Sciatic pain is common, and as a yoga teacher you have many students recovering from sciatica.
What is sciatica?
Sciatica (pain) radiates in the buttocks and leg that occur due to irritation or compression of the root of the largest nerve in the body called the sciatic nerve. The sciatic nerve starts in the lower back and travels down through the legs to give them feeling.
When the sciatic nerve root is compressed due to changes in the lower back such as a herniated disc or other weaknesses in the back, it causes severe pain in the buttocks and legs. In many cases, the pain is so severe that one cannot even walk. Most often the pain is on one side, but bilateral sciatica is also possible. Treatment for sciatica depends on its causes.
The two most common causes of sciatic pain
The most common cause of sciatica is herniated discs (disc-shaped cassettes in the lower spine). These discs herniate due to stress, trauma, or disease. 85% of sciatica cases are due to disc disease. [1]
A less common cause of sciatica is piriformis syndrome, a condition characterized by spasm of small muscles below the larger muscles of the buttocks called the piriformis muscle . Spasms of the piriformis muscle can irritate or compress the sciatic nerve. It is the second leading cause of sciatica. Piriformis syndrome is a common cause of low back pain that is difficult to diagnose. [2]
diagnosis and treatment
In most cases, a medical history of radiating pain is enough for a doctor to come to a diagnosis. A physical exam along with certain exercises can help confirm the condition. The doctor may also request imaging tests such as X-ray, CT, or MRI to confirm the diagnosis and identify causes.
Fortunately, most sciatica pain subsides within two to 12 weeks, although it may last longer in a lesser form. Rest is only recommended in the initial period. For most people, treatment includes pain management with the help of medication and physical therapy. Only a few cases of severe spinal deformity may require surgical correction.
It is important to note that physical therapy is an integral part of the treatment, which includes massage, manual therapy and exercise therapy. Physiotherapy attempts to correct spinal alignment, strengthen local muscles, and relieve excessive tension in the piriformis muscle.
Without exercise therapy, sciatica can come back as local problems in the lower back or piriformis persist. The choice of physical therapy for sciatica is crucial, as physical training involving dynamic movements or strong forces applied to the body can do more harm than good.
Yoga for Sciatica Relief
Yoga is very suitable for people with chronic back problems and sciatica. These are neither rapid movements nor movements with the influence of high forces. It mainly consists of gradually stretching and strengthening the muscles.
Yoga poses that stretch the hip flexors, hamstrings, and glutes are thought to be particularly useful for back pain and sciatica. However, in the later stages, when the pain has subsided, strengthening of other supporting muscles such as the pelvic, abdominal and back muscles is also needed.
Before you start yoga, be sure to consult a doctor. During an acute phase or in the case of severe hernias, it may be better to rest. In general, rest is recommended during the acute phase as it helps reduce inflammation and minimize further damage. However, once the acute phase is over, yoga can help speed the healing process and prevent future sciatic pain by correcting spinal alignment, strengthening local muscles, and relieving excessive tension in the piriformis muscle.
Does Science Recommend Yoga for Sciatica Relief?
Yes absolutely. There are thousands of clinical studies and research articles supporting the use of yoga for lower back disorders. In modern medicine, systematic reviews are seen as a higher level of evidence to support therapy. Systemic reviews are studies that summarize data from numerous studies, perform statistical analysis, and then determine the effectiveness of an intervention.
Cramer et al. conducted one of the best planned systematic reviews and meta-analysis on the benefits of yoga for back pain [3]. The study considered data from multiple clinical trials involving a total of 967 chronic low back patients. The study concluded that there is clear evidence for yoga to relieve back pain.
The above systematic review focused on all causes of back pain, not just sciatica. However, does yoga work for patients with herniated discs and resulting sciatica? In the clinical study, 60 participants were randomly divided into two groups. Of them, sixty-two percent had sciatica. At the end of the study, those who did yoga along with conventional treatment had much better scores and reduced discomfort. The study therefore concluded that yoga is a safe and effective way to overcome sciatica caused by a bulging disc. [4]
The second most common cause of sciatica, although often underestimated, is piriformis syndrome. There are still no conclusive studies showing that yoga may have a positive effect on sciatica caused by piriformis syndrome. However, a very common treatment in these cases is external rotation glute stretches, which precisely target the piriformis and other lateral rotator muscles below the glutes. Yoga has a large repertoire of asanas that stretch these muscles.
When teaching yoga to students with sciatica, make sure the student is out of the acute pain phase and has received clearance to practice yoga from their doctor or physical therapist. Also, ask the student to share with you what general recommendations for movement and exercise they were given, which movements and stretches are recommended, and which are better avoided.
9 yoga poses to relieve and prevent sciatica
The misalignment of the lumbar spine that causes the pressure on the sciatic nerve is very often caused by poor posture habits over a long period of time. A lot of sitting and „slouching“ leads to tightened hip flexors, tightened glutes and hamstrings, and a muscular imbalance between the abdominal and back muscles. Restoring a healthy and natural lumbar curve is essential as it relieves pressure on the intervertebral discs.
Below are 9 yoga poses that can help release tension in the muscles that often cause sciatic pain and rebalance and strengthen the relevant muscle groups. Make sure you use these exercises in a balanced way, and ask your students to give you feedback if they feel that a certain posture or exercise increases their pain during or after the exercise.
3 poses to realign the lumbar arch
- Deep Lung (Yin Yoga)
- Sphinx (Yin Yoga)
- Matsyasana | Fish
3 poses to strengthen the supporting muscles
- Ardha Setu Bandhasana | shoulder bridge
- Bhujangasana | cobra
- Sarvangasana | shoulder stand
3 poses to stretch the piriformis muscle
- Eye of the Needle (Yin Yoga)
- Cow Face (Yin Yoga)
- Pashchimottanasana | Seated forward bend
resources
[1] https://www.nejm.org/doi/full/10.1056/NEJMra1410151
[2] https://link.springer.com/chapter/10.1007/978-1-59745-247-2_5
[4] https://content.iospress.com/articles/journal-of-back-and-musculoskeletal-rehabilitation/bmr00531
[5] https://yoga-sci.eu/wp-content/uploads/2014/06/6-romanov-radak-e.pdf
About the author
Kalyani Hauswirth-Jain has been Senior Teacher and Creative Director at Arhanta Yoga Ashrams since 2013. She has been the lead trainer for the 200 hour yoga teacher training , the 300 hour yoga teacher training , as well as a variety of 50 hour courses such as Yin Yoga and Vinyasa Yoga for over eight years.
She also co-authored the book Hatha Yoga for Teachers and Practitioners : A Comprehensive Guide to Holistic Sequencing .
[my_newsletter]
[thrive_leads id=’430480′]
