Exercise is the first step in preventing sciatica. That’s the word from Dr. Hooman Melamed, a board certified Orthopaedic Spine Surgeon and Director of Scoliosis at DISC Sports and Spine Center in Marina Del Rey.
“Back muscles and the spinal structure can become deconditioned from lack of exercise or movement, making them less able to support the back, which leads to back injury and causes back pain,” says Dr. Melamed. “Movement helps exchange nutrients and fluids within the discs, which keeps them healthy and prevents pressure on the sciatic nerve.”
But Dr. Melamed cautions that doing the wrong type of exercise, however, can worsen existing sciatic pain, so it is important to get an accurate diagnosis prior to starting a program of sciatica exercises.
Not all back pain emanates from injury. In fact, according to a New York Times article on sciatica, in the majority of back pain cases, the causes are unknown. But as more young adults are showing signs of disc deterioration (one third of adults over 20) and the aging population’s decreasing bone density, increasing weight and lack of exercise combine to increase their risk of sciatica, DISC Sports & Spine Center is recommending a holistic approach to preventing and treating back pain.
Described as a possibly tingling, numbness or weakness that originates in the lower back and travels on one side of the body, through the buttock and down the large sciatic nerve in the back of each leg, sciatic pain can vary from infrequent and irritating to constant and incapacitating, with symptoms usually relating to the location of a pinched nerve. Pain in the lower back, buttock or leg is worse when sitting, can radiate to the hip, and can often be accompanied by shooting pain that makes it difficult to stand up. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.
Being overweight, not exercising, and even wearing high heels can also contribute to back pain.
Dr. Melamed says gentle core muscle strengthening exercises – fortifying abdominal and back muscles – and stretching exercises not only alleviate sciatica pain, but they also help people to recover more quickly from a sciatica flare up and diminish the likelihood of future pain episode.
Gentle yoga exercises, such as the ones featured on YogaJournal.com, may be beneficial in strengthening muscles and improving flexibility. The journal Spine published a study on chronic back pain sufferers who practiced lyengar yoga for 16 weeks, for example, and at the end of the study, 64 per cent reported a reduction in pain.
“When back pain does occur, your first thought may be to seek bed rest, but it’s actually better to exercise to relieve sciatic pain,” says Dr. Melamed. “A day or two of rest is okay, but any longer and the pain usually intensifies.”
Heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.
Topical anti-inflammatories, such as St. John’s wort oil and/or cayenne pepper cream, applied to the external pain area two or three times a day can help alleviate pain. In severe pain cases, Qutenza, a low-dose prescription patch derived from chili peppers that’s used to treat shingles, can be applied to the pain area. Turmeric Ginger and Omega 3 supplements also have powerful anti-inflammatory effects.
Certain forms of massage therapy may also provide pain relief while also increasing blood circulation, relaxes muscle spasms and releases endorphins, which are the body’s natural pain relievers.
Acupuncture, once thought of as an alternative medicine, has been approved by the U.S. Food and Drug Administration (FDA) as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica.
Dr. Melamed also recommends avoiding dairy, processed foods, and any processed or refined sugars and grains. Removing these foods from your diet is an effective way to help your body manage pain and more importantly, aid in recovery.
For most people, sciatica typically improves on its own in a few days or weeks. Following initial pain relief, a program of physical therapy and exercise should usually be pursued to alleviate pain and prevent or minimize any ongoing sciatic pain.
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