Sciatic Pain and Weightlifting

Overview

Sciatica refers to pain that travels along the path of the sciatic nerve. The sciatic nerve travels from the lower back through the hips and buttocks and down each leg. Sciatica most often occurs when a herniated disk or an overgrowth of bone puts pressure on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg. Although the pain associated with sciatica can be severe, most cases clear up with treatment in a few weeks. People who have severe sciatica and serious leg weakness or bowel or bladder changes might need surgery.

What Does Sciatica Feel Like?

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.
Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.
One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg. Rarely, both legs may be affected together.
Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region.

It is important to note that any type of lower back pain or radiating leg pain is not sciatica. Sciatica is specific to pain that originates from the sciatic nerve.

Causes

Sciatica occurs when the sciatic nerve becomes pinched. The cause is usually a herniated disk in the spine or an overgrowth of bone, sometimes called bone spurs, form on the spinal bones. More rarely, a tumor can put pressure on the nerve. Or a disease such as diabetes can damage the nerve.

What are the risk factors for sciatica?

Have an injury/previous injury: An injury to your lower back or spine puts you at greater risk for sciatica.
Live life: With normal aging comes a natural wearing down of bone tissue and disks in your spine. Normal aging can put your nerves at risk of being injured or pinched by the changes and shifts in bone, disks and ligaments.
Are overweight: Your spine is like a vertical crane. Your muscles are the counterweights. The weight you carry in the front of your body is what your spine (crane) has to lift. The more weight you have, the more your back muscles (counterweights) have to work. This can lead to back strains, pains and other back issues.
Lack a strong core: Your “core” are the muscles of your back and abdomen. The stronger your core, the more support you’ll have for your lower back. Unlike your chest area, where your rib cage provides support, the only support for your lower back is your muscles.
Have an active, physical job: Jobs that require heavy lifting may increase your risk of low back problems and use of your back, or jobs with prolonged sitting may increase your risk of low back problems.
Lack proper posture in the weight room: Even if you are physically fit and active, you can still be prone to sciatica if you don’t follow proper body form during weight lifting or other strength training exercises.
Have diabetes: Diabetes increases your chance of nerve damage, which increases your chance of sciatica.
Have osteoarthritis: Osteoarthritis can cause damage to your spine and put nerves at risk of injury.
Lead an inactive lifestyle: Sitting for long period of time and not exercising and keeping your muscles moving, flexible and toned can increase your risk of sciatica.
Smoke: The nicotine in tobacco can damage spinal tissue, weaken bones, and speed the wearing down of vertebral disks.

Weight Training with Sciatica

Avoid aggravating exercises when weight training with sciatica, such as squats and deadlifts. These movements require contraction of the buttocks muscles and increase the load on your lumbar spine. Focus on strengthening your upper body while your sciatica heals. Consider using lever machines rather than free weights or barbells — machines stabilize the weight for you, relieving some of the burden from your core muscles. Use proper posture during exercise and as you transition between machines. Squeeze your shoulder blades together and keep your lower back straight. When retrieving something from the ground, hinge at the hips rather than bending over at the waist. Lift one leg straight out behind you to counterbalance and help keep your spine straight.

Be sure to use proper form when resuming previously aggravating exercises once your symptoms have resolved. For example, follow these steps, for the front squat:

Grip the barbell with your hands shoulder-width apart. Bend your elbows and bring them under the bar.
Resting the barbell on your shoulders, step away from the rack.
Assume your squat stance — often slightly wider than hip-width apart.
Hinging at your hips, send your butt backward and bend your knees until your thighs break the parallel plane. Keep your chest up and core tight.
Straighten your knees and stand back up. Fully extend your hips at the top of the movement.

What are the treatments for sciatica?

We will look at treatments for acute and chronic sciatica individually:

Acute sciatica treatments
Most cases of acute sciatica respond well to self-care measures, which include:

Over-the-counter painkillers such as ibuprofen
Exercises such as walking or light stretching
Hot or cold compression packs help to reduce pain. It is often helpful to alternate between the two.

Chronic sciatica treatments
Treatment of chronic sciatica usually involves a combination of self-care measures and medical treatment:

physical therapy
cognitive behavioral therapy (CBT) – helps manage chronic pain by training people to react differently to their pain
painkillers.

Surgery may be an option if symptoms have not responded to other treatments and continue to intensify. Surgical options include:

Lumbar laminectomy – widening of the spinal cord in the lower back to reduce pressure on the nerves.
Discectomy – partial or entire removal of a herniated disk.

Depending on the cause of sciatica, a surgeon will go over the risks and benefits of surgery and be able to suggest a suitable surgical option.

Summary

Sciatica often goes away on its own over time, but some kinds of exercise can help the pain and some can make it worse. Exercises that relieve sciatica include low-impact aerobic activities like walking, certain strengthening exercises, and gentle stretching. Exercises that can make sciatica worse include high-impact activities like running and aerobics, hamstring stretches, and some core-strengthening exercises.

The most important thing to remember about exercise and sciatica is not to overdo it. Once the sciatic nerve is already irritated, it doesn't take much to trigger symptoms. Listen to your body and stop or slow down if you experience any pain.

14.09.2022