. It is most commonly caused by pressure on the sciatic nerve from a herniated disc (also referred to as a ruptured disc, pinched nerve or slipped disk) in the lumbar spine. Other common causes of sciatica include lumbar spinal stenosis, degenerative disc disease, isthmic spondylolisthesis, sacroiliac joint dysfunction and piriformis syndrome. Each specific condition producing symptoms may warrant a distinct approach to asana practice.
Get a Diagnosis
Western allopathic medicine is really good at one thing: diagnosis. Get an MRI or other tests to find out which of the sciatic pain-inducing conditions is creating your discomfort. Then you can practice accordingly.
Do Your Yoga
Tell your teacher that you are working with sciatica and s/he may tilt the class towards poses that can help. If during the class you encounter a pose that excites the nerve, don’t do it; modify or take an alternate pose. The nerve won’t heal if you keep aggravating it. If you can’t find a class that doesn’t get on your sciatic nerve, maybe it’s time to practice at home or take private lessons. Whatever you do, don’t give up! Doing nothing, hoping it will go away or just trying to live with it will lock the condition into place as the body contracts around the pain-building scar tissue and muscular rigidity.
Stretch and Strengthen
You’ll want to both stretch the affected area and strengthen the muscles of the low back and hips. Remember, your mileage may vary-it will take some experimentation to find the right asanas that will help your condition.
Generally speaking backbends are indicated, particularly in the case of disc herniation, but these same poses are counterindicated in the unusual case of spinal stenosis. Drop to the floor six times a day and do some cobra or sphinx poses. Think of them as prostrations to the Sciatica Healing Gods.
Spinal twists are not usually a great idea. Supta matsyendrasana (reclining spinal twist), done more for its hip and low back stretch than its spinal twisting quality, is fine for most people. In many cases, forward folds will irritate the nerve and are not recommended. However, do stretch the hamstrings often since tight hamstrings can be a major factor contributing to sciatic conditions; utthita hasta padangusthasana (extended hand to foot pose) with the sole of foot on a wall does the trick. In general if it doesn’t negatively work the nerve and seems to stretch and strengthen the affected area, go ahead and just do it. The Warrior poses are in general the safest and most effective poses in this regard.
Take Care
That nerve is excited, inflamed and irritated. Take a week off from yoga and let it calm down. Ice the low back and buttock for two minutes at a time about six times a day. Alternate heat with ice application, but heat the whole body in a hot tub or sauna, not just the affected area, to avoid accentuating the inflammation.
Non-steroidal anti-inflammatory medications (NSAIDs) or their ayurvedic herbal equivalents such as tumeric, boswellia, pirant oil and guggul, and omega-3 essential fatty acids will also help reduce the inflammation. Especially if you’ve been diagnosed with a herniated disc, avoid prolonged sitting. When you do sit always use a lumbar support. Massage and chiropractic care may be helpful especially if the cause of your woes is piriformis syndrome or sacroiliac joint dysfunction. Acupuncture may help alleviate the pain and address the root energetic causes of your condition.
Top 10
Here’s a list of the top ten yoga poses I found the most helpful.
10. Supta Padangusthasana (Reclining big toe pose)
9. Supta Matsyendrasana (Reclining spinal twist)
8. Agni Stambhasana ( Fire Log or Double Pigeon)
7. Prasarita Adho Mukha Svanasana (Standing straddle downward facing dog)
6. Utthita Parsvakonasana (Extended side angle pose)
5. Backbends (pick your favorite)
4. Utthita Hasta Padangusthasana with sole of foot on wall (Standing hand to foot pose)
3. Vira Bhadrasana I, II (Warrior I, II)
2. Ardha Chandrasana (Standing half moon)
1. Raja Kapotasana prep (Pigeon preparation)
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Got sciatica? Get Yoga! Let me help.
If you live in Los Angeles, we can heal your sciatica problem with private yoga sessions.
If you live elsewhere, let me help you via telephone and email consultation.
I can help you get on the path to freedom from sciatic pain!
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