EP 79: Get Rid of Sciatica Pain - Short and Long Term Strategies || WBWL

This is a great episode I made last year that people got a lot of values from. I wanted to put this one back on just in case you have missed this.

This episode is all about sciatica!

What is sciatica?

Who's most susceptible to sciatica in their lifetime?

What are long term strategies to keep sciatica out of your life?

And lastly what are some quick short term relief tactics you can use now?

Dive in and let me know what you think of this episode. I truly hope it helps!

Transcript

0:01

Welcome to the Won Body, Won Life Podcast. Hi, I'm your host, Dr. Jason Won, lifestyle, physical therapist, and pain relief coach. We help busy parents, healthcare workers, and professionals eliminate chronic pain and fully recover from injuries without injections, surgery, or manual therapy. Now, if you desire to get out of chronic pain long term, You may benefit from my online coaching program. We provide custom exercise, programming, coaching calls, movement analysis, habit retraining, and a ton of accountability to ensure you never slip backwards back to a state of chronic pain. So this program's not for everyone, but if you're interested in applying and seeing if you're a good fit, go to go.flexwithdoctorjay. com/apply-extended. Or go to the description section in this episode. Again, go to go.flexwithdoctorjay. com/apply-extended. And we're currently accepting applications right now. But spots are very limited for this summer. And today, I wanted to cater strictly to the busy parents, healthcare workers, and professionals struggling with chronic sciatica. First, I'll define what sciatica is. who often is more prone to sciatica, and lastly, end it with five tips to decrease your pain associated with sciatica. Now, sciatica, how that's defined, is basically a number or even a cluster of symptoms associated with any pain that emanates below the gluteal cleft, and that can range from either just behind your thigh, on the lateral aspect of your thigh, all the way down into either your calf or to your foot. Now, if you would just have strictly just chronic back pain and it goes into your glutes, for example, if you're just having more so gluteal pain or gluteal tightness or any mixture of even back pain, that's really not considered chronic sciatica. And if it doesn't really emanate or go below the gluteal cleft, which is basically, think of that buttocks bone, that's That you sit on, then we don't really consider that sciatica, but sciatica is basically any number or a cluster of symptoms or pain or tension that goes down the back of your leg. Now with sciatica, it's such a large umbrella term. And the reason why I say that is because sciatica can originate from many different things. Sciatica is not just a result of your. nerve going under tension. While it is the largest nerve in the body, is that sometimes what I see a lot of times is people that kind of stretch it out, they take some pain medication for it, and that's oftentimes not really a long term solution for that. The people that I see that are more prone to sciatica are those that either have an overly stressful job, it's either a lot of lifting and let's say a lot of classically a lot of construction workers that have to lift a lot of things It results in a lot of strain to the pelvis and to the lower back Which then starts to form potentially pain going down your leg a lot of times. It's complete opposite So I'll often see in time see very sedentary individuals who sit at the desk a lot And whether they sit at the desk a lot, and it's causing stiffness in their pelvis, their lower back, or even the muscles of their leg, or long term, may even cause some weakness, or some instability to those areas, can oftentimes result in sciatica. Sciatica, if it's any pain that maybe even goes down the back of your thigh, or even goes below the The popliteal fossa, which is basically the back of your knee, or even goes down into your ankle, all that being is that it can be considered some form of sciatica. The sciatica, because it is the largest nerve in the body, I think a lot of people have their reservations in terms of how to go about getting rid of that pain. But there are a lot of strategies that I see on either social media, Or even see other physical therapists who strictly just try to stretch things out, or they try to, let's say, massage their piriformis, they try to stretch their piriformis. And, I would honestly say that if it were that easy, I think a lot of people would be Free of sciatica, but you can see that it's a good amount of people that either they put Piriformis stretches on there or they say massage their glutes or they try to stretch their nerve out While none of that I think is a bad idea I also think don't think that those really lead to any long term relief from sciatica so let's go ahead and dive into five tips to decrease your pain associated with sciatica right now And These here, just to let you know, just a disclaimer, you do everything at your own risk, I don't really take any responsibility for it, but hopefully this will give you a more broad scope of how to go about any sort of nerve related pain or tension that is going down your leg. The first one that I want to go through is something that's a little bit more holistic, which is you just gotta stress less. It's very hard to tell somebody that is stressed to just do it less. This is more of a long term approach, being able to outlet your stress better, understanding that there are positive coping mechanisms versus negative coping mechanisms. A good example of what negative coping mechanisms would be, you just rest in bed to try to get rid of your pain, or let's say you take a, you take an Advil. You put a heat pack on your legs or put a heat pack on your back to try to lessen the sciatica. Even CBD, as promising as CBD is with regards to the research, I don't think that CBD is a long term approach either. It may decrease pain, it may decrease nerve related tension, but it's never a long term approach. So I would definitely consider that more of the even so negative coping mechanisms versus positive coping mechanisms is taking a proactive role. And potentially putting movement at the forefront. So you're either performing strength training to try to decrease that stress. You're either going out for a walk, which not just gets the nerve, the sciatic nerve moving in a very light and gentle manner, but at the same time, it clears your head from stress or even just meditation. I know that meditation and yoga are not for everyone, but even meditation or deep breathing, being mindful, mindfulness is huge, mindfulness based training. But I would say definitely my first thing with sciatica is stress less. Now, why do I say that is when you're looking at how Interconnected pain is in relation to stress or to the brain is that when we are in a lot of stress We oftentimes carry stress in different areas whether that is our neck Our shoulders sometimes our upper back. I'm one person that if I do start to get stressed out Or if I get lack of sleep and my body's feeling physically or mentally or emotionally stressed I'll definitely start to feel some upper back pain come back But for some stress can emanate in different places. The analogy that I like to use is Stress is more of a mental, is more of a mental stress, right? So we're mentally stressed out, we start to think not as clearly, or we start to get into our own head. But when we have this, let's say this empty cup, and this empty cup is 8 ounces, if I can only tolerate a certain amount of stress, let's say I put 4 ounces into an 8 ounce cup, then I can handle that stress. The stress is bearable. The stress is not getting me myself to a point where I'm like overwhelmed by any means and I can tolerate that stress and research Just show that a certain amount of stress is needed in order for us to succeed in life To make us feel fulfilled and that's basically the there's a correct amount of stress Even lack of stress is also not good for us leads to lack of motivation laziness sedentary behavior, etc But most of us especially in an american society are very over stressed. So when let's say You we have an 8 ounce glass, and then that 8 ounce glass is analogous to the amount of stress that we can tolerate. If you're constantly, every day, trying to pour 16 ounces into that 8 ounce glass, then you're overfilling that glass. What ends up happening is, when you overfill the glass, and when you're mentally overstressed, that stress can start to perpetuate or to start to appear as physical symptoms. So stress, very commonly, if you notice that, let's say you have bilateral sciatica, you have pain going down both legs, you have pain going into both hips, or let's say you have pain on both sides of your neck or both aspects of your shoulder. A lot of times when it's more bilateral symptoms, meaning it's appearing on the left and the right side equally, is when that pain is potentially coming from a very stressful moment. That stressful moment could be fired, you got in a fight with your spouse, you're not getting along with your child, there was a death in the family, there was a pet that passed away, and you're very stressed about that. Financially it could be whatever it is, but when you notice That when there is more of bilateral symptoms or even bilateral sciatica that could potentially be that you are very stressed and that you need to start outletting that stress in different ways, start to replace some of your negative coping mechanisms with more positive coping mechanisms. And that would be my first tip for sciatica is thinking about it more from a holistic perspective. The fact that stress, the main, secretion or the main hormone for stress is cortisol. Cortisol will affect literally every joint, every muscle, every nerve and every organ in your body. When you are stressed, your body goes into an autonomic fight or flight type system. Your sympathetic nervous system is in overdrive. So when that happens, your hair's Your hairs on your skin start to sprout up, your, increase your blood pressure, your heart rate starts to increase. Just a whole bunch of ways if we can just decrease the cortisol secretion. And I know that some people chronically have over, amounts over secretion of cortisol. We can start to work at that slowly. I think that can start to, that can be a more holistic way to decrease sciatica. Alright now that I went through a more holistic way, let's give you a more tactical, very immediate way to decrease sciatica. And one of my favorite ways, that's super easy, that is basically a no excuse kind of intervention, is actually massaging your foot. So either, either massaging your foot or getting your foot to touch the ground, which I'll call grounding. So when your feet get to touch the floor, is that there's actually physical electron, electron transfer from the ground that is coming from the earth and that goes into your foot. Now when there's a lot more of this electron transfer, that actually can invigorate the nerves in a great way, that could start to either calm the nerves down and grounding can actually decrease cortisol secretion and also decrease sympathetic drive. Okay, so when you are massaging your foot, it's not just you're not just massaging your foot I'll go into a little bit more of the physiology But you are actually massaging your nervous system and that can actually decrease cortisol secretion. It can decrease stress And so that could be a great way in order to help That's why you know, I see a lot of the women that go to get mani pedis and they're massaging their foot They feel so good I don't really know a lot of women that say they don't like a good mani pedi, especially when it's accompanied with a calve or a foot massage. There's a reason why we walk out of there feeling like a million bucks, because they massage your foot, and that has a lot of nervous system changes. Okay, so physiologically though, the foot has four layers of muscle and all those muscles usually a lot of the muscular control of your foot is either coming from the lateral plantar nerve or the medial plantar nerve, right? So those are the main bundles of nerves that control the muscles of your foot. At the same time, the lateral and the medial plantar nerve also accompany the sensory portion. Any tension, anything, if I touch your foot, there basically it's a motor. And a sensory nerve and people fail to realize that those lateral and those medial plantar nerves Actually come from a larger nerve, which is your sciatic nerve, right? So if let's say it's very you're trying to stretch out your nerves. You're trying to put a heat pack on it You're trying to massage your glutes if that's not working Try getting like a large lacrosse or a tennis ball, put that on the ground, and just start to massage your foot out. It's pretty crazy how you may try this, try to touch your toes. And if you're a person that does, that can't touch your toes, and you have sciatica, then you may feel tight. Like you may feel like your calf or your hamstrings or glutes or even your lower back is tight. Try massaging your foot. both of your feet for let's say one to two minutes and get into the nitty gritty. So try to get to the point where it's a little bit tender and when you massage the foot and you start to stretch out your toes, you try to like crunch and even contract your toes while massaging it. Try standing after those one to two minutes and then try to reach the floor again. It's not for everyone, but I would say a good amount of people, after they massage your foot, they start to reach for the floor, and they can actually go a little bit further. And that actually shows that you've actually decreased the pain. Some of that sciatic tension by doing something as simple as just massaging your foot. Okay now because again Physiologically the lateral and the medial plantar nerves attached to the sciatic nerve is that when you massage the muscles you start to bring good sensation and pressure sensation to the foot that can actually somewhat inhibit the muscles that are accompanying not just the foot, but your cavity, your sciatic nerve as well, along with your hamstrings, and that can actually give you a good amount of relief. So again, that's just more of a tactical thing if you are somebody that just wants more immediate relief. Okay, so let's dive into number three. Number three is still more of a long term, but you can actually gain immediate benefits. I'll definitely say number three is more you can gain immediate benefits if you do this correctly, but long term benefits, it can actually prevent sciatica. And this is actually to strengthen your hamstrings. So your hamstrings is a muscle that attaches from your gluteal cleft, your ischial tuberosity, basically your butt bone, and attaches into the back of your knee. A majority of your hamstring muscles are actually innervated by your sciatic nerve. Okay, so when you strengthen your hamstrings, your muscles basically are contracting, and that actually can decrease the sensation associated with sciatica, because the largest motor neurons are actually your motor nerves, okay? And then after your motor nerves are actually your sensory nerves. So then you have basically, your temperature receptors, and then you also have your vibratory receptors, and you also have your pressure receptors. Now all of those, if you look at pressure, like somebody like just pushing into your hamstrings, temperature, hot and cold, versus vibratory, basically if you have a massage gun in your hamstrings, all of those are sensory. So we're trying to change the sensory system in some way or form so that you feel less pain in the back of your leg. How do you do that is if you can use, if you can actually strengthen or load your hamstrings, it will actually overwhelm all the other sensory motor nerves. Sensory neurons as well. Okay, so I've seen it time and time again where people are just trying to stretch their hamstrings because they saw it on social media or their PT has told them to do it. Oftentimes don't see that stretching is always a long term approach, but when they start to do strengthening, either they do a hamstring curl, they do an RDL, a Romanian deadlift, they start to notice pretty immediate results as long as you're not doing too much. So don't try to Do 100 to 200 pounds deadlift right away. That wouldn't be smart, but just try even just anywhere between 5, 10, or even 20 pound dumbbells, just depending on your size and your capacity. If you can strengthen your hamstrings, I would argue that can actually decrease your sciatica. tremendously in the short term and just continue to strengthen your hamstrings in many different ways And you can get some long term benefits there So just remember your hamstrings attaches from your gluteal cleft, which is your ischial tuberosity So you can strengthen your hamstrings through hip extension basically just kicking backwards in some way or form You can also just bend your knee and the main muscles that help to bend your knee is your hamstring So if you bend your knee you strengthen your hamstrings from the more distal portion or if you do any hip extension like Hip thrusts, bridges, deadlifts, there's a bunch of hip extension type of exercises, even kettlebell swings, kettlebell deadlifts. Then you're strengthening more from the hip portion. And so those are the two ways you can strengthen your hamstrings, okay? Number four is just a more holistic view. It's more of a stop doing this. Just don't do less stretching. To be honest, I think there's stretching, yes, less effort. Yes, less calories needed. It's much easier to do. It's less time intensive. And also, it just feels good for a lot of people to just stretch your hamstring. To just reach forward, bend your toes. Or to do sciatic nerve flossing. Again, I think that stretching has its role. I don't think that it has any long term benefits. Research backs out that stretching really doesn't reduce injury. It can actually increase your risk for injury. Stretching really doesn't have any long term carryover to long term pain relief. It does not prevent disability in any ways. Stretching, by any way or form, it's just not a long term thing. I actually, personally, I'm completely pain free at this point. I do a lot of strength training. I've actually stretched so much less and my body feels good. I don't need to stretch very much at all. So I would definitely say for those that have sciatica that you don't really need to stretch your glutes a lot. You don't need to stretch out your hamstrings or stretch out your sciatic nerve in any ways. I find that many people that do a lot of stretching for their sciatic nerve probably have more tension and sometimes it can backfire against them. So I would definitely say it's just like a, It's like a spinoff from number three, which is if you strengthen your hamstrings, that should take up more time so that you have less time for stretching. Okay, less stretching, more strengthening. That's the premise behind this. All right, lastly, number five, and I think everyone can benefit this, which is more so just core strengthening, specifically triplanar stability. And the reason why I say that is because when people stretch their sciatic nerve, They're really not attacking the root cause. Okay, so the root cause, really, the true root cause, honestly, is more lifestyle, your, sedentary behavior or maybe you're a person that just doesn't know how to stop, right? So maybe you're either 0%, you're very sedentary, or you go too hard for your body and you stress it too much. But I would definitely say for, from a core strengthening perspective, triplanar stability is very important because when it comes to sciatica, sciatica is not just, sciatica is more so the symptom. It's more so the root cause may be coming from something higher up. Maybe it's lack of core stability, maybe it's poor hip strength. So when you strengthen your core, strengthen your obliques, your rectus abdominis, even your transverse abdominis, you strengthen your paraspinals. So basically All these words I'm saying are basically muscles that attach near the center of your body, basically everything that is right near your belly button, all those muscles right there. So when you can strengthen your core in different ways, I find that a lot of people can immediately see less pain. discomfort with sciatica, they notice that their hamstrings feel less tight, they notice their calves feel less tight. A lot of times you core strengthen and they notice less foot tightness. So when you strengthen the center of gravity, so think about strengthening the command center if you will, it actually decreases symptoms in a lot of different places. So some of my favorite ones, maybe just like any plank variation, you can try supermans, you can try bird dogs, may be a good place to start. I wouldn't just stay with bird dogs the rest of my life, but I would even say like side planks and the use of ropes and bands to pull you in different directions. Triplanar stability is basically strengthening your body in multiple planes. So not just strengthening your front abdominals, doing as many sit ups as you can, but also strengthening the backside, strengthening the side muscles, strengthening your core in terms of rotation and being able to resist rotation. So your spine, as we get older, we have five vertebrae L1 to L5, and then you have your sacrum. Those specific vertebrae, while they are very large and they're very robust and very stable is that it does undergo stress. So if you carry things the wrong way, you carry your baby on one side of your body, or let's say you're very right hand, right leg dominant, Pick up things on your right side is you are creating some sense of indiscrepancies or you're a lot stronger on one side versus the other. So that can create a lot of torsional stress. It can create like sheer stress or compression stress. Basically, there's all fancy terms for stress that can stress the spine in different ways. How to resist that stress and to create less damage to your spine over time is via either core strengthening, adding in some strengthening of your hamstrings as well, and strengthening your overall body. I'm not discounting the fact that strengthening your, even your upper body can help with your sciatica. I'm just narrowing it down to what are some of the main muscles you want to strengthen, Likely hamstrings and a mixture of glutes, but also your core at the same time. Maybe a little bit less stress less stretching, less stressing as well. And if you need something more immediate, definitely you can massage your foot with a lacrosse ball. And these are some either easy, or More acute short term strategies for your sciatica right now and even some long term strategies like strengthening over time a lot along with Stressing less and for those that have maybe been feeling short on time or have been feeling stressed for a long time This can be a definitely a long term Project if you will, but maybe try the massaging every foot Maybe just trying a little bit of strengthening right that kind of accompanies stressing less All right, so that's what I got for you guys today. If you enjoyed this episode definitely hit that subscribe follow button I release new episodes every morning on Wednesdays, and I'd love if you can leave a rating on your podcast So my content will reach more people who could benefit from the tips that I put out and there's any feedback about the content I'm putting out good or bad or there's any specific things that you want to see on future podcast episodes Definitely send a quick text My number is 415 965 6580 or you can email me at jason@flexwithdoctorjay.com. I reply to all my messages personally and I'll leave you always with these last words of advice. We only have one body, one life. Make every action you take be one that makes you a better version of you. Take care.