2. Low Back Pain and Sciatica
The spine consists of four main areas
Cervical
Thoracic
Lumbar
Sacrum/coccyx
Spinal Anatomy Overview
3. Symptoms
• Depending on the cause, symptoms can
vary
– Dull, sharp or burning
– Felt at a single point or over a broad area
– Occurs suddenly or comes on gradually
– Occurs with spasms or stiffness
– Associated leg symptoms such as pain,
numbness or tingling
4. Red Flag Symptoms
• History of cancer
• Progressive motor
or sensory deficit
• Prolonged steroid
use, IV drug use
• Major trauma
• Numbness in
groin/saddle
• Bilateral leg
weakness
• Fever and chills
• Unrelenting
severe pain with
rest
• Loss of bowel or
bladder function
5. Diagnostic Testing
• Physicians will not generally order
diagnostic tests in the first six
weeks of low back pain
• Most of the time, the causes for
back pain cannot be found by x-
ray, CT scan or MRI
6. Intervertebral Disks
• Acts like a
cushion
between the
bony vertebrae
that make up
the spine
• 90% water
• Wears with age
8. The spine consists of four
main areas
• The disks between our vertebrae
act like shock absorbers
• When disks are injured from either
wear and tear or a sudden force,
they are unable to repair
themselves very well because they
lack the rich blood supply needed
for healing
9. Sciatica
Sciatic nerve
(largest nerve in body)
• “Catch-all” diagnosis
• Back pain radiates down leg to
foot
• Avoid long periods of sitting
• Stand up every 20 minutes to
recover
• arch in spine
• Keep mobile – go for walks
• Stretch regularly
• If pain persists see doctor
10. causes
Sciatic nerve pain can have a number of
causes:
bulging or herniated disc
narrowing of the spinal column
inflammation of the soft tissues in the
surrounding areas
short or spasming piriformis muscle in the
buttock (piriformis syndrome)
12. Natural sciatic pain relief
Many natural and physical therapies, and simple lifestyle
changes, can provide sciatica relief and prevent it from
returning.
A healthy diet improves your body's ability to heal. Use
citrus fruits and juices, such as lime juice - vitamin C
boosts your immune system, prevents serious illnesses,
and reduces the swelling around the sciatic nerve.
Proper posture, healthy weight, ergonomic working
environments and an active lifestyle all play important roles
in treating and preventing sciatic pain.
Relaxation techniques help you manage and reduce the
psychological impact of chronic pain.
13. Relaxing the muscles around the
sciatic nerve
Rest at regular intervals, in postures chosen to
relieve sciatic pain to provide sciatica relief.
Intentionally relax all the muscles in your body
in these positions:
Lay on your stomach with a pillow or rolled towel
underneath your hips.
Lay on your stomach with one leg bent and out to
one side - the first aid recovery pose. Put a pillow
under the knee to remove any strain on your back.
My favorite - lay on your back with a pillow under
your head. Rest your feet on a chair so that your
knees are bent and your lower back is flat against
the floor.
14. Massage to relieve sciatic pain
Ice: If you have acute sciatic pain after an injury, apply ice to
the lower back for 10 minutes every few hours. Ice reduces
inflammation and provides temporary pain relief in the first
few days after your injury.
Heat: If you have longer-term sciatic pain, apply heat to the
lower back to encourage circulation and tissue repair, relax the
surrounding muscles and reduce pain. A hot bath or shower
relaxes the muscles and calms the nerve.
Menthol-and capsaicin-based sports rubs or plasters may
provide short term relief of chronic back pain.
Massage and spinal manipulation may provide some short
term relief, but should only be performed on sciatica patients
by qualified and experienced practitioners
15. Correct posture and ergonomics
Use a balanced posture in all activities to prevent sciatic pain.
• Walking / Standing: Use smooth, gentle and relaxed
movements - tense muscles increase the pain. Stand tall, and
make sure your lower back is not curved - keep your buttocks
tucked in.
• Carrying: Never carry a bag on one shoulder, or all the shopping
bags in one hand. Distribute weight evenly on both shoulders, and
in both hands. Use backpacks, not shoulder bags.
• Lifting / Reaching / Bending / Twisting: Avoid heavy lifting if
possible. If you must lift something, don't bend over or twist your
back. Use your knees to lift and your feet to turn. Avoid twisting
when reaching for something above your head or below your
waist.
16. Sitting: Use a chair which supports your lower back. Position
your knees at the same level as your hips, with your feet flat
on the ground. A lower back pillow, or rolled towel will support
your lower back.Use the arms of the chair to help you sit or
stand.
Note: constantly sitting tightens the piriformis muscle - get up
and stretch regularly.
Driving: Avoid driving when the pain is severe. Use a pillow or
lumbar roll to support the lower back and maintain a correct
sitting posture.
Sleeping: A firm mattress with one supportive pillow under
your head encourages good sleeping posture. An extra, soft
pillow between the knees may provide sciatic relief. Be careful
not to twist or place strain on your back when getting into or
out of bed.
17. Yoga to relieve sciatic pain
Many gentle yoga poses can relieve sciatic
pain. Plus there are many other stretching
and back strengthening poses to prevent
sciatic pain from reoccurring
18. Back pain relieving yoga poses
cat-cow pose relieves pressure and increases mobility in the
back (marjariasana).
standing forward bendloosens the hips, stretching the
hamstrings and lower back (uttanasana).
head to knee pose stretches the lower back and hips (janu
sirsasana).
big-toe pose stretches the hamstrings and relieves lower
back pain (supta padangusthana).
a butterfly leg pose opens and loosens the hips (baddha
konnasana).
fire-log pose opens the hips (agnistambhasana).
lower back twist loosens the back muscles
(bharadvajasana).
sage's pose loosens the back muscles (marichyasana).
19. Back strengthening yoga poses
Be careful when attempting the strengthening poses. If at
any time your sciatic nerve twinges, stop, stretch gently
and relax.
extended side-angle pose stretches the outside of the
leg and chest, and strengthens the back (utthita
parsvakonasana).
warrior pose variations strengthen the legs and lower
back (virabhadrasana).
cobra pose strengthens the back, but be careful not to
over-stretch (bhujangasana).
downward facing dog lengthens and strengthens the
back and arms (adho mukha svanasana).
20. Cat-cow pose (marjariasana)
Steps :
Come onto the floor on your hands and knees. Bring the hands shoulders width
apart and the knees hips width apart.
Inhalation slowly and completely. Open the chest forward, arching the back
downward. Feel the tailbone and the crown of the head lifting equally towards the
sky.
Exhale slowly and completely as you begin to arch the back upward. Tuck the
tailbone and the crown of the head moving them towards each other. Use your
hands and knees for support in the pose.
Continue to coordinate the breath and the movement of the spine, repeating this
sequence and many times as is desirable. When you are ready to stop simply
bring the spine back to a neutral position, parallel to the floor.
21. Benefits:
Excellent for creating a supple spine, preventing injury
Purifies the blood
Reinvigorates the spine and internal organs
Relieves tension in the low back
22. Cautions
Knee problems
Cronic or recent back pain, injury or surgery
Cromic or recent wrist pain or injury
Cronic or recent neck pain or injury
23. Standing forward bend
(uttanasana)
Stand in Tadasana, hands on hips. Exhale and
bend forward from the hip joints, not from the
waist.
If possible, with your knees straight, bring your
palms or finger tips to the floor slightly in front of
or beside your feet, or bring your palms to the
backs of your ankles.
With each inhalation in the pose, lift and lengthen
the front torso just slightly; with each exhalation
release a little more fully into the forward bend.
Uttanasana can be used as a resting position
between the standing poses. Stay in the pose for
30 seconds to 1 minute. It can also be practiced
as a pose in itself.
24. Benefits
Calms the brain and helps relieve stress and mild
depression
Stimulates the liver and kidneys
Stretches the hamstrings, calves, and hips
Strengthens the thighs and knees
Reduces fatigue and anxiety
Relieves headache and insomnia
Therapeutic for asthma, high blood pressure, infertility,
osteoporosis, and sinusitis
25. Contraindications and Cautions
Back injury: Do this pose with bent knees, or perform
Ardha Uttanasana (pronounced ARE-dah,ardha= half),
with your hands on the wall, legs perpendicular to your
torso, and arms parallel to the floor.
26. Head to knee pose (janu
sirsasana)
Step by Step :
Sit with the legs outstretched in front of you, on
a block if you back isn’t straight.
Bend your right knee and place the right foot on
the inside of the left thigh towards your
perineum, let the right lower leg rest on the floor,
shin in a right angle with the left leg.
Keep the left foot flexed, lengthen the spine on
an inbreath and on an outbreath turn the spine a
little to face the left leg and than fold forward
from the hips.
Keep your spine long chest open and shoulders
drawn down. Relax your face.
Stay in the pose for 1-3 minutes.
27. Benefits
Stretches your spine, back muscles, hamstrings, and
groins.
Massages and stimulates your internal organs like the
liver and kidneys.
Improves digestion and helps heal gastric ailments.
Calms the mind and central nervous system.
Relieves anxiety, fatigue, headache, and menstrual
discomfort.
Therapeutic for high blood pressure, depression, and
insomnia.
28. Cautions
Knee injuries - Avoid flexion of the injured knee if
discomfort occurs. Try performing with the bent knee
supported on a folded blanket.
Low back injury especially if history of lumbar disc
herniation.
Diarrhea
Asthma
29. Big-toe pose (supta padangusthana)
Step by Step :
Lie on your back, legs extended, feet flexed pressing out through the heels.
On an exhalation draw the right knee into your chest, fold a strap around the arch
of the right foot and extend that right leg up to the ceiling, hold the strap with
both hands, walk hands up along the strap till the arms are straight keeping
shoulders pressing in the floor.
Keep strongly extending through the left leg pressing the top of the left thigh down
and extend through the right heel creating a comfortable stretch in the back of the
leg.
Stay here or turn the right leg out and bring the leg down to the floor on your right
side, keeping the left hip grounded.
Stay in both variation for about 1-3 minutes.
Once back to centre, hold the leg up for another 30 sec
30. Benefit
Stretches the back of the legs, the hips and lower spine
Balances the nervous system and calms the mind
Improves digestion
Relieves lower back ache, menstrual pains and sciatica
Restores your energy
Strengthens the muscles around the knees
32. Butterfly leg pose (baddha
konnasana)
Step by Step :
Sit with your legs outstretched in front of you,
you may want to sit on a blanket or pillow to raise
your hips, so you can sit with a straight back.
Pull in your feet and place the soles of the feet
together, as close as possible to your pelvis, let
the knees fall out to your sides.
Release your groins, the head of the thigh bones,
and allow the knees to relax down as well, don’t
push them.
Hold your big toes with the first two fingers and
your thumb, or hold the outsides of your feet.
Keep your pelvis level, sit with a straight back.
Firm your shoulderblades into your upper back, to
help open your heart.
33. Helps in opening your hips
Stretches groins, inner thighs and ankles
Uplifts your mood
Stimulates abdominal organs
Beneficial for menstrual pains
Stimulates the circulation in the pelvic area
You can stay in this pose anywhere between 1-5 minutes
To come out you lift your knees and straighten your legs again
34. Cautions
Groin or knee injuries
Lower back injury or a herniated vertebral disc
35. Fire-log pose (agnistambhasana)
Steps:
Sit on your mat with your knees bent in front of
you, feet flat on the floor and palms pressing into the
earth behind you.
Lean back in to your hands, releasing your shoulders
down your back. Cross your right ankle over your left
knee, until you make a figure four shape with your legs.
Keep your right foot flexed and draw your right knee
away from you until you feel a stretch in your right hip.
Wiggle or heel-toe your left foot towards the right. Walk
your hands slightly forward, so that you have enough
room to sit up straight and stack your legs.
Line up the ankle or side of your right foot over your
left knee, and your right knee over your left ankle, or
side of the foot. Try to make your shins parallel to each
other, with the right stacked directly over the left.
Breathe here, or walk your hands forwards and recline
forwards. Hold for 1 minute or more, and then uncross
your legs to come out of the pose. Repeat on the
opposite side.
36. Benefits
Double Pigeon Pose is an intense hip opener with several
benefits:
Stretches and opens the hips
Stretches the groins
Relieves anxiety, tension and stress
38. Sage's pose (marichyasana)
Steps :
Start in Staff pose. Draw your right knee in towards you
with your foot planted firmly. Make sure the right thigh
is making contact with the right side of the torso. Keep
the left leg strong and active with your left foot firmly
flexed.
Sitting up tall, extend the right arm forwards with your
palm facing out and your thumb pointing directly down
to the ground. Lengthen your torso and reach forwards
through your fingertips as you take a deep inhalation.
On the exhalation, sweep the right arm around the front
of the right shin.
Keep reaching forwards through the crown of your head
as you sweep your left hand in behind your back. Grab
hold of the left wrist in your right hand.
Lengthen your torso forwards and begin to fold in
towards your left thigh. Ensure your chest stays open
by pulling your shoulders away from your ears.Your
right sitting bone may come off the ground.
Stay here for up to one minute, then return to Staff
Pose. Repeat on the other side.
39. Benefits
This seemingly simple, yet challenging pose offers many
benefits:
Stretches the hips, hamstrings and shoulders
Activates the abdominal organs
Stimulates digestion and metabolism
41. Help and Healing Sciatica
with Nutrition
Diet needs to contain fibre rich foods, lots of fruits and vegetables that
will prevent constipation.
2 – 3 cups of green tea per day
Turmeric, garlic, ginger
The B-Vitamine are highly important and can be found in green peas,
spinach, navy beans, nuts, pinto beans, bananas, sweet potatoes,
whole grain fortified cereals and breads and unpolished rice and
legumes.
Foods rich in A-Vitamine such as dairy products - milk, cheese and
yogurt, carrots, dark green leafy vegetables, orange-coloured fruits,
e.g. mangoes and apricots,
C-Vitamine is found in fruits – especially citrus, regular and sweet
potatoes, cabbage, spinach broccoli, tomatoes, and green and yellow
vegetables.
K-Vitamine sources such as broccoli and spinach, alfalfa, vegetable oils
and cereals.
Drink plenty of water.
