We’ve posted many blogs on sciatic nerve irritation. “Sciatica” as it is often called is a very painful irritation of a large nerve that runs from the lower back down the back of the leg. As we’ve mentioned before “sciatica” is not a diagnosis. Irritation of the sciatic nerve can occur for various reasons depending on the structure that is causing the problem. Regardless, it is very painful. Usually, there is an accompanying pain in the lower back, although this isn’t always the case. Quite often the pain in the leg is worse than the back pain. There are various treatment approaches for sciatic pain and nerve pain in general. Chiropractic, physiotherapy, massage, and acupuncture are all very conventional approaches. Laser therapy, interferential current and home ice are also common considerations to help with sciatic pain. As for most conditions, there are exercises that practitioners will give their patients to do at home. Sciatica and nerve irritation is no different.
The McKenzie approach (including McKenzie exercises) is a common strategy. Usually this is employed when a disc injury is suspected. Although there are different positions and movements with this approach, perhaps the most common is when you see patients lying on their stomach and doing a “lazy push-up” where the stomach slouches to the floor. Another perhaps less common home exercise for sciatic irritation is nerve flossing. Through a series of patient movements, the nerve is mobilized around a site of irritation, similar to when you floss your teeth.
The differentiation between nerve tension and nerve sliding (gliding) is important. We often use nerve tension to diagnose. Although it can be used in treatment, tensioning an irritated nerve will teach the practitioner whether nerve irritation is part of the problem. The Straight Leg Raise test is an example. With a patient lying on their back, the practitioner will lift the leg (while straight) and will move the ankle to put a stretch on the calf area. Pain in the lower back (especially with leg pain accompanying it) is a positive test suggesting nerve irritation. Nerve sliding (or gliding) involves moving multiple joints so that slack is put on the nerve in certain areas. Perhaps a good way to explain the difference is to use the analogy of a garden hose. Imagine your nerve is a garden hose. Stepping on the garden hose is like pinching the sciatic nerve. Nerve tension tests would be similar to pulling the garden hose from one end while at the “other end” the hose is being stepped on. In a small way, the nerve (garden hose) is being stretched. Nerve sliding approaches would also mean that we’re pulling the garden hose from one end, but we would also be pushing the nerve from the other side so that the hose isn’t stretched. Instead, it is more like the garden hose (nerve) slides along your grass a little!
Keep in mind that although these strategies can be helpful, they can easily exacerbate your nerve pain. These exercises should only be attempted under the advice of a professional who is familiar with sciatic nerve irritation and diagnosis.
Questions? Do you think you have nerve pain? Give us a call at (905) 220-7858 or Contact Us so we can help! Burlington Sports Therapy treats athletes and people in the Hamilton, Burlington and Oakville area.
Coppieters MW, Andersen LS, Johansen R et al. Excursion of the sciatic nerve during nerve mobilization exercises: an in vivo cross-sectional study using dynamic ultrasound imaging. Journal of Orthopaedic & Sports Physical Therapy 2015; 45(10):731-737.