Is sciatica really curable? Sciatica nerve pain afflicts over 40% of the American population, lowering the quality of life. Characterized by hip and lower back pain, sciatica turns mundane tasks such as walking, sleeping, and sitting into a nightmare.
The condition often results when you carry too much tension in some critical muscles in your lumbopelvic hip region (which is your lower back, pelvis, and hips). Tension in these key muscles may be the main culprit behind your sciatic nerve pain.
Targeting these muscles with specific stretches and direct, prolonged pressure helps relieve the tension. Eliminating muscle tension and restoring alignment in your body provides a permanent solution to this painful condition.
What is sciatica and what causes it?
Sciatica is nerve pain that results when the sciatica nerve is irritated or injured. Originating from the gluteal area or the buttocks, the sciatic nerve is the thickest and longest nerve in the body.
It comprises five nerve roots – two that originate from the lumbar spine and three from the sacrum. The five nerve roots merge to form a right and left sciatic nerve. The sciatic nerve extends from your hips, buttocks, and down your thigh to terminate just below the knee on each side of your body.
The nerve further branches into other nerves that run down your legs to your leg, foot, and toes. While an actual injury to this nerve is rare, sciatica often describes any pain originating from inflammation, irritation, compression, or pinching of the sciatic nerve.
People with sciatica experience mild to severe pain that mirrors the sciatic nerve path. You can experience pain anywhere from the lower back, buttocks, hips, and down one or both of your legs. Sciatica causes numbness and weakness in your legs, weak muscles in your leg and foot, and unpleasant sharp and painful tingling sensations in the lower limbs.
The type of sciatica pain you experience depends on its cause. Some patients describe it as sharp jolts of pain shooting down the leg. Others describe it as electric, burning, or stabbing. The pain is usually more severe in the legs than in the lower back.
Sciatica is not a medical condition but a symptom of an underlying spinal disorder. Common causes of sciatica include:
- Tight iliopsoas muscles
- Tight piriformis muscles
- Herniated or bulging disc
- Bones spurs
Since there are multiple causes of sciatica, the treatment option depends on the underlying cause.
Coping with sciatica
The pain associated with sciatica spans across the entire pain scale. It ranges from mild to severe back pain that radiates to your legs. Patients often compare severe sciatic nerve pain to being repeatedly hit with a cattle prod. Experiencing a dull throbbing pain, a burning sensation, numbness, or weakness in your legs can be highly inconvenient.
While there are many ways of coping with sciatica pain, we believe in working towards longer-term solutions. Instead of managing the pain, you can fix sciatic nerve pain by addressing the root of the problem.
Typically, inflamed or strained piriformis muscles and iliopsoas muscles are involved with your sciatic nerve pain. Releasing the tension in these muscles can help reduce the irritation and compression on the nerve and permanently fix this problem.
Will sciatica pain get better on its own?
Sciatic nerve pain requires active intervention because sciatica does NOT go away on its own. Usually, sciatica is a symptom of underlying conditions such as tight and weakened hip flexors and the piriformis muscles. It could also result from a bulging or herniated disc, trauma to the spine, or misalignment of the pelvis.
If left untreated, this condition could worsen and subject you to excruciating pain. The severity of your sciatic pain could also increase with time if you fail to address the root cause of the problem. The pain can lower your quality of life by affecting your ability to sleep, sit, or even walk.
Get better sleep, even with sciatica
People with sciatica often have trouble enjoying a whole night's rest because their pain increases when they lay down. Lying down places additional pressure on the damaged nerve, further irritating it. The severity of the pain depends on your choice of mattress and sleeping position.
Picking an optimal sleeping condition is the fastest way to improve your ability to sleep with sciatica. First, you need to ascertain which side of your body is affected by the hip pain and avoid sleeping on that side.
You should also avoid sleeping on your stomach because it causes your back to arch toward the mattress. Sleeping with a pillow between your legs also helps to relieve sciatic pain while sleeping by allowing your hips to remain in a neutral position.
Opting for a medium-firm mattress is preferable when sleeping with sciatica pain because it improves spinal alignment. Softer mattresses enhance the curvature in your spine to compound your sciatica pain.
Sitting with sciatica pain
Prolonged sitting is a leading cause of sciatica and lower back pain because it compresses your spinal column, which increases the likelihood of a nerve injury. Still, sitting causes hip flexor tension which creates a tug-of-war between the front and back of your hip, resulting in sciatic nerve compression.
To avoid exacerbating your sciatica pain when sitting, you should avoid sitting for more than half an hour (if possible). Stand up, stretch, and walk around every 30 minutes to rest your hip flexor group and increase blood circulation to your other muscles.
3 simple hacks for sitting with sciatica
- Pick a chair that suits your body and ensure it's set at the correct height. The best chair keeps your knees below your hips and allows your back to maintain its natural curve.
- Never sit with your legs elevated on the coffee table or an ottoman. Stretching your legs out in front of you while watching TV might seem relaxing, but it may hurt your nerves. You're stretching all the nerves in your posterior chain in this position. Unlike muscles, nerves don't appreciate being stretched for this long.
- Keep both your feet flat on the floor and avoid crossing them while you sit. Also, sit squarely in your chair and avoid leaning to one side.
Sciatica pain when pregnant
Sciatic nerve pain is common during pregnancy because the additional weight in your abdomen places further strain on your back and hips. The weight of your growing baby, hormone-induced hip shift, enlarging uterus, and baby's position are leading sciatica causes in pregnancy.
These changes in your body may cause your hip flexor muscle to engage in a tug of war with the piriformis muscles in your gluteal region. An irritated piriformis muscle is often directly responsible for sciatica pain in pregnancy.
Combining gentle stretches, light exercises, and targeted muscle release is an ideal way to combat sciatic pain during pregnancy. Yoga poses such as modified child's pose and camel pose, half pigeon, butterfly, and cat-cow effectively relieve hip pain in pregnancy.
Short term solutions to relieve sciatica pain
Stretches, massages, and rubs offer short-term relief when dealing with sciatic nerve pain. They can soothe the muscle to increase blood circulation to give some form of relief.
Stretches for sciatica pain relief
Stretching tense muscles is a great way to relieve sciatica pain and there are a variety of helpful sciatica pain stretches to help you deal with this problem. You can also take some yoga poses and modify them to suit your flexibility needs and get pain relief from sciatica.
Figure Four Stretch
There are two variations to this effective sciatica pain stretch that targets the piriformis and other deep hip rotator muscles. You can do it while sitting or lying on the floor.
- Sitting: Sit on the edge of a chair and rest the ankle of your left leg on the knee of your right leg. Gently press the elevated knee downward for 30 seconds and take relaxed breaths. Then switch legs and repeat.
- Lying down: Lie on the floor with your legs bent at 90-degrees with your feet firmly on the ground. Place your left ankle over your right knee and then interlock your fingers behind your right leg. Gently pull the figure four towards your torso and hold for about 30 seconds and breathe. Switch legs and repeat on the other side.
Lie flat on your back and cross the leg affected by the sciatic nerve pain over the other leg. Try to keep your upper back flat on the ground as you cross the leg over and rotate about the waist. You should feel a gentle stretch in the outside of the hip, and perhaps even the lower back too. If you feel a pinching in your hip joint or in the lower back, don’t go as far into the stretch and consider bending the knee on the leg that is crossed over the other. Hold the stretch for half a minute and remember to breathe, then switch legs.
Standing Hamstring Stretch
Tight hamstring muscles tend to pull your pelvis, increasing the stress on your lower back, which may irritate your sciatic nerve.
- Stand with your legs shoulder-width apart, then place your left leg in front of your right and ensure they're about 3 feet apart.
- Ensure that your shoulders and hips are facing forward and are level.
- Send your hips back as you bend forward at the waist. It is okay for the knee on the back leg to bend, but the front leg should remain straight. Feel free to reach your arms forwards towards the toes on the front leg to intensify the stretch, but do not let the lower back round. Keeping the back straight helps keep the stretch more isolated to the hamstrings on the back of the front leg.
- Hold the stretch for 15 to 30 seconds and repeat with the other leg.
- Aim for 3 to 5 sets on each leg.
Will stretching cure sciatica permanently?
No. Stretching is typically the go-to solution when looking to relieve sciatica pain, but it's not the most effective solution for long-term results. If you have sciatica pain caused by tight muscles, it’s likely that there is built-up tension (such as muscle knots or trigger points) that developed over a longer period of time that is contributing to the issue.
While stretching helps to lengthen the muscles leading to improved range of motion, blood circulation, and muscle repair, stretching a knotted muscle elongates the muscles but does not relieve the tension. Typically, the muscle will remain contracted and return to its original length and state of feeling tense soon after you stop stretching it.
Similarly, rubbing or massaging a knotted muscle produces short-term relief. Like stretching, massaging a tense muscle improves blood circulation and pliability, but doesn't directly address the tension being held in certain spots within the muscle. The muscle fibers will elongate slightly but revert to their contracted state after you stop manipulating the muscle.
While you're guaranteed to feel good when massaging, rubbing, or stretching a muscle, these benefits are typically more short-term in nature because these manipulations do little to release the tight and contracted areas of your muscles. Finding these contracted areas and holding prolonged pressure on the muscle knot to produce a "good hurt" is the most effective way to release tense muscles and improve sciatica pain.
How to get rid of sciatica for good
A sound understanding of sciatica is critical to combating pain. The condition results when the muscles in your lumbopelvic hip region carry too much tension, which negatively impacts the alignment of your body, increases tension on the discs and joints, and pinches on or creates compression around the sciatic nerve.
If muscle tension, poor alignment, and increased compression on the nerves is what causes sciatica to develop in the first place, then we must undo and improve each of those things to get rid of the sciatic pain for good. As was discussed previously, tightness in both the iliopsoas and piriformis muscles typically has something to do with the development of chronic back pain and sciatica.
Releasing muscle tension to relieve pain
The best way to eliminate muscle tension is to “release” it. This is achieved by the application of prolonged pressure to the muscle for at least 30 to 90 seconds (or longer). Sustained, consistent pressure is most effective because it engages the brain in a different way.
During the first 30 seconds, pressing into the muscles might feel sensitive or uncomfortable. As you continue to take deep breaths and relax, the brain begins to realize that it is holding tension and that releasing the muscle poses no danger to your body. As you approach 60 to 90 seconds (or more), the brain will instruct your muscles to relax and stop contracting as much, and the tension you previously felt will begin to fade away.
For the best results, we recommend following this 3-step process (outlined below) to help release tension in the muscles on both the front and back sides of your pelvis and also perform a realignment exercise.
This process, when performed with consistency, helps to reduce the tightness in your muscles, decrease compression on the joints and discs, and improve the alignment of the spine and pelvis to ultimately reduce irritation of the sciatic nerve and get rid of your pain.
Performing these steps will also put your body into a better position to begin adding in other corrective exercises to help strengthen and stabilize around your lower back, pelvis, hips, and core to make your sciatica pain a thing of the past.
Step 1: Release Tension in the Iliopsoas to Relieve Sciatica Pain
The iliopsoas muscle is your body’s main hip flexor muscle and attaches to the lower back, pelvis, and hips. A tight iliopsoas can create a misalignment of the pelvis, causing the lower back to arch too much. This poor position of the lumbar spine combined with the tightness in the iliopsoas creates a lot of downward pressure on the discs and joints in the lower back, which may play a role with a pinched nerve or a disc injury that presses on the sciatic nerve and causes pain.
The iliopsoas muscle is actually composed of 2 separate muscles that lie deeper within the pelvic region. The psoas muscle is several inches deep within the abdominal area and is best accessed by applying perpendicular pressure (straight up and down) as you lie over a tool to help release this muscle. The iliacus muscle is a little bit hidden, tucked away on the inside surface of the pelvic bone. Because of this, you can’t access it with a tool that goes straight up and down – you need a tool that can curve in there at an angle to press directly on the iliacus.
Many people think that using a lacrosse ball can get the job done. In reality, it is too small to reach the psoas muscle. You would need a larger massage ball of about 4” in diameter to press into the psoas, but even that has its limitations. The round shape and size of the ball won’t allow it to apply direct and precise pressure to the iliacus muscle, no matter how close to the pelvic bone you try to force it in there. Releasing the psoas and not the iliacus is another method (like stretching) that falls under the category of shorter-term relief.
Addressing BOTH the psoas and iliacus muscles is going to yield the best and most effective results when it comes to releasing tension in your hip flexors to make the longest-lasting impact. Seeing a trained professional (like a physical therapist or massage therapist) who has worked on these muscles and understands their importance is likely the best option. But if you’re looking for the best tool to use for sciatica pain relief that you can use on your own, then the Hip Hook is going to be what you’re looking for.
The Hip Hook is a patented tool designed by a physical therapist to replicate the skillful touch of a trained professional. When you first position the tool with the platform flat on the ground, the tip is able to apply perpendicular pressure to your psoas muscle. Then when you press down on the handle, the tip of the Hip Hook rotates and is able to apply angular pressure to your iliacus muscle. The Hip Hook empowers you to release both of these important hip flexor muscles and deliver the right amount of pressure at the right angles to experience the best release of tension.
Step 2: Release Tension in the Piriformis to Relieve Sciatica Pain
We’ve already discussed how the hip flexors and the piriformis muscles like to play tug of war with each other. After releasing the psoas and iliacus on the front side of the pelvis, you would then address the back side of the pelvis by releasing the piriformis muscles, as they could still be tight and compressing on the sciatic nerve.
Although the piriformis lies deeper within the gluteal region, releasing this muscle is easier than what we just did in the first step. With a ball or a foam roller (or maybe some other type of tool), you can release muscle tension in the piriformis muscle to target sciatica trigger points, decrease compression around the sciatic nerve, and eliminate the pain.
Roll the ball or foam roller along the length of the piriformis muscle to find the sore spots. Once you find a knotted spot, hold the pressure on that spot and apply pressure for 30 to 90 seconds. Breath in and out normally and feel the muscle relax as you release the pressure. Repeat the process on other parts of the body that feel tight and sore.
Step 3: Realign the Pelvis to Relieve Sciatica Pain
When you have had tension in the muscles around your pelvis, there may be a higher likelihood that a pelvic misalignment could also be playing a role in your sciatica pain. When releasing your muscles in Steps 1 & 2, you may find that one side is tighter than the other and this could be creating a twist in your pelvis. If you are someone that typically only has sciatica down one leg, then there is likely one side of your pelvis that is rotated forward more than the other
Follow the tips in the video linked here to learn more about how you may be able to determine which side of your pelvis is rotated with the Supine to Sit Test. The embedded video below will take you through the pelvic realignment exercise that you will perform on the “shorter” leg that you determined just before.
After performing these 3 steps, you now have the pelvis in a better alignment where the surrounding muscles are also more relaxed. If you just performed them, hopefully you are feeling pretty good, too! Feel free to add in any other corrective exercises you want to help strengthen and stabilize your hips, core, and pelvis in this improved position. Now would be the perfect time to do so!
It is important to understand that doing these 3 steps just one time is not going to fix your sciatica pain permanently. Your muscles have likely been tighter for a longer period of time and continue to have a certain “muscle memory” that could later cause your muscles to tighten (as you sit or move around with your other daily activities) and pull your pelvis back out of alignment.
Instead, it will be through a consistent routine of releasing tight muscles, realigning your pelvis, and strengthening the weaker muscles that helps to “undo” the old muscle memory that once caused you sciatica pain and establish a better way for your muscles to function and support your body and ultimately relieve your sciatica pain permanently.
Frequently Asked Questions about Sciatica Pain
What causes sciatica pain?
Sciatica pain is the painful condition that results when the sciatic nerve, the longest nerve in the body, becomes inflamed, compressed, or irritated. The condition results when the key hip muscle carries too much tension and changes how they function.
How does stretching, massage, and exercise help sciatica?
Stretches, massages, and exercises are great ways to address tight muscles. They help improve blood circulation, elongate short muscles, and increase its range of motion. However, these popular muscle relaxation methods do little to relieve muscle tension. Their effects wear out after a while, and the muscle resumes its original tense state.
What's the best way to get rid of sciatica for good?
Pressure release is the best way to get rid of sciatica pain for good. Applying direct, prolonged pressure on the muscle knots in your hip muscles for 30 to 90 produces permanent results. Using specialty tools such as the Hip Hook produces the best effect than a tennis ball or a foam roller. A hip hook actively targets the iliacus muscle and lets you deliver just the right amount of pressure to permanently cure your sciatica.