How A Tennis Ball and Stretching Can Help Relieve Sciatic Nerve Pain
What Is Sciatica And Its Relationship With Low Back Pain?
The prevalence of low back is very high in industrialized countries, with some articles claiming rates of between 60-70% that affect the population.
Low back pain can then be further classified into acute or chronic, keeping in mind that symptoms can flare up due repeated trauma to the injured site.
Sciatica, however, is a much more specific condition that is often linked with low back pain and is the subject of this blog post.
Sciatica is a medical diagnosis characterized by lower back pain and radiating pain down the leg that results from irritation of the sciatic nerve roots.
The sciatic nerve passes underneath the piriformis muscle, runs down the leg, and terminates behind the knee where it bifurcates into different branches that innervate the leg.
It provides direct and indirect motor function to muscles of the lower body, as well as sensation to parts of the lower leg and foot.
Where Is The Sciatic Nerve?
The photo below illustrates the close proximity the sciatic nerve has to the piriformis muscle.
Due to this intimate relationship, when the piriformis muscle becomes spastic, it can pinch the nerve initiating a pain cascade and the beginnings of sciatica.
How Prevalent is Sciatica?
It has been estimated that up to 40% of individuals in a population experience sciatica symptoms at one point in their lifetime.
How Does Sciatic Pain Commonly Present?
Sciatica pain is most often unilateral (one-sided) and described as a painful, aching, prickling, and/or burning sensation.
Affected areas include, but are not limited to, the buttocks, lower back, below the knee, on the back of the calf, on the sole of the foot.
The pain can persist from four to eight weeks in the short-term (acute sciatica) or a longer period of time (chronic sciatica).
It can be aggravated by flexion of the lumbar spine, twisting, bending, and coughing. Other symptoms of sciatica are leg weakness or heaviness.
What Causes Sciatica?
Sciatica is commonly caused by conditions that irritate and/or compress the sciatic nerve.
Below is a list of some of the most common causes, but please keep in mind that this is meant to be an exhaustive list.
- Spinal causes (majority of cases)
- Lumbar bulging or herniated disc
- Spinal stenosis
- Degenerative disc disease
- Spinal tumors in the lumbar region (rare)
- Non-spinal causes
- Piriformis syndrome
- Post-operative complications
Sciatica Or Piriformis Syndrome? What Is The Difference?
While it can be difficult to differentiate sciatica from other conditions creating similar symptoms of pain in the low back and leg(s), distinct symptoms of sciatica are: low back (lumbar spine) pain, pain felt only on one side of lower body (eg. one leg), deep pain or burning feeling in the glutes of the associated side, “pins and needles”, heaviness or weakness in the leg, and/or pain upon a straight leg raise.
Such symptoms arise due to irritation of the sciatic nerve due to an injury or spasm, causing swelling or compression of the Piriformis muscle.
However, because of the variance in orientation of the sciatic nerve to the piriformis muscle, passing next to or through the piriformis muscle, one can experience sciatica like symptoms especially when the nerve passes through the muscle.
In the majority of individuals, it is common for the Sciatic nerve to pass through the Piriformis muscle, thus initiating pain in the low back and hip, ultimately causing poor movement and balance leading one to experience what is known as Piriformis Syndrome.
In fact, beginning symptoms of Piriformis Syndrome will be between the low back, hip and buttock regions that result in pain, tingling, or numbness especially in the buttock(s).
Such pain can be caused by previous trauma to the muscle or repetitive vigorous activities that recruit piriformis muscle use (eg. long distance running).
Furthermore, pain can also be elicited when stair climbing, applying pressure over the piriformis muscle, or long periods of sitting.
However, more severe chronic pain symptoms that run down the back of the leg(s) to the associated foot, can be cause for concern as it may be Sciatica.
Even still, the reason for one’s sciatica is not necessarily attributed to Piriformis Syndrome but can be considered as part of the differential diagnosis list.
I Have Sciatica! Now What?
Don’t worry! As stated earlier, many individuals will suffer from back pain at one point throughout their life.
It’s likely that simple home stretches, and conservative management like visiting your chiropractor, massage therapist, or physiotherapist will help to alleviate your pain.
The blog post endeavours to go through some simple techniques to help relieve your pain.
Let’s Get Into Some Home Stretches
Supine or Seated Piriformis Stretch
Lie on your back on a mat with your knees up and feet flat on the ground.
Cross the leg of the affected side so your ankle/shin rests on your other thigh.
Then gently, pull on the knee of the crossed leg towards your chest just enough that you feel the stretch deep in your glute muscle.
If you do not feel a stretch, grab the thigh of the affected side and pull it towards your chest.
Otherwise, hold the position for 5 deep breaths, and then switch to the other side and repeat.
Sit nice and tall on a firm chair to start, and then cross your right leg so that your right ankle rests on your left thigh.
At this point you should feel a deep stretch along the back of the right thigh into the buttocks.
If not, ensure you are still sitting up nice and tall as you exhale and hinge forwards at the hips and press down on the right knee.
Whatever your depth is in this stretch, hold the position for 5 deep breaths, and then switch to the other side and repeat.
Long Adductor (Groin) Stretch
Sit on the floor with your legs outstretched with a slight bend in the knees, and place your legs as far out as they go in opposite directions.
Then sit up nice and tall and rest your palms on the floor in front of you, and gently hinge at the hips, letting your palms slide forwards.
Only go as far forwards until you feel a light stretch, and hold for 5 deep breaths.
**Note: if you experience any pain in the thighs or behind the knees stop immediately
Short Adductor (Groin) Stretch
Sit on the floor with the soles of your feet touching and hold your ankles with each hand and inhale deeply and stay in this position for 5 deep breaths.
If you do not feel the stretch, gently push down on your knees with your elbows.
Stop if you feel any pain, and ease off pushing down on your knees a couple of inches before you stay there for 5 deep breaths.
Knee Hug Stretch
Lying on your back on a mat, tuck your chin down slightly (use a thin book or a thinly folded towel for more comfort), and bend your knees so that your feet are flat and hip width apart.
Relaxing the upper body, using both hands hold your right thigh just below the knee joint and hug the knee towards your chest.
At this point you may already feel a stretch in the low back, hip, and buttocks on the right side.
If not, gently start to straight the right knee as you continue to hold the leg until you feel a slight stretch.
Then hold for 5 deep breaths, before lowering the leg and returning to the starting position, and then trying it on the left side.
For time efficiency, this can be tried by hugging both knees towards your chest.
Start by lying on your side with the affected side facing the ceiling. Keeping your feet stacked on top of another, bend your legs back so that your knees form a 90 degree angle.
As you keep your spine neutral, ensure your hips are also stacked on top of each other such that both hips make a straight line towards the ceiling.
Now lift the top knee up, being careful not to roll backwards with your hips and the body remains in the starting position.
Then bring your knee back so that you are back in the original position.
Repeat 10 times. Please note this exercise should only be done in a pain free manner.
With your hands and knees on the mat to start, make sure that your hips and knees make a straight line, as well as your wrists and elbows with your shoulders.
Next, make sure to keep a neutral spine, by tucking your chin down, and gently engaging your core.
Then turn your right toe up towards your shin, and gently lift the right leg up towards the ceiling, keeping your spine neutral. Repeat 10 times.
Please note this exercise should only be done in a pain free manner.
Stand with your feet shoulder width apart behind a sturdy chair or at a counter, place both hands on the back of the chair or counter.
Stand up nice and tall with your feet shoulder width apart, and a slight chin tuck for proper neck alignment.
Turn your right toes up towards your shin and gently lift your right leg back without arching your low back. Lift far back enough that you feel a slight stretch of the abdominal muscles.
Please note this exercise should only be done in a pain free manner.
Nerve Flossing Exercises For Sciatica & Piriformis Syndrome
What is Nerve Flossing?
Nerve flossing is a technique that can be done on your own to aid with proper nerve gliding in the body, such that it is also known as neural or nerve gliding.
By engaging in nerve flossing painful symptoms of sciatica, due to irritation or constriction of the sciatic nerve, may be relieved.
Furthermore, nerve flossing exercises can increase one’s flexibility and strength for overall general health, resulting in possible improvements in one’s range of motion and reduction of damage to the nerve(s) itself.
Nerve flossing is used by chiropractors and physiotherapists alike, and can have a significant impact in decreasing pain.
Nerve Flossing For SCIATICA: Seated Sciatic Nerve Floss
Sit nice and tall on a sturdy chair with a slight chin tuck to for proper neck alignment with both feet flat on the floor.
Then straighten the right knee in front of you with your foot/toes turned up, as far as they go, towards your shin; and lift your chin up and tilt your head back so that you are looking up at the ceiling.
Then bring your chin back down towards your chest at the same time that you lower your lower right leg back slightly more than 90 degrees.
Repeat this on the right side 10 times before switching to the left side for 10 repetitions.
Nerve Flossing For PIRIFORMIS SYNDROME: Lying Outer Hip Stretch
Start by lying flat on a mat with both legs straight.
Next, bend the right leg and use the left hand to hold the leg under the knee, as you bring the right knee across towards the left shoulder.
Hold this stretch for 5 deep breaths and switch sides.
Stabilize yourself by keeping the right hand on the floor.
You should feel this stretch in the right hip, low back and in the right glute.
How Can I Use A Tennis Ball To Relieve My Sciatic Pain?
As described above, sciatica can be caused by irritated musculature around the sciatic nerve as it pierces through the piriformis muscle.
As a result, using a tennis ball as a way to trigger point and release tension in muscles surrounding the sciatic nerve can be an effective way to modulate pain.
Let’s Try Standing First …
Use a firm ball to roll against the lumbar muscles, gluteal and piriformis muscle group for 30 seconds – 1 minute.
The pressure should not be that which causes pain or numbness down the leg, but rather gentle enough to feel relieving after the exercise is ceased.
Repeat between 5-10 times per day, or as directed by your medical practitioner.
Let’s Use The Tennis Ball On Your Low Back …
As we mentioned earlier, the lumbar spine musculature can also be affected with sciatica.
Using a tennis ball against the wall, use the ball to massage the lumbar paraspinal muscles on each side of the spine, being careful not to apply pressure to the vertebrae themselves.
Pressure can be applied for 30 seconds – 1 minute in one area, and moved to different parts as needed
Ready For Something Harder With A Tennis Ball?
The picture below shows where you want to target the tennis ball – hold it in place for between 15-30 seconds, ensuring to move it periodically with the same caveat as above not to trigger any numbness down the leg.
What Else Can I Do To Help Relieve My Sciatic Pain?
In addition to the tennis ball release method and the various exercises explained above, other measures one can take to alleviate or prevent aggravating sciatic pain include:
- Use of cold/hot packs
- Practicing good posture
- Avoidance of wearing high heels
- Avoidance of prolonged sitting/standing
The Home Exercises Listed Above Are Not Working – What Should I Do Now?
Since the above stretches are meant to be a general overview, it’s likely that you may need additional guidance from a trained medical professional.
Please contact a trusted chiropractor, registered massage therapist, or physiotherapist in your community for an assessment and appropriate treatment.