Sciatica is one of the most common types of pain, and it’s estimated that up to 40 percent of people will experience at least one episode of sciatica in their lifetimes. Sciatica pain:
- Becomes more common as we age, and while it is a condition related to the spine, actual pain in the back is not typically associated with sciatica.
- Can range in severity from minor aching to serious weakness in the muscles and accompanying loss of bowel and bladder control.
If you believe you may be struggling with sciatic pain of some sort, contact your doctor. If the pain hasn’t gone down in several days or is severe/accompanied by weakness and/or numbness, get to an urgent care facility or an emergency room.
While sciatica is usually treated via pain medication and observation, as the body generally resolves the issue itself, there are certain things that can delay recovery and greatly worsen sciatic pain. To understand how these activities worsen sciatic pain, we must understand why it occurs in the first place.
How Does Sciatica Occur?
The spine is composed of stacked bones called vertebrae, which are separated by jelly-filled spinal discs. These discs help give the spine its flexibility. Surrounding these discs, and attached directly to the main spinal cord, are numerous nerve roots that branch out all over the body.
However, as we age, and in the event of excessive stress, the discs between our vertebrae may become damaged or inflamed. Our lower back is particularly susceptible to such damage because our lifestyles and general anatomy put the vertebrae in the lower back under the most amount of stress.
As such, many people will experience or have experienced inflammation or swelling in the discs of the lower back, impinging on the roots of the sciatic nerve, one of the body’s longest nerves. The nerve travels from the lower back through the leg, contributing to the innervation of many muscles and some organs along the way.
This is perhaps the most common cause of sciatica, but it is far from the only one. Anything that places excessive pressure on the sciatic nerve can cause symptoms of sciatica, including:
- Benign or malign tumors
- Other sources of inflammation
- And even pregnancy
Sciatic pain is usually felt in the buttocks down to the leg, rather than the lower back, even though the damage occurred in the lower back. Most of the time, the swelling goes down and the pain subsides. In extreme cases, such as injury, the damage may be severe enough that a person cannot feel portions of their leg, or they lose control over their bladder and bowel.
But in most cases, some light exercise and being mindful of how movement can alleviate or worsen symptoms will be enough to reverse the condition. Here are some of the things you should never do while struggling with sciatica.
Sciatica Pain and Footwear
High heels may affect sciatica. Research on this is inconclusive and has little to do with your feet, and everything to do with lower back curvature and your pelvis. Your pelvis serves as the hip bone that connects your legs to your torso, and it also serves as the base of the spine.
High heeled shoes tend to force people to lean forward ever so slightly to keep balance on the middle of the shoe, which naturally causes their pelvis to tilt with an anterior shift (i.e. tilting down in front of you). Just as the base of the spine shifts, so does the spine itself.
A pelvis that is tilted forward will further compress the vertebrae of the lower back as your spine fights to remain upright, thereby placing more pressure on the swelling in your back. Being mindful of one’s pelvic tilt can help alleviate symptoms of sciatica.
Whether you wear heeled shoes regularly or not, you may naturally be struggling with a pelvic tilt due to muscular imbalances caused by inactivity and poor posture. The telltale sign of an anterior pelvic tilt is an excessive curve in the lower back, akin to a duck.
How Your Wallet Might Be Hurting You
Some of us make it a habit to use the back pocket for our phone or wallet. While this might not be much of an issue for the body when just walking around, it becomes an issue when we sit down.
A solid item like a phone or wallet in the back pocket can compress the piriformis muscle in the buttocks, a small muscle that contributes to rotating the leg outward (away from the midline of the body). The sciatic nerve also runs underneath said muscle. Compressing it can impinge on the nerve, causing your leg to fall asleep, leading to pain, or worsening your existing sciatic pain.
Tights and Compression Shorts
Similarly, if your pants are too tight around the belt or if you’re wearing some form of overly tight compression underwear or yoga gear, it can compress the sciatic nerve. Keeping your legs active throughout the day might help alleviate that issue, but if you’re spending the day sitting around in tight pants, it can exacerbate or even cause sciatic pain.
Poor Sitting Habits
While curling your lower back can help alleviate sciatic pain, poor posture one way or the other (too much flexion or extension in any part of the spine) can continue to exacerbate existing back problems, or contribute to the development of new ones. No one has ever explicitly gotten injured because of the way they were sitting, but poor posture habits can play a role in how easily one might get injured, or how painful the recovery process might be.
Consider reducing the amount of time you spend sitting at a time and split your workday into several seated sessions with regular bursts of walking or short exercise. When you do sit (and are pain free), aim to find ways to keep your spine stable and in a neutral position without discomfort.
Inactivity and Bodyweight
Contrary to popular belief, we do not spend more time sitting today than ever before. However, we are more inactive than ever before.
Research gathered on the physical health of hunter-gatherer tribes and their activity levels showed that while they spent about as much time sitting around as the average American (nearly ten hours), they spent four times as much time “exercising” than the average American (via hunting, climbing, and brisk walking), and their method of sitting required more muscular activity than just sitting on a cushioned chair (various forms of squatting and sitting on the ground).
We’re built to take every opportunity to rest, but too much rest can make the body too weak for its own good. Daily activity is important to help keep the muscles strong enough to maintain our frame and avoid the pain that comes from imbalance and weakness. That doesn’t mean we need to become athletes or return to the wild.
While there is no such thing as the optimal exercise program, some form of regular daily or weekly physical activity is shown to reduce the chance of recurring back pain. The beneficial side effect of more exercising (lower body fat) can also help reduce back and joint pain by reducing the amount of fat storage that the body has to carry.
Lifting and Moving Improperly
Often, just bending over improperly can be enough to hurt yourself, let alone trying to lift something off the ground. For those with a history of back pain and sciatica, it will be doubly important to learn to move properly and healthily, and strengthen the muscles involved in moving, particularly the extensors and flexors of the hip, and the musculature of the core (the erectors, the obliques, the abdominal muscles, and others).
Learn to hinge at the hip (which guarantees a straight back) instead of bending at the waist (which flexes the lower spine) and lift with the hips and legs rather than just the legs. While it’s not advised to lift anything while you’re struggling with sciatic pain, exercise in general is still a good idea, and will help speed up recovery. An experienced pain management specialist and/or physical therapist can instruct you on lifting carefully and properly, and reaping the benefits of a simple resistance exercise program during the recovery process.