Sciatica

Jathara Parivartanasana - with bent knee extended instead, foot rests lightly on floor. Hook thumb into crease between thigh and abdomen applying gentle pressure in direction of feet to create length in spine (releases low back).

Also, anything that strengthens abs and low back. Hurts at first then gets a lot better! :) Advise not to overstretch during forward bends - very important. Holding back and focusing on getting my back stronger has virtually eliminated my symptoms!

Hope some of this is helpful.

From Margaret Goodson:

I was told recently by a massage therapist that the movement of riding a bicycle can really help to relieve pain in the sciatic nerve.

From Beth Howard, Cheyenne, WY:

Dear Susan,

A great reference book for yoga teachers is Back Care Basics by Mary Pullig Schatz, M.D. It is subtitled, A Doctor's Gentle Yoga Program for Back and Neck Pain Relief. Chapter Eight is on Sacroiliac Pain and Sciatica and offers several useful poses and stretches.

In regard to working with sciatica therapeutically, Schatz indicates that it is important to determine the cause, which could be a bulging or herniated disc or piriformis syndrome (a short or tight piriformis muscle.) The book has specific recommendations for each cause.

Poses referenced to stretch the piriformis muscle include: Jathara Parivartanasana (Supine Twist); Parivrtta Trikonasana (Revolved Triangle); and the leg position for Ardha Matsyendrasana (Half Spinal Twist.)

Blessings

From Rebecca Smith:

I use the head to knee pose, child's pose, hare pose, cat/cow stretch, cobra pose. I have this also if I don't do these regularly.

From Donna O'Neil:

Dear Susan,

Yes! Recurring sciatica can be caused by more than one thing. If it is just tight muscles, the piriformis stretch can be helpful, because that muscle can clamp down and squeeze the sciatic nerve between it and the gluteus muscles. Other poses, like Ekkapada Rajakapotasana (pigeon) can be helpful. However, it could be the result of a more serious condition such as a bulging disc (usually in the L5 area). If so, it needs to be treated carefully, and avoiding certain things. I have this condition, and with physical therapy, I've become aware of what exacerbates it. I avoid going deep in lower back twists, and am very careful in forward bends not to let the lower back go into flexion—which means you must keep the natural curve in the lower back even during forward bending. This awareness has helped immensely. Also avoid deep Trikonasana, unless you can show the student how to do it properly and keep the natural curve. John Friend showed me this, and it has made all the difference. The physical therapy showed me how to push the bulge back in place when I begin to feel it. The actions are similar to cobra and other back bends, only a more yin approach. (The McKenzie Method) For yoga approach, I recommend John Friend's Principles of Alignment, and also a book by Sam Dworkis, Ex-Tension.

Hope my experience can help.

Blessings

From Susan Hayes, grad 1999:

Hi, Susan! It's your buddy, Susan Hayes (1999 AYTT grad). I, too, am a sufferer of sciatica, so I take a special pleasure in helping students with this chronic back condition.

Firstly, find out if the student knows which way the disk that is impinging on the sciatic nerve is bulging (towards the front, in which case forward bends make it worse; or towards the rear, in which case backbends hurt).

Here are the routines that I do when students complain of sciatica: starting out lying on the back, just resting, with knees bent and feet on floor. Then start by hugging each knee into the chest, one knee at a time, other leg either bent or outstretched, breathing into the lower back and relaxing the shoulders. This can be done every morning, before getting out of bed. Then hugging both knees into the chest and rocking gently from side to side. Finally, doing knee circles (fingertips on tops of kneecaps, wrists raised, then gently pushing the knees away from and pulling the knees towards the chest, making an oval-shaped "circle" which massages the sacral spine).

After that, you can move into supine pelvic tilts, rock the baby (sitting up), eye of the needle, supine spinal twists, happy baby, leg lifts (from the floor) with straps, cobbler's pose (sitting and lying supine), pigeon, and cow-faced pose. They all work the hips and lower and back and, most importantly, the sacro-iliac joint. Runners lunges and 90-degree angle bends at the wall are wonderful for sciatica, too. In savasana, always elevate the knees over a bolster or a blanket that is rolled up, to take the arch out of the lower back.

God bless you!

From Marcia Framsted, grad. 1989

Dear Susan,

One of my students has suffered for years with sciatica. We do a series of stretches on our backs, on the floor which have helped her greatly. First we do the right side, hamstring stretch, release the stretch and lower the right leg toward the floor on the right side. Bring the right leg back to center and cross the right ankle over the left knee, for "threading the needle" (by the way, the left leg is bent, left foot on the floor while we stretch the right side.) Last in the series, a twist to the left, rolling on the left hip. From threading the needle move the knee to cross over the left knee, right foot is a few inches off the floor on the left side of the body. Arms out on the floor at shoulder level, reach up with the left hand and bring both knees to the left. Left foot can walk toward the right hip for more twist. Then repeat the series on the left side after a brief rest.

From Mary Jo, Cleaveland:

Susan: I have found Gary Kraftsow's book "Yoga for Wellness" to be very helpful in specific physical conditions, like sciatica. Ananda's routine for hip openers is excellent if it is done carefully....paying close attention to the first signs of pain. Hope this helpful.

From Kyle Forman:

Susan,

I suffer from sciatica and am a yoga instructor and massage therapist. It has been an ongoing problem for me that I am working with a chiropractor and recently a physical therapist with. Mine results from L4,5 and sacroilliac joint disfunction. Many of the stretches that are logical to me and that the PT advocates are hip, hamstring, and psoas stretches. Deep tissue massage and trigger point therapy in the glutes, and lumbar area have helped too as well as the chiropractor.

Hope this helps, Namaste

From Nicole DeAvilla, Kentfield, CA, grad. 1984:

Dear Susan,

There are many degrees of sciatica. Take it slowly until you get a feel for the severity level that your student is experiencing at any given class. Some days your student may be able to do a regular asana class with careful attention to alignment and other days she/he may need to only do therapeutic asanas

A few key points:

Focus first on pain relief with the more therapeutic and restorative asanas
Do not do anything that aggravates the sciatic even slightly, even if it is something that I or some one else said would be helpful.
As soon as possible move into strength builders (abdominal and back)
Flexibility in the hamstrings and gluteal areas are important, but you want to go gently and slowly until the condition becomes more stabilized. 5. With standing asanas, correct alignment is crucial.

While your student has sciatica pain, have her/him avoid twisting, forward bends, seated asanas, and most backward bends, and be careful that there is no twisting at all on the side bends. So what is left, you may wonder? Focus on therapeutic and building block asanas. Examples of therapeutic asanas for sciatica are pelvic tilts, single and double knees to the chest, (just be sure your student does not lie down flat on his or her back without either the knees bent with feet on the floor or bent with the support of a pillow or bolster under the knees), leg stretches with a tie (in supine - on their back - position)forward only. You can also ask your student if she/he has been given any therapeutic exercises by a health care provider (physical therapist, M.D., chiropractor etc.). If so, you can always ask them to do those exercises while you do something else with the rest of the class that would be inappropriate for them to do. I have never met a student that did not appreciate having some class time to work on their P. T. (physical therapy) exercises.

Examples of appropriate building block asanas would be table pose instead of downward facing dog or other forward bend. When lifting the leg, be sure that their lower back does not hyperextend (sway) or twist at all. Another might be cobra pose only on the forearms and not holding it for more than a few seconds, repeating it six times.

Pranayama in the supine position is very good. Just be sure that what they do is comfortable for them so that they are not tensing up inadvertently as they practice their pranayama.

For further study, Mary Pullig Schatz, M.D.'s book, "Back Care Basics" is very good.

Best wishes to you.

Namaste

From Cynthia Saffell:

A physical therapist taught me a good one for sciatica. While lying on your back, bend both legs and hold one thigh tight to your chest from behind the thigh. Of course your leg will be bent. While holding your leg to your chest - point and flex your foot.

Namaste

From Genevieve Ryder, grad. 2000

Dear Susan,

Yoga poses should emphasize elongating the spine. With sciatica, forward bends should be avoided, as the stretch of the hamstrings will aggravate the condition. The safest one that might be considered would be seated in a chair with knees apart and gently folding forward between the knees as tolerated. The best poses in general are backbends - especially 1/2 locust. Locust should be done extending one leg back at a time to open and elongate the spine, and then the leg may be lifted. Emphasis is on elongation rather than lift. Alternate sides, start with 3-6 repetitions, work up to 12 repetitions. Namaste

From Allyson Cannata. PT, RYT, grad. 1996

Sciatica is a vague term that doesn't always explain the root of the problem/cause. This would be important to know. If the student has not seen a doctor or physical therapist to determine the cause, that would be a good first step.

If it turns out that the cause is primarily from tight musculature, that would mean the student has tight hip external rotators and/or tight hip extensors. So visualize movements that use these muscles (i.e. make them shorter). Stretches/movements in the opposite directions would be appropriate stretches. (This concept works for any muscle you want to stretch, by the way.)

Examples of stretches that would help include:

1/ pigeon pose (if this bothers knee, try variation with student on back, sciatica side ankle resting on opposite thigh, and bring sciatica side leg toward chest) 2/ any knee(s) to chest movement 3/ student on back, sciatica side knee to opposite shoulder

Important: Move slowly into stretches, hold at least 30 seconds (or 10 breaths) and do several repetitions each day.

Also notice how student stands and moves that may contribute to the continual tightness.

If the root is of another nature, seek advise from the P.T. or doctor first.

From Christie McClelland:

I have been a deep tissue massage therapist for 10 years, I have treated countless cases of sciatica and pseudo sciatica. With sciatica, the nerve is impinged in the low spine so poses like padahastasana with bent knees would be beneficial as well as twists like jathara parivartanasana. With pseudo sciatica the nerve is impinged in the piriformis, a muscle which runs from the sacrum to the femur under the gluts. For this, pigeon pose is most excellent, as well as the warm up stretch where the client lies supine and bends the knees with one foot on floor and one ankle crossing opposite knee. Draw thigh to chest. Also sitting upright on the edge of a chair and crossing ankle over opposite knee. Lean forward with straight spine keeping gaze up. For additional stretch press knee toward earth while hinging forward.

Blessings

From Terry Cramer:

Standing up take right foot over left, toes together heels apart, bend forward try to touch floor without pain, if touching walk hands to right, do other side

From Sally Jo Beck: Hi Susan, I have found that twists work well for sciatica. Especially upright twists, like sitting on sit bones with one knee folded under and other leg crossed over and twisting the opposite direction. Also, reverse triangle stretches and tones that area as well. Good Luck, Sally JO