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Sciatica: Rest or Exercise?

SCIATICA: The Other S Word Everybody Dread

If you have experienced sciatica, know someone who has experienced it first hand or heard that term before, you must know it is a very debilitating condition that can arise… generally suddenly, without warning signs.

Sciatica is not a diagnosis. It is a symptoms that can originate from various medical condition.
It refers to the pain one feels down their buttocks, thighs and/ or below their knee and possibly into foot and toes. It occurs with certain motions and originates in the lower back( your lumbar spine and tailbone/ the last 5 spinal vertebrae and sacrum) when your sciatic nerve ( the largest nerve in your body) or one of its nerve roots( the nerve origin coming out between each vertebrae of your spine) gets irritated by another structure.
This creates serious and acute pain down your lower back, buttocks, thighs and sometimes all the way down  to your toes. Sharp, searing, and shooting pain, “zingers”, numbness, tingling, ” cold water running down my leg” are common description of sciatica. 

When this occur, a lot of people feel powerless, un-wanting to move because most movement seems to increase that pain, even if they have been taking pain pills or muscle relaxers.

This is exactly what happened to one of my patient, Richard, last month…
He was busy all weekend building a flower bed in his garden, meaning repetitive bending over and spending several hours in this position. 
Later that night, he sat/ slouched in his couch, exhausted, watching his favorite TV program. 
When it was finally time to get up, he stood up but felt an excruciating shooting pain from his lower back down to his ankle. 
Richard ‘s injury is what you call classic SCIATICA. 

And like most human beings, he expected his problem would go away after taking it easy  for a couple days and resting and trying to ignore his back and leg pain. 
This is a big mistake( i still cringe when I hear patients mentioning  they were told to do so by their physician) as resting, which means a lack of movement and a lot of sitting is hands down the worst thing you can ever do when experiencing a bout of sciatica. 
It took Richard three weeks to finally feel like he was making improvement, all the while looking for any help possible, before he scheduled an evaluation and treatment with Butheau Physiotherapy. 

By then, he missed 10 days of weeks, hours of frustration and lack of improvement with his symptoms which progressed into constant tingling and numbness in his leg. 
He took painkillers which did not help at all ( and if you have read my post before, you know i am not a fan of these since they rarely help, being only a bandage but not actively working toward fixing the problem).

Many people suffers from chronic sciatica with lingering numbness after months from their injury, even though most people will recover within 6 weeks. 

So I would like to start this series of blog post and videos on sciatica by showing you how to do what we call nerve floss. With sciatica, something( discussed in my next post) irritates your nerve, or and the nerve sheath, the structure that encases your- sciatic nerve in that case, nerve and protect it. 

These nerve floss are performed first on your back and then progressed to sitting as your condition improves. 
The video is pretty self explanatory but it is important to make a special effort to  limit this “stretch” or floss within your pain threshold/  tolerance range.  The key is to basically tease the “flexibility” of the nerve sheath to your pain tolerance. 
If you follow that rule, you will not risk adverse effects and should experience a relief in your symptoms. 

In my next post, I will go over the causes of sciatica and other techniques for self treatments. 

DISCLAIMER: If you are suffering from acute sciatica, the following technique might be a little too aggressive and not work for you. 
Always make sure to have your condition evaluated by a manual physical therapist to expect faster progress and a good understanding of where your symptoms are coming from.
The most important thing to remember when you experience sciatica symptoms is that this condition involves your nervous symptoms. The sooner you give attention to your symptoms and look for help, the more likely you are to recover, without permanent neural damages and symptoms. 
If your sciatica involves changes in bowel and bladder  control, get yourself to the closest emergency room, it’s an emergency.


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