Stop Sciatic Back Pain

As difficult as sciatica is to endure, it’s as simple to understand and to undo — and sciatica is usually a “doing”, not usually a state of damage to the nerve that must heal. It just takes the correct and most direct kind of approach.

What is that “doing”? It’s muscular contractions in the neighborhood of the sciatic nerve. The sciatic nerve gets entrapped either between neighboring vertebrae pulled too closely together or between contracted muscular tissue.

The muscles involved are usually under voluntary control and relaxed when not involved in movements. The sciatic nerve doesn’t mind momentary compression, as in movement. However, in sciatica, these muscles stay contracted in the grip of habituated postural reflexes — on autopilot, out of the control of the sufferer.

To end sciatica, then, involves freeing oneself from the grip of those involuntary postural reflexes. That gets done by a certain kind of movement training, about which I will say more, shortly.

That’s the simple understanding that explains most sciatic back pain and how to stop it. (The other kind of sciatica results from rupture of intervertebral discs — a much rarer and more difficult situation. I’ll say more about that at the end so you know which version you (presumably, it’s you) may have).

Now, more detail.

Two most common forms of sciatica exist:

* lumbar sciatica
* piriformis syndrome

LUMBAR SCIATICA

Lumbar sciatica consists of two habituated muscular contraction patterns at once:

1) low back muscles producing excessive lordosis (spinal curve)

2) waist muscles producing a side-tilt to one side

The combination of these two muscular actions compresses the sciatic nerve where it exits the spine at L3/L4 – L5/S1 (basically, the low back).

PIRIFORMIS SYNDROME

The piriformis (or pyriformis) muscles are buttock muscles. When tight, they turn feet toes-out. The sciatic nerve passes around or sometimes through the piriformis muscles and can get trapped and squeezed between the piriformis muscle and neighboring muscles.

Piriformis syndrome is the rarer and simpler form of sciatica.

HOW TO STOP SCIATICA BACK PAIN

While words have explanatory value, a video clip shows the process. This clip shows the first of two procedures needed to stop sciatic back pain and deals with the “back pain” part of the problem; another procedure deals with the side tilt. These procedures are called, “somatic education.”

Now, a word on other methods of dealing with sciatica — and that includes muscle relaxants, surgery, and any kind of therapeutic manipulation. If they don’t address the muscular activity behind sciatica and if they don’t teach a person control of that activity, they can’t be effective in the long term. It’s as flat as that.

Finally, words on sciatic back pain from a ruptured disc.

RUPTURED DISC or MUSCULAR ENTRAPMENT?

When a disc ruptures, its pulpy center squeezes out of the rupture site into the neighboring space, where the nerve is. The pulpy center (“nucleus pulposus”) squeezes on the nerve root. In such cases, the approach I have outlined doesn’t work — but it also doesn’t hurt.

If you don’t get rapid improvement (two clinical sessions or a week of somatic exercises), it’s likely you have the disc problem. That’s usually a surgical situation, although some therapists claim to be able to get the disc material into the disc via the MacKenzie Technique. Even in that case, the muscles must be freed or the situation is likely to recur.

For more video on back pain relief click emergency back self-care.

For access to the Home Website on this approach, click here. For access to practitioners and self-help instruction, “stop sciatica”.

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6 Responses to “Stop Sciatic Back Pain”

  1. Jukka Says:

    Thanks for great blog Lawrence. I’m having severe back pain which was triggered by slip on stairs Nov 2009 when falling on my buttock. The pain started roughly week after slippery. I had previously had sore back occasionally for more than ten years every but less mildly. My physiatrist says I most definetly have disc herniation. He didn’t mention sciatica but mentioned tight hamstrings and shortening of SI joint.

    If there’s “disc problem” does it always need a surgery ? Can somatic exercises heal my back if I have herniated disc ?

    Thanks

    Jukka

    • lawrencegold Says:

      Hi, Jukka,

      Disc problems don’t always need surgery; many times, merely alleviating the compression forces of contracted muscles gives the disc(s) enough space to heal. That’s the function of somatic exercises.

      Often, the pain doesn’t come from the disc, at all, but from the highly contracted muscles that span the disc; disc pain is usually nerve pain at a distance from the disc. Sciatica is such nerve pain (see my write up on sciatica at http://somatics.com/sciatica.htm).

      “Trauma reflex” is the term to describe your condition; it occurs with injuries as a cringing/guarding reaction to pain and can persist for decades, creating secondary problems, such as disc problems. See, “Completing Your Recovery from an Injury” at http://somatics.com/recovery_from_injury.htm .

      For self-help instruction, see http://somatics.com/emergency_back_care.htm

  2. Kim Bowman Says:

    Larry,

    I have read several of your articles and watched the 17-minute video this morning, but I’m confused as to whether I should do it or get other professional help. I was in a car accident in August of 2009. I started receiving chiropractic care and massage therapy. Prior to this, I was not in great shape – I was finishing my degree, along with private piano teaching -, although my husband and I played tennis throughout the summer and volleyball. After the accident, I began working out at the gym hoping to strengthen my low back and get relief. I just kept getting worse until I was unable to do anything but the treadmill. I have sciatic pain down the right buttock, traveling down my right leg. I have numbness that comes and goes in the left heel. After I sit, it is difficult to stand and straighten – severe pain and stiff – like I’m 90. Then I’m okay to walk. At night, sleeping is difficult and very painful to turn over – so much so that I yell out. I have pain all the time. My bones constantly pop or crunch with every movement and step. I went to physical therapy – just continued to get worse. Had an MRI done a couple weeks ago and found that I had degenerative disc disease and a broad-based disc bulge at L4-L5, mild central canal narrowing, small far lateral disc protrusion, extends into the left neural foramen. It says it may contact the undersurface of the exiting left L4 nerve root. The right neural foramen shows minimal narrowing. At L5-SI the central canal shows minimal narrowing from disc bulge. The neural foramina are widely patent. My chiropractor feels that the results of the MRI are not that bad. I ask my physical therapist and chiropractor many times about the bone crunching, but it is almost as if they don’t hear me. I can put my hand on my hips and feel the bones popping when I move. Is it going to cause damage to my bones? I have a high pain tolerance – I don’t take any drugs (don’t like to, hurts my stomach) and I could keep doing things, but I fear that I am making it worse. I still want to do things!!! I am a professional pianist and a singer. Sitting at the piano for long periods of time is difficult. I was rear-ended as someone was coming off the freeway and I was sitting in my car waiting to merge with my foot on the brake. Please help me or direct me to someone who can help! I live in Bellingham, Washington. For the last two weeks, I didn’t go to any appointments, nor did I exercise. The pain was less. But the minute I start doing things, such as vacuuming, housecleaning, volleyball, it gets way worse and bones crunch more.

    Here is the summary of the MRI: Mild degenerative disease. No high-grade levels of central canal or neural foraminal stenosis to suggest impingement. There is a small far lateral disc protrusion at L4-5 which may contact the undersurface of the exiting left L4 nerve root.

    Thank you!!!

    • lawrencegold Says:

      Hello, Kim.

      Medical opinions can sound like a prison sentence, with terms like, “degenerative disc disease”, “central canal narrowing,” and “disc protrusion.”

      Well, it’s not as bad as it sounds.

      First thing: “degenerative disc disease” is not a disease any more than excessive tire tread wear from habitual overloading of a vehicle is a disease of the tire.

      Your back muscles went into contraction as a protective reflex during your motor vehicle accident and stayed contracted, compressing your discs; that’s the overload. Discs protrude and eventually break down over time under that kind of overload condition.

      However, discs heal when relieved of their excessive load. Their protrusions recede. It does take some time for discs to heal (months, generally), but the pain can ease very quickly (days or weeks).

      Bone crunching is evidence the muscular contractions have pulled your spine short.

      Central canal narrowing may be an observation, but it’s not a reliable cause of pain.

      The common mistake people make is to think in terms of strengthening. How do people suddenly arrive at the idea that they need strengthening? What does that accomplish? What does it even mean? It’s an idea that comes, I think, out of the fitness business: strong = good.

      Well, it’s wrong.

      Muscles in contraction aren’t weak and in need of strengthening; they’re tight, fatigued and sore, and are in need of rest. In their fatigue, they may feel weak, but they are not in need of strengthening. They need normal rest.

      With a back injury such as yours, you are suffering all the effects of contracted muscles and discs under compression, simple as that.

      So, I agree with your chiropractor.

      To go further, I say here, as I have in my articles and on the video page, that you need to restore length and freedom to those muscles. They will cease to be sore, your bones will cease to crunch, and you’ll have your mobility back.

      Given that your muscles and bones are held tight by the protective reflex triggered by your accident, you need to ease that reflexive action and regain your control. That’s what somatics accomplishes.

      … back to the 17-minute video for you, and then to a practitioner or to the instructional self-help program, Free Yourself from Back Pain.

  3. Kim Says:

    THANK YOU so much for your response and suggestions. I will definitely watch the video again and make use of the suggestions.

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