Five daily habits for sciatica pain relief

You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. Hey everybody, it's your co-host, Sebastian, with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. We are covering five productive habits today that you can do for a condition called sciatica. Sciatica is leg pain, usually starting around the butt cheek or a side joint. It goes down the back of the leg to the back of the calf sometimes, and sometimes to the foot, usually the bottom of the foot or the side of the foot.

I've done other podcasts about sciatica in the past, so please go back into our archives and look at those to make sure that you're learning the right rehab and things that you could possibly be doing wrong unknowingly to actually make your condition persist a little bit longer. So sciatica is one of those things that at some point everybody will experience, unfortunately, but the good thing is a lot of times it can go away on its own over the course of about a week or two. I've met a lot of people who have had it for years on end, but everybody has their own variables, everybody has their own habits, everybody has their own body.

So everybody is a little bit different when we talk about complete recovery. So if you guys ever need individualized care, we do offer consultations and we have telehealth services we're licensed in different states, and we also have online programs that we have people follow as well. It's on the link for the podcasts that you have there. Now, number one is going to be staying active. The first habit is staying active. Number two is going to be stretching regularly. Three is maintaining good posture. Four is getting quality sleep. And number five is avoiding prolonged sitting. I'm going to cover each one of these in turn so you get a little bit more context to it.

But just so you do know ahead of time as well, sciatica is a symptom of many types of conditions. For example, foraminal stenosis or arthritis of the lower backs and sometimes create sciatica. So the sciatica is secondary to it. Younger individuals like 15-year-old kids who have leg pain, that might be from discogenic symptoms, which is more of a disc injury. And there's many things in between that can create the condition. So this tends to give more of a wishy-washy answer to some of these things because what's good for one person is not always good for the other. And that's why curated care and one-on-one attention is actually an accelerant.

It's like having a cheat code to getting improvements. But generally speaking, though, staying active is one of the best habits you can possibly do. I would say this would go for many different types of injuries as well. When it goes to muscle tears or MCL injuries or plantar fasciitis, like generally we want people to stay active. And nature has its own way of solving some of these problems. And you'd be surprised how many people actually get better just by moving more with sciatica. I've met many people over the years who have had ripping leg pain. And then they say they actually feel better with walking.

And I say, how often are you walking? And they said, well, I'm only doing it for like about 10 minutes a day because I don't know if it's going to make things feel worse. And it's like, well, but does it feel worse doing it? No, it doesn't. It feels great. Do it more. I remember one lady that I spoke with that she actually felt, she was kind of the same category. She felt really good walking. And so she took it upon herself to take that a little bit more to the extreme. She started walking about six, seven miles a day. Previously, when she was only walking about 30 minutes or so. And this was not a stretch for her.

She had been a marathoner before, so she liked to be out and about. But she said that once she started doing that, there was huge chunks of the day where she didn't even experience a sciatica at all. She was previously told by a surgeon that she would require low back fusion to get rid of her sciatica. And I still talk to this lady as of today. That was over 10 years ago. She has only had one reoccurrence. And she is very, very active. And she still walks a bunch. So being active is a very helpful thing for most people. But also giving the disclaimer that certain activities for a little bit of time are not going to be helpful either.

For example, a lot of times sit-ups don't feel good for people who have lower back pain. And creating sciatica. Sorry, we're going to talk mostly about sciatica today or the leg pain portion. A lot of people who are doing Russian twists, it doesn't feel good. For some people, doing things like inversions of yoga, like cobras, don't feel good. Down dogs don't feel good. Forward folds don't feel good. But there's variations of this that you still can do without avoiding everything completely. Most of the time, things like forward folds and downward dogs and things like that that feel worse, the commonality they have is they have the knee extended.

So if you soften the knee and bend the knee quite a bit more, a lot of times it just abolishes the symptoms completely. And so in that scenario, the person can still stay very active going to things like yoga if that's what they like to do. If they just allow the pose to be sloppier than typical. So it's not going to be your standard types of forward folds and so on. But staying active helps out also with getting the core to become active. I did a podcast recently where I talked about some five of the biggest mistakes that people make with sciatica. And I talked about how using arm exercises can actually be very helpful as well.

The reason for that is because if you just take, if you're in your car right now and you put your hand on the steering wheel, if you're stopped at a light, you can push on the wheel firmly. And you'll notice that when you push firmly, your belly will contract, like it doesn't have a choice. And if you push two hands on the wheel, your belly will contract. But more so when you put one hand on the wheel, mainly because with one hand movements, like one hand presses, one hand pulls, your belly has to stabilize so your body doesn't rotate. So there's a lot of core activity that is enhanced with doing arm exercises, even though it's not technically specific to your sciatica.

So what that would end up looking like is that if you are trying to stay active and it hurts to go do things like deadlifts or squats at the gym, you can do all your arm stuff and you can even do single arm stuff. Like it doesn't have to be bench. It could be one single arm dumbbell press. It can be overhead pressing. It can be lap pulls. It can be single arm lap pulls and so on. So there's a lot of things that still can be done that help out with keeping the core stable and in the equation as the sciatica is repairing itself. But be aware that you should not be fighting through pain with this.

That is a good rule. Pain is usually pretty appropriate and it'll tell you, hey, you shouldn't be doing that for now and just find another exercise. Number two, stretching regularly. I would say that you can stretch pretty much anything you want to, except if it creates the leg pain. A lot of people that I do meet end up stretching the leg. They end up stretching the hamstring and the calf because they feel like it's getting the quote unquote the right area. But oftentimes they actually feel worse later. So I would say stretching the hip, stretching sometimes the back, the mid-back, the upper back is a great one.

Stretching the shoulders, stretching the knees, very good to do. Hip flexors. And sometimes doing even things like focal, they used to call it mash work. I don't know what they're calling it now. Foam rolling, lacrosse ball work into areas in the thigh, in the glute can be very helpful. Well, I wouldn't do it in the lower back area as much, but the glute medius is a good one. The calf is a good one. And they've even found through, I don't know about various studies, but I remember one study they talked about just basically massaging the nerve. Again, this is not for everybody, but they would say that since the nerve has swelling in it, a lot of times is if you decrease the amount of local swelling in the nerve, kind of pushing the fluid along, you can actually decongest the nerve.

And a lot of times people can feel better, but that's not for everybody. That's only for certain scenarios. Number three is going to be maintaining good posture. This is where things kind of divide a little bit. If you have dyskogenic symptoms and you're a 15-year-old kid or you're a 30-year-old man or whatever, younger individuals tend to respond better to quote-unquote good posture as we would all typically stereotype it as, sitting up tall, making sure you're not rounding your back, etc. I remember when I was in high school, I had some sciatica and it was from a disc. And I had to go to the library and get a book.

I rented a small novel. I didn't read the novel, but I put it behind my back just so I could build up the arch point, like where I can lean against the book. Because I'm 5'7", and so I couldn't really have my feet on the ground as well as lean up against the back support. So I enhanced the back support by putting a book there. Some people do things like jackets and so on, so they can let the back support do its job. If you're in the car like I am now, then there's actually a lot of times a dial on the seat for the newer vehicles that build up the lumbar support, which can help out too. A lot of times people will need to move their seat a little bit forward in the car, because as we discussed previously, activities where the knee is fully extended don't always feel better.

And in fact, a lot of the positive testing that we have for people's sciatica, like straight leg raise tests, slumps tests, they involve the knee extended. So one of the easiest thing is you slacken the nerve and you put some bend in the knee, and that's a very helpful way to do it. And all you do is slide the seat forward a couple inches and sometimes can really take the edge off. Now that's for people with more of a disc-related type of sciatica, which is one of the most common types. For the less common type, I don't want to say it's not common, but it's just uncommon with younger individuals.

Usually people over the age of 60 or so would be more in this category, but you get a little higher in age. Typically, they'll have more degenerative findings, more arthritic findings, which usually lends to more of a posterior element of the spine compression. So there's more compression into like the facets or the intervertebral foramen, which tend to feel worse with good posture. So these individuals would probably be a little bit more comfortable with rounding the back, sitting super sloppy posture, almost like they're depressed. They would take all of the air out of their lumbar supports.

They would still slide the chair forward in the car, but usually having the back rounded more so would be more helpful. Now, again, all this seems really counterintuitive, right? It's like, well, bad posture helps people's sciatica. Sometimes. And this is why sciatica, I think, is very hard to self-manage. Again, if you want a cheat code of how to improve this, just contact somebody who's experienced in it. If you guys are struggling to find somebody, you can obviously reach out to us. We have telehealth options, and we're licensed to different states, like I mentioned before. But there's plenty of good providers around who can do work with you.

But you have to talk to them about things like that. They should be familiar with McKenzie method. They should be familiar with McGill's work. They should be familiar with a technique called neurodynamics, which is taught by a guy named Michael Shacklock. All these components actually come very much into the picture if they're going to treat you effectively for sciatica, because some people respond to different types of treatment than others. I can't stress that enough. Number four is getting quality sleep. I should have put this probably number one on the list. You cannot repair, and you cannot feel better if you don't sleep.

I don't know how many people that I've seen over the years where I think I should have probably talked about sleep a little earlier on in their care. And after not really getting any response from them for over a month, which is kind of uncommon, like six weeks or so, they're not getting better. Or it's very temperamental. They'll feel better for a little bit, but it comes back hot. And sometimes finding a lifestyle part, which is a huge variable, like sleeping, is a huge win. And so I remember the last person I spoke with that they always would report they feel worse during the week, but on the weekends they feel better.

And I said, well, what's your work shift? You know, thinking about maybe sitting. And they said, well, I do work some of the weekends too. More of my day off is like Monday, Tuesday. And so, but they feel better on the weekends. That's really weird. I said, what else is different about the weekends? And they said, well, I split custody with my kid or with, of my kids. And I don't have them on the weekend. And I said, so what's different about your weekend than your weekday? And they're like, well, I do a lot to get the kids ready for school. I make them dinner and X, Y, and Z. And they basically said they sleep four hours a day when they're during the week.

I said, how much do you sleep during the weekend? And they said, oh, eight hours. So there's countless people where there are lifestyle parts that are completely ignored with musculoskeletal conditions like sciatica. Sleep is a huge part. Nutrition is a big part too. If you're eating like garbage, expect to feel like garbage. So just, we can change those simple things, which can have a dramatic effect on your recovery. Having good sleep habits is a major part. Make sure that you do limit screen time for about an hour before going to sleep. If you're someone who is preoccupied and thinking about things that you should be doing, have a notepad by the side of your bed and write them down.

That way you don't feel like you have to think about them before going, while you're actually sleeping. And sometimes solving problems before you go to sleep is a good idea. Like if you had a disagreement with a friend or a spouse, don't go to sleep angry. Like talk it out and get to a good settling point. That way you're not so worried about it when you sleep. And things like drinking water too close to bedtime can wake people up at night. So make sure you're drinking water throughout the day and you should be getting a ton of water. So don't skimp on it. Make sure you are drinking it actually throughout the day and not just saying, oh, I couldn't get it in and I'm going to chow it all before bed.

And I find things like magnesium can be helpful. I can put a link in the description, the one that I use. I know not all magnesiums really help out because sometimes they give people some GI issues. I love the one that I use and it is something I don't use on a daily basis. But I have found that when I really drink a lot of water and I've not had a stressful day or I've done my part to decrease my mind clutter before going to sleep. And I take something like magnesium and I don't eat too close to bedtime. That really helps me with having a really good night's sleep. Everybody should be sleeping, I think, of their estimate between seven and nine hours.

I know people do sleep quite a bit longer sometimes. I'm not saying that's not good. That's more power to you. But I think the minimum is going to be about seven. Now, the last thing is for active, avoiding prolonged sitting. This can be hard for people with certain types of jobs. If you're a driver or you commute a lot to work, it's going to be very tough. I remember one gentleman that I was working with that he got better quite a bit during the course of the last five days of the week. And then every Monday, he'd have to drive back and forth to LA, which is about two, sometimes two and a half hours from where we're at based upon traffic.

And he would just feel lit up for a couple of days after that. And so eventually he asked the employer if he can spend more of home days, work from home. And they agreed to it. And all of a sudden, his back pain got a ton better. Now, I don't want to say this is just avoidance because there is a period in time where maybe you should just not pick the scar and or not pick the scab rather. And he can probably go back and drive long distances very soon. But to force it at a point where he's not really feeling good or his tissues aren't ready for it is kind of hard to do. For those of you who are desk workers, having a desk that raises and lowers is very helpful.

I actually found online, I've not gotten them to send me a sample. I wish they would, but I know they're very expensive to get. It's actually a standing desk that actually lowers all the way down to like almost like a Japanese dining room table. It's super low. You have to like sit crisscross applesauce to actually do it. I just sit at the table. I have a coffee table that I do it with. And I actually feel for some scenarios where I have some of the leg pain, I actually feel like that helps dramatically when something like a standing desk does not help. But I've also had vice versa. The people who actually respond the best to each one, in my opinion, would be the ones that if we've already established what we call directional preference.

And you've had an exam performed and you figure out that this person responds really well to rounding their back and they feel worse with extending their back or arching their back or walking or standing. In that scenario, someone who's like 70, 80 years old and using a standing desk and they feel worse with all those things I just mentioned, that's all the same thing. It's just it's extension of lumbar spine and it may not feel better for that person. So maybe like a Japanese sitting desk type of style work better for them or even being actually at their sitting at a normal desk. But with something like a more active seat, like a BOSU ball or something like that would be helpful.

Kneeling can not work as well, like in a half kneeling position. For those of you who are the younger individuals, you have more discogenic type symptoms, like a standing desk is probably going to be better for you. A sitting desk is not great. Also sitting on the floor like a Japanese coffee table, probably not a good idea either. But eventually later, yeah, I think all three would be actually a good thing. There's actually a thought with sitting that is I think it's a very good way of looking at things because everybody demonizes sitting. But we all have to actually sit at some point, too. There is what we call metabolic equivalence and metabolic equivalence is imagine if you are laying on the ground, you're not doing anything.

That is like a zero. It's like you're not putting out any effort. So there's zero metabolic equivalence being used in that activity. So it's very stationary as opposed to running or walking, more metabolic equivalence required, more core stability required. You have to move your body, etc. And so using something like a static chair where the chair does all the work for you, that's lower metabolic equivalence than kneeling because you have to support yourself. Standing, you have to support yourself. Sitting, crisscross applesauce, you have to support yourself. Or even using something like a BOSU ball or other versions of chairs that are a little bit more wobbly based can be helpful to increase your metabolic equivalence, which requires you to self-stabilize.

What we find is that people who have to use more metabolic equivalence throughout the day in positions that they have problems with tend to do a lot better. So I hope this was helpful to everybody. And if you're looking to have some targeted suggestions given to you, remember, we do offer telehealth and we're licensed in different states. We also have online programs that give very good context to the things that I'm talking about as well. And we share all the exercises and stretches that we do for various different types of sciatica in those as well. So those are all in the description for the podcast.

See you guys next time.