With the approximate thickness of a pencil and running from the low back down to the feet, the sciatic nerve is the longest nerve in the body.
It originates in the lower part of the spine, travels through the muscles in the buttocks, branches out down the leg and attaches to the foot.
It can become irritated by muscles in its path (most commonly in the buttock or leg) tightening or going into spasm, or by a bulging or herniated disc in the low back pressing into it.
It is also associated with degeneration of the spine, or spinal stenosis, which causes a narrowing of the tunnel which the nerve passes through.
This irritation causes the pain down the buttocks, leg or foot which is commonly referred to as sciatica.
It is also associated with degeneration of the spine, or spinal stenosis, which causes a narrowing of the tunnel which the nerve passes through.
A slipped or herniated disc is the most common cause of sciatica.
It happens when the outer edge of the intervertebral disc ruptures and the inner jelly-like centre pushes out and presses on the sciatic nerve.
Sometimes the outer edge doesn’t break, but the disc protrudes. This is referred to as a bulging disc and can also put pressure on the nerve.
As the bump grows, your centre of gravity shifts.
This can lead to an increased arching of the back which in turn tilts the pelvis forwards.
This can sometimes mean that the muscles in the buttocks tighten and pinch on the nerve. Some woman also find that the expanding uterus can press directly on the nerve towards the end of pregnancy, or even as the baby starts to move into position, it can rest on the nerve.
As we age, our intervertebral discs can deteriorate. Over time (or sometimes due to injury), the disc can become arthritic, narrow or shrink.
This can increase the risk of the disc rupturing and therefore potentially giving rise to sciatica.
The degenerative process could also lead to the development of spinal stenosis, a narrowing of the bone canal through which the sciatic nerve passes which in turn compresses the nerve.
Smoking has been associated with a higher risk of developing sciatica.
This could be due to the reduced blood flow to the discs, leading to degeneration.
Excessive body weight places additional pressure on the back, increasing the rate of degeneration.
This increased pressure also increases the risk of disc injuries.
The Piriformis muscle is located in the buttocks, near the top of the hip joint.
The sciatic nerve passes through the piriformis muscle and can be compressed if the piriformis muscle is tight or goes into spasm.
This can be caused by prolonged sitting (particularly on hard surfaces), repetitive action during sports (i.e. football, running) or climbing stairs.
One of the most successful treatments for sciatica is a physical therapy programme.
A key aim is to reduce the pressure on the sciatic nerve. This can be achieved by strengthening the back muscles and core strength work. This increased strength will help support the spine.
A programme should also include exercises to support correct posture.
Sports massage and stretching/flexibility work also helps by reducing inflammation and easing and tight muscles which may be constricting the nerve.
At Core Strength Studios, we include the above in our rehabilitation programmes for clients with sciatica. In addition, the root cause of the problem will be advised on, and any additional treatment included accordingly.
If you think you have sciatica and would like to speak to a specialist for an assessment and to discuss treatment options, we would like to invite you to a complimentary 60-minute consultation. To register, click here, complete the form and we’ll be in touch to make your booking.
You know when you have back pain, everyone and their dog wants to give you advice. Like being pregnant but without the little bundle of joy at the end of it.
I know people mean well, but there are some common misconceptions out there which we hear A LOT and though said with the best intentions, really won’t help you at all. In fact, some can make it worse.
So, read on, and we’ll do our best to debunk some of the myths surrounding back pain, so you can say a silent ‘thanks but no thanks’ the next time someone tries to bestow their wisdom upon you.
Probably the most common ‘advice’ people hear. I think back in the olden days, this was what we were told to do when in fact, during extended periods of inactivity, muscles can weaken and grow stiff and ligaments and tendons can also lose flexibility and leave you more vulnerable to further injury.
Just like us, our tissues (including our intervertebral discs) need nutrients to stay healthy. By moving, we promote good circulation which in turn delivers nutrients and oxygen to the tissues to help them repair. Incidentally, this is also a reason why sports massage is so great, but that’s another post in itself
Brrr, as I’m writing this it’s November and about 4 degrees outside so the thought of ice on my back is painful right now! To be fair, even if it was 30 degrees today, you can bet that as soon as the ice touches your skin, your poor achy muscles will immediately tense against the chill.
For a back which is already tense, and potentially in spasm, we would recommend heat rather than cold. A warm bath (now that’s a nice thought) or hot water bottle can help the muscles relax and reduce any spasms. Cold is better used for inflammation, when you need to reduce swelling.
Au contraire! Now obviously this depends on how acute your pain is and the severity of your injury but when you can, and within pain-free limits, exercise is one of the best things for back pain. The weaker your muscles, the more vulnerable you are to pain and further damage. Keep your body mobile, and work on activating and strengthening your deep core muscles to strengthen your spine’s support network.
If you don’t act to help yourself, then maybe, yeah. But nobody should just accept that back pain is something they must live with forever. Most back pain can be helped by strengthening the core and back.
One study found 80% of patients with back pain had weakened muscles in their back. It’s not known whether the weakness was a cause or result of their pain, but by strengthening these muscles, and working on maintaining this strength it’s possible to significantly reduce pain or eliminate it altogether.
Evidence shows that deconditioning because of pain and reduced activity in people who have chronic back pain can result in weakened muscles of the low back and spine.
It is possible for the body to be strong everywhere except the back. The back can only be strengthened when the lumbar spine is moving against resistance. and typically, if you have back pain, you will (unknowingly) change your body mechanics to protect your back, substituting pelvic motion for lumbar motion.
When we talk about the muscles of the back, we are referring to the lumbar extensor muscles at the back (right) which are attached to the spine and stabilise, rotate and extend the back.
When we talk about the core muscles, however, we are referring to the muscles of the trunk (Rectus Abdominis, Obliques and Transverse Abdominis – left – as well as the lumbar extensors) which surround the mid-section, front and back like a corset, stabilising the trunk as the limbs move, providing support for the back and helping us bend and rotate.
It’s not possible to tell whether the weakness causes the pain, or is as a result of the pain, but if you have any of the following symptoms, you may one of many who have weakened muscles of the low back and core:
It is the primary job of your core and back muscles to keep you upright. When the muscles aren’t strong enough to support your body, they fatigue and ache as demand on them increases.
Same as above, your back and core will be working extra hard to maintain your posture and technique as you run/exercise or will force other muscles to work harder to compensate.
One study on a group of runners found that when the deep muscles of the core were in a weakened state, the body was forced to overcompensate using superficial abdominal muscles, meaning the runner was able to run in the same way, but with an increased load on the spine. https://www.painweek.org/media/news/avoiding-runners-chronic-back-pain-its-all-core
This could be a sign of muscle weakness. Again, your core and back have been working hard to maintain your position all day and may tire as the day progresses.
(note: any back pain which you notice at night when you lie down, and doesn’t go away when you adjust positions should be checked by a doctor as it could be a sign of something more serious)
Your core muscles are designed to carry your body in the best position for your comfort and health and to maintain correct alignment of your body, that is how your head, shoulders, spine, hips, knees and ankles line up with each other.
You should have a natural ‘s’ shape in your spine, so if you are not in alignment (for example, if your shoulders are rounded and your spine curves forwards excessively), your muscles become imbalanced. Some become shorter and tighter and others long and weak resulting in a reduction of use and weakening as a result.
When we stand and move, our deep core muscles are activated and working to keep us upright and to facilitate movement. As soon as we sit, the muscles switch off. This prolonged decrease in use can cause them to weaken over time.
During pregnancy, the muscles at the front of the abdomen stretch and separate to accommodate the growing baby. This, combined with the tipping forward of the pelvis affects the ability to stabilise the core and weakens the muscles as they elongate.
The pelvic floor muscles also make up part of the ‘core’. They are essentially a hammock at the bottom of the pelvis, supporting the pelvic organs. As the baby passes through the pelvic floor muscles during birth, core stability is further compromised, and the pelvic floor can become weak.
During a caesarean delivery, the abdominal muscles are separated to allow the baby to be delivered. After they are stitched back together, scar tissue forms, which can affect the muscle’s ability to work properly as they contract.
If the abdominal muscles have been cut during any abdominal surgery, just as with a C-section (above), the formation of scar tissue where the incision was made will affect the muscles’ ability to contract and may result in decreased strength.
There may be an imbalance of the core muscles if they are forced to maintain an unnatural position for prolonged periods. This can be common in occupations such as mechanics, bricklayers and carpet fitters to give a few examples.
To speak to a back pain specialist about strengthening your core and back to reduce back pain, claim your complimentary ‘reduce back pain’ consultation.
To claim, enter your details below and we’ll be in touch to arrange your session.
Back pain is a scourge of our modern lifestyle. Hours spent sedentary at the office, combined with sitting in the car or train for long periods and slumping on the sofa in front of the TV or phone after a hard day can lead to the onset of back problems.
Postural changes along with a lack of movement can reduce mobility of the spine and lead to atrophy of the muscles.
One key contributor is a shortening of the muscles in the hips and legs. In a seated position, your Psoas muscle at the front of your hip is in a shortened state.
Over time, this prolonged position can cause the muscles to adaptively shorten, meaning you lose flexibility and range of movement in your hips.
Because the muscle attaches to your spine – this shortening and tightening can cause an imbalance and result in a tilting of your pelvis which in turn changes the position of your spine, causing pressure on the discs and low back muscles.
Stretching the tightened muscles can help release them and improve flexibility to ease the pressure on your back.
Try these simple stretches at the end of the day, holding each for around a minute and making sure you repeat the stretch on both sides.
Put one leg in front of the other and lean into the stretch, feeling it along the front of your hip. Lift your arm, rotate slightly and increase the stretch by gently leaning away
Sit with your back straight and cross one leg over the other. Use your arms to pull your knee up towards your chest and your other hand to angle your leg until you feel the stretch in your buttock.
Use a band or rolled-up towel in the arch of your foot (not the ball of your foot) and keeping your leg straight, gently pull in towards you until you feel the stretch in the back of your thigh.
Lying with one leg bent, extend the arm out to the side, keeping your head looking in the opposite direction. Use the other hand to gently push into the floor and extend the stretch so you feel it in your chest.
As well as tan lines and inside-leg chain ring imprints, there is something less welcome which many cyclists have in common.
Though it’s frequently thought that knee pain is the main culprit, back pain is in fact the biggest cause of complaint amongst cyclists spending long periods in the saddle.
In one study, out of 116 cyclists who had suffered some kind of overuse injury in the past 12 months, 58% had experienced lower back pain.
So why is it so prevalent in such a low-impact sport? The chances are, the cause of the pain is not limited to any one thing, but a combination of factors which may or may not be correlated.
Blame is commonly placed on the little-known psoas muscle. Originating in the low back, it travels through the pelvis and attaches to the thigh bone and is responsible for pulling the leg towards the chest.
Given that this is the position that cyclists find themselves in for long periods of time with the muscle in a shortened state, it’s no surprise, then, that the muscle adaptively shortens, causing the back to arch as the muscle pulls on the spine, causing pain, weakness and muscle imbalances.
This is increased risk in riders who spend long periods sitting during the day, and whose psoas may be in an already shortened state.
Counteract this by stretching the psoas, particularly after a long ride. Kneeling down (see below), put one leg in front of the other, foot on the floor and push your hips forwards until you feel the stretch at the front of your hip (keeping your back straight). Increase the stretch by raising the arm on the same side as your back leg and bending and twisting to the side. Repeat on the other side.
Deep tissue or sports massage on the psoas and low back can also help to release the muscle and ease any tightness.
One of the jobs of the deep core and back muscles are to stabilise the pelvis and back. For cyclists, this means transmitting energy from the trunk down to the pedals without compromising the stability of the spine or pelvis.
When the core is weak, however, this increased instability places additional strain on the back, intensifying the risk of pain, as well as more sinister problems such as slipped discs.
During a ride, the muscles in your legs fatigue. As they tire, your postural muscles may be forced to compensate by taking on additional load. If they are already tired from keeping your position throughout the ride, this additional strain can cause your back to ache.
By performing some simple core strength exercises a couple of times a week, you’re protecting yourself against weakness-related pain and giving your muscles a better chance to support your body and prevent back pain.
Try this quick 10-minute core strengthening routine for back pain
Book a complimentary consultation with a back pain specialist in our Bristol studio to assess your pain, diagnose why your back hurts when you’re cycling and learn how to prevent pain long-term.
To register, complete your details below and we’ll be in touch to book your session.
A study recently found massage more effective for reducing back pain than medication and other traditional methods.
According to the research, 40% of subjects who had a weekly massage for 10 weeks reported a significant reduction in their pain, compared to just 4% of subjects receiving usual care.
I’ve been practising sports massage for over 10 years and, where it was a little-used treatment for back pain when I first qualified, it’s now often the first thing people investigate when suffering chronic pain and we’re now getting more enquiries than ever here at the studio.
So, want to know a bit more about it and see what all the hype is? Read on…
Sports massage is a deep-tissue treatment which works by stretching and manipulating the soft tissues of the body to increase circulation, promote relaxation of the structures and break down any adhesions.
The main difference between a sports massage and a regular massage is that it specifically targets and reduces tension in muscles and soft tissues that are affected by pain or injury. Pre-event, light, fast, stroking, vibration and percussion techniques are used to stimulate circulation and relaxation of the muscles. Post-event massage is best done within an hour or two of the event and restores the muscles to normality by similar light, long techniques to relax the muscles and flush out waste products. Rehabilitative massage is aimed at restoring function and alleviating pain through deep stretching, kneading and pressure techniques and trigger point therapy is often used to break down adhesions and aid movement.
Reported benefits are:
It’s not just for sports people as, as demonstrated in the study, it can help greatly with back pain as well as relieving sore shoulders and stiff necks. Probably because of today’s lifestyle (and where we’re placed-in the middle of a busy commercial district) we treat more tension and posture related pain than anything else.
On the face of it, there are very little similarities between your teeth and your back, right? Other than the fact that – when healthy – they both support your basic human function, albeit in very different ways.
Now think about this; what happens when your teeth are NOT healthy? Pain, difficulty eating and costly dental treatment are all likely scenarios.
Similarly, if your back health is compromised, you may experience pain, time off work, having to stop doing the things you enjoy, and costly treatment fees.
In order to avoid problems with our teeth, we visit the dentist. Regular check-ups make sure any potential problems are identified early and rectified before they become an issue.
The same can’t be said for our backs, though. What tends to happen is that we only seek help when we are in pain. By this time, poor back health is having a detrimental affect on our lives, we can’t move properly and it becomes very expensive to fix.
What if we could do the same for our back as we do for our teeth? We could identify potential issues before they become a problem, meaning no time off work, no disruption to our lives and a significant reduction in the amount of money we need to spend on it.
The good news is that now we can. Through the use of specialist MedX rehabilitation equipment, we are able to test the strength of your back, and predict the likelihood of potential back problems in the future based on your results.
To do this, we isolate and test the strength of your back muscles at various angles through your spine’s range of movement.
The force that you generate is then displayed and recorded and your results are compared to normative data for a person of the same age, gender, height and weight as you.
If your results show a weakness in your back, you may be vulnerable to back problems in the future so we’ll work to build a plan to improve your strength and work on the prevention of more serious back problems.
Back check-ups are free of charge, last 30 mins and take place from our Redcliffe studio. To book yours, complete your details below and we’ll be in touch to book you in.
With 49% of us suffering from back pain at some point in our lives, and a whopping 2.9 million days being lost due to work-related back disorders on 2014/15 (source), it’s time to take action against back pain at work and arm ourselves with the tools to prevent the onset of attacks.
With back pain related absences costing the UK economy £14bn a year (source) and a growing number of freelancers, self-employed people and other people not bring eligible for sick pay, the financial implications of back pain mean it’s not just our health which is suffering, our pockets are also feeling the pinch.
It’s not just manual workers feeling the strain either, with 50% of office workers experiencing some level of back pain. There are ways you can help prevent back pain in the office. Here are some tips on how to organise yourself, and your workstation to help prevent pain:
Finally, try to take breaks every 15-30 minutes. Standing up every 15 minutes and stretching your body forwards, backwards and side to side is proven to help reduce back pain. Even if you just get up to make a drink, or visit the loo, your body will thank you for a break from maintaining a static position and giving you a chance to loosen your muscles.
If your back ever ‘goes’, you’d like to think that it was from doing something heroic, right? Something you can impress your mates with as you regale your story of courage and bravery.
Take it from someone who did their back in by picking up a piece of Lego, 9 times out of 10 people experience that terrifying locking-up from doing something slightly less bold. Think taking the washing out of the machine, closing the car door, or sneezing. Wave goodbye to your bragging rights.
The good news is that 90% of people who experience back pain will recover within 6 weeks. The aim of this stage is to stay comfortable, manage your pain and avoid making the problem worse as you recover.
If you are unlucky enough to seize up next time you pick up a pencil (really) then follow these tips for some self-care which you can do at home.
I get it, this is easier said than done but when your back seizes up, the muscles are in spasm. The more tense you are, the less likely this spasm is to ease. Be reassured by the fact that there’s a 90% chance you’ll recover in a few weeks and try to relax as much as you can.
Try and find a comfortable position when your back first locks up. To help the muscles ease, rest in this position for about an hour.
Movement is highly beneficial for back pain. When you move, your joints release a fluid which helps lubricate them. If your spine is locked up, the release of this fluid with help you move more freely and feel less stiff. In addition, your muscles will loosen off, and you’ll be helping your core muscles activate (more of that a bit later)
I get that in the initial stages, walking may be pretty uncomfortable so take it in baby steps, just walking around the house for 5-10 mins at a time at first.
Ibuprofen is both a pain-reliever and an anti-inflammatory so it can help with pain and reducing any inflammation caused by your injury. Short-term it may provide relief.
Heat therapy can work wonders on muscle spasms by increasing circulation, helping you to relax and by decreasing pain transmitters to your brain. Take a warm bath or shower or use a heat pack or hot water bottle on your low back.
You know how when you have a bad leg, you limp as your body tries to compensate and use the stronger muscles instead of the injured ones? The same can happen with back pain. Your body will try and protect your back by moving differently (which you probably won’t notice, it’s very sneaky) and not using the muscles which you need to keep your back strong.
The danger in the first 6 weeks is that your back and core muscles will weaken, which then leads to a longer-term problem and leaves to vulnerable to injury. Override this by consciously activating your core every time you move, lift and bend to maintain your strength and protect your back.
And avoid long periods of time sat down. As I mentioned before, your body needs to move to avoid seizing up so over the course of your episode, stay as mobile as you can. Take frequent breaks from your desk if you’re office-bound and try and fit in a daily walk, or some gentle exercise. Which leads nicely on to…
We have an easy 10-minute routine on our YouTube channel which is ideal for people with back pain, as is yoga or pilates. You can also try some of these simple stretches for back pain. Try and avoid sit-ups, as they won’t work your deep core muscles and may put extra strain on your back.
Your back is at it’s weakest when it’s bending and twisting at the same time. Often that’s the movement you were doing when it went in the first place. When putting washing in the machine, kneel down before you twist, and if you’re picking something up, position yourself so you don’t have to twist as you do so.
If you’ve ever had back pain, you may be familiar with that ‘rusty hinge’ feeling. You know when you feel as if your muscles are conspiring against you to stiffen you up and not let you bend Further than a few degrees? Or when the thought of being stretched on one of those medieval racks becomes ever more enticing.
Finding the right stretch to to ease this stiffness can be tricky, you end up contorting your body into all kinds of weird and wonderful positions just to find the sweet spot.
Here are a few of our favourites which we recommend to clients (and use ourselves) This combination of exercises will help stretch out your back, but also the muscles of your legs and hips which, if tight, can contribute to back pain.
Stretch to a point where you can feel it, but are not in pain. Hold for 30 seconds and then as you feel your muscles relax, increase the stretch a bit further for another 30 seconds or so.
Kneel on one leg, raise the opposite arm and rotate slightly towards the side of your supporting leg. For a greater stretch, bend to the side.
Sit tall with one leg outstretched. Bend the other and cross it over the other leg, keeping your foot on the floor. Use your arm to gently pull the bent keg into your body until you feel the stretch in your buttock.
Lie face up with one foot on the floor and use a band or towel around your other foot to gently pull your leg in towards your body, keeping your leg straight and hips on the floor.