Sciatica and Yoga

Sciatica is a name for a wide range of symptoms and has a variety of causes – it is often difficult for sufferers to find relief from symptoms that range from tingling and numbness to sharp pain in the hips, legs and feet. Although yoga can be helpful for relieving sciatic symptoms, it is also possible to develop sciatica from practicing yoga.

Any kind of nerve-related symptoms should be taken very seriously and assessed by a trained therapist because nerve damage causes degeneration of muscles and Sciatica can be a symptom of serious problems in the spine.

The Sciatic nerve is formed from roots rising from the spinal cord between the lower Lumbar vertebrae and the sacrum that join together to form a large nerve that travels down the back of the hip and leg and branches to the toes. Sciatica symptoms are caused by compression of the nerve or its roots. The most common sources of irritation are the vertebrae or the Piriformis muscle, because in 15% of people, the Sciatic nerve travels through the fibres of the Piriformis muscle and tension in the muscle compresses the nerve. Sacroiliac joint problems also produce Sciatica symptoms because hip misalignment creates tension in the lower back muscles that attach to the lumbar vertebrae, irritating the nerve roots.

Yoga can cause Sciatica symptoms in these ways:

1. Direct compression of nerve roots when backbending is taken to extremes, especially if the Lumbar spine is hyperextended
2. Holding asanas like Hanumanasana and Kurmasana for long periods can stretch and damage the Sciatic nerve
3. Sciatica often develops after Hamstring injuries
4. Many yogis develop weak gluteal muscles and unstable, misaligned hips: commonly from practicing too many leg-strengthening postures and over-stretching the hip muscles. Muscle imbalance within the shoulder girdle also affects hip alignment and can cause sciatica.
5. Body asymmetry and previous injury causes misalignment of the hips, shoulders and Sacroiliac joint and Sciatica. Problematic body alignment is often reinforced by asymmetrical asanas: all kinds of standing poses that are done on the left and right sides.

Many people have marked differences between the left and right sides of their bodies and are often unaware of these differences. It is up to the class teacher to act as an outside observer and point out differences – helping students to correct imbalance – for yoga to have any therapeutic value. Correcting painful body alignment requires specific therapy and is beyond the scope of a general yoga class or set yoga sequence.

Sciatica that is related to body asymmetry improves when sufferers avoid asymmetrical standing poses – or practise more on their weaker side, working with maximum awareness – and strengthen the core muscles with asanas that require stabilisation, such as Vasistasana, Purvottanasana, Salabhasana and Bakasana, rather than abdominal exercise involving  flexion and extension of the torso and legs.

Strong, flexible hips and shoulders prevent hyper extension of the lumbar spine in asanas like Urdhva Dhanurasana.  Yogis often don’t understand the difference between bending from the Thoracic spine and bending the Lumbar spine in asanas like Salabhasana, Bujangasana, Urdhva Mukha Svanasana and standing back bends. Teachers are greatly responsible for ensuring that students learn safe back bending habits.

Stretching the Piriformis muscle is commonly prescribed as treatment for sciatica but this is often unhelpful for long-term yoga practitioners because the hips are stretched so much anyway: tension in the Piriformis is then a sign of muscle imbalance or body alignment problems. Sciatic symptoms are often worse after practicing Eka Pada Rajakapotasana, Gomukhasana, Garudhasana and Parvritta- versions of Trikonasana, Ardha Chandrasana or Parsvakonasana – especially bound Parsvakonasana. Contrary to prevailing wisdom, Sciatica caused by yoga improves by avoiding hip-openers and strengthening the hips and core.

If Sciatica develops after long-term yoga practice, it can be helpful to get a physical assessment to check for pelvic crossed syndrome (weak butt and lower abdominal muscles) and work on correcting muscle imbalances and pelvic stabilisation. Correct use of Bandhas stabilises the lower back and pelvis. The link below is to exercises that help to teach pelvic stabilisation. The articles are available for download in Adobe pdf format although it helps to be taught them properly by someone trained.

http://dianelee.ca/education/article_deep_core.php

Reading Sources:
De Franca, 1996, Pelvic Locomotor Dysfunction
Kendall, McCreary, Provance, 1993, Muscles, Testing and Function
Lee, 1999, The Pelvic Girdle