Low back pain and sciatica can often keep you from sitting comfortably. It can cause pain during long car rides or while sitting at work. The different positions and postures we sit in during the day have a great effect on low back pain and sciatica. There are certain sitting positions that can help relieve your pain. However, there are also positions and postures that can aggravate your sciatica and low back pain.
What is sciatica?
“Sciatica”is the term used to refer to pain caused by irritation of the sciatic nerve. The sciatic nerve happens to be the largest nerve in the body (It is actually a bundle of nerves). It is comprised of several different nerves that branches off the spinal cord in our low back. This nerve then travels down the back of our leg and splits into two nerves around the back of the knee and goes into the foot. This is why when people have “pain in their leg” it can be a bit confusing because while the pain is felt in the hip, leg, or foot region it can actually be coming from the back. For a little more information about nerves and what they do you can refer to this article here (maybe place a link to the pinched nerve article?). (can you all find a basic anatomy picture of sciatic nerve leaving the low back? )
What are the signs and symptoms of sciatica?
There are several signs and symptoms to be aware of when determining whether or not you have sciatica. Some of the more common include:
- Pain, numbness, or tingling that goes down your leg (it can be just in the upper leg or go all the way down into the foot)
- Pain in the back, hip or leg with long periods of sitting
- Pain in the back/leg when bending forward to pick up objections.
- Radiating or sharp pain into buttock/hip region
What can cause sciatica?
Sciatica can arise from several different causes. It is important to understand what is causing your sciatica and to understand that the majority of the time the pain is originating from your low back. Even if you just have some mild low back pain or stiffness it can still be the cause of your sciatica pain. Many people will get confused with this because often times the sciatica pain down the leg can be more severe than some of the back pain that they may be experiencing. A history of back pain before a bout of sciatica can also help indicate where the root cause of the pain is coming from.
Below are some of the common causes of sciatica.
- A Herniated or bulging disc is the most common cause of sciatica. This occurs in the age range typically 50 yrs and younger. Some of the common symptoms include pain down the leg when sitting in a slouched posture, pain when bending forward, and relief when getting up to walk around. If the sciatica is caused by a herniated disc it is very important to pay attention to sitting posture which I will discuss later in this article.
- Stenosis is a condition which affects the 50 yr and older population. This causes sciatica down the leg during standing and walking activities . Stenosis occurs when the holes where the nerve exit the spine encroach upon the nerve causing irritation. Typically sitting down will help relieve this condition.
- Degenerative disc disease. As we get older our discs loose some of the cushion that they naturally have in our younger years. This can lead tochanges in the ability to move our back through natural motions. Once we have lost the ability to move through a natural arc of motion we can start to impose an effect on our back and it’s surrounding structures including the nerves. When a loss of motion occurs the sciatic nerve is unable to move a freely as before causing sciatica symptoms down the leg.
What steps need to be taken if back pain and sciatica is making it difficult to sit?
The first step that needs to be taken is to identify which sitting posture gives you the “most relief”. This is not to say that your pain will completely go away but you will need to find the “position of most relief” in order to take some of the bite off the pain. Here are three different sitting postures you can try out.
You will need to ask yourself several questions when you are sitting in these postures. 1. Does my pain increase or decrease? 2. Do the symptoms in my leg/hip become less noticeable or more? 3. Does my back pain increase?
- Sitting slouched. This posture typically brings about the most pain in sitting. HOWEVER in a rare occasion you may actually get relief from the sciatica when doing this which is why I am discussing it now. All you need to do is slumped down in your chair so that your low back presses against the back rest . (Place picture of sitting slouched fromphoto files)
- Sitting in an extended upright position. The majority of people will get relief when sitting in this position. From a slouched position youwill rock your hips forward. This will cause your back to straighten and you will immediately sit up taller. Keep moving forward and stick your bottom out so that you now have a backward bend in your back. (Think sitting with an extreme lumbar support in your back). You may also roll up a towel and place it behind your back so that you can hold this position. (Place picture of sitting arched from photo file)
- Sitting in a neutral position. The first two sitting postures we went over are on the ends of extreme. One causes you to slouch to the extreme and the other to arch up to the extreme. The third posture involves sitting in a more “neutral position”. As you rock back and forth from a slouched posture to and upright posture stop mid way. You should feel your tummy tighten and have the sensation that you are “holding yourself in place”. This is the neutral spine position. (Place picture of neutral spine from photo file here)
Watch this video that discusses the different sitting postures that you should be aware of and how to closely find the position of relief.
Aside from finding the position of most relief for you in sitting it is important to perform micro stretches. This allows for pressure to be taken off the nerve and can reduce the sciatic pain. If you have the option for a standing desk you may want to switch over to standing instead of sitting for the majority of your day at work. Taking a short “walking break” every 30 minutes to 1 hour from sitting can also be beneficial as it can help loosen up a stiff back or hips which is often accompanied by sciatica. More stretches and exercises are talked about in detail here.
Keep in mind that these are some of the beginning steps to ending your sciatica pain. It is not just about one magic exercise or stretch to fix the issue but also about changing your movement patterns and postures throughout the day. Being aware of how you sit and move during the day will be one of the first steps you need to take in order to allow for proper healing!