What To Do When Sciatica Comes To Visit

In my 25 years of practicing in East Tennessee, both massage and acupuncture, patients presenting with Sciatica have averaged 1-2 per month. In the past three weeks, 11 people (some new patients, some regulars) have shown up to my office with Sciatica complaints- a tidal wave of literal 'pain in the butt'!

Why do Sciatica patients show up for Acupuncture? Traditional Western medicine has little to offer for relief besides pain medication or muscle relaxers, which both simply mask the symptom and do not address the root problem of the issue.

Causes of Sciatic Nerve Pain

This buttock/ leg pain pattern shows up after an event such as a long car ride or slip on the ice, but just as often patients wake up with it 'out of nowhere'! Despite the onset details, the situation has often been 'brewing' for months or years with poor posture such as watching Netflix in bed, sitting for too long at work, and then aggravated by high-inflammation diet choices.

Sciatica can present in various forms: pain traveling from the spine down the leg, tingling, numbness, 'pins and needles' sensation, weakness or tightness of muscles, coldness to touch, etc. Sensations can present in only one leg, but can also alternate side to side.

Acupuncture for Sciatica

Three ways Acupuncture helps musculoskeletal issues such as Sciatica:

1. reduces local swelling and inflammation

2. enhances blood circulation

3. relaxes central nervous system, which relaxes skeletal muscles

Sciatica can come from an 'upstream' cause, where a spinal nerve gets pinched  from radiculopathy, herniated disc, or degenerated disc, or from a 'downstream' cause of tight gluteal muscles such as the piriformis muscle putting pressure on the sciatic nerve. When treating Sciatica with Acupuncture, I address all potential causes just to cover our bases.

There is a great chance Acupuncture can offer complete relief in 2-3 visits for these causes.  For many people, this can be a one-and-done situation and they will have no more sciatic issues at all, especially if they keep up with some form of preventive movement such as yoga or stretching. Others may experience future recurrence, especially if they have a history of long-term back pain, chronic spinal disc issues, or have an ongoing  job which stresses the low back such as medical workers lifting heavy patients or truck drivers.

However, root causes of Sciatica which are structural in nature (spinal stenosis,  bone spurs, spinal tumors) require surgery to eliminate the issue. For those who are not candidates for surgery or who choose to put off surgery and manage the condition with as few medications as possible, Acupuncture can help with pain management, and by reducing inflammation/ swelling to allow more mobility and circulation.

Sciatica Exercises and Self-Care

Always with the hope of inspiring patients to step up preventive care, I have chosen 4 simple exercises which can ease sciatic pain and/or help prevent future flare-ups:

NOTE: When working with back pain or Sciatica, exercises done lying on the floor are ideal, as they stabilize the spine to prevent more damage. Work within your comfort zone, don't overdo it. Exercises # 1 - 3 increase in mobility.

1) Lie on the floor and pull one knee to the chest, keeping the other leg flat on the floor. Only pull the knee in as much as the body will allow while keeping the spine straight.

*For exercises # 1 - 3, alternate left and right knees, 3x each side. If one side feels tighter, start and end on that side to give it an extra workout. Breathe!

2) Same position as above, pull one knee into the chest with the other leg lying flat on the floor. As the muscles ease a bit, guide the knee across the midline toward the opposite shoulder. Keep both hips flat on the floor and lower spine straight- do not stretch so much that the lower spine twists. Instead, the stretch should be felt in the hip and buttock of the raised leg.

3) Begin in same position lying on your back on the floor. Bend left knee and place left foot on the floor. Bend right knee, and place right ankle on top of left knee (cross your legs 'like a man'). Gently press right thigh out to the right, with aim of feeling a stretch in right hip. If you feel pressure in the right knee, ease out of the position- this stretch should not be felt in the knee.

If this stretch is easy for you, you can reach behind your left thigh with both hands and pull it toward your chest, which pulls your right ankle into the chest as well. This is sometimes called a 'figure 4'.

4) Position of ease: Sit in a chair which allows your thighs to be parallel to the floor. Scoot to the front of the chair and let your elbows come to your knees. Use a pillow under your elbows if this is too much for your back right now. Slowly lean your weight forward, using your elbows to catch the weight of your upper body, so that your low back receives a gentle traction stretch. Relax and breathe for about 5 seconds. Press into your elbows to sit up, repeat 3x. This is great to do several times each day, especially for those with spinal disc issues.

Two last hot tips:

• In Chinese medicine, after the first 24 hours of an injury, we never advise using ice, which simply numbs the area (reduces pain) but also slows blood circulation, so critical for the healing process. We advise using heat in increments of 15-20 minutes, especially boosting circulation just before bed, which is our least active time the day. Use a heating pad or WARMING topical liniment/ salve/ cream.

• Consider cleaning up your diet for a while. Common things such as sugars, alcohol, and stimulants (coffee, tobacco) raise our inflammation levels, which only contribute to the issue. When you begin feeling better, you may feel motivated to continue eating that way!

• The old-fashioned health drink: WATER. Our body, and our spinal discs especially, depend on hydration to function and to cushion our body's activities. It's cheap and it's easy- aim for at least half your body weight in ounces per day.

Want even more support?

Try a visit to your local Acupuncturist to address your pain- in relation to you as a whole individual: your body, emotions, and constitution!

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