If you missed it, Adele has been battling with sciatica pain. She’s had on and off bouts of experiencing this condition since she was 15 years old (that is almost 20 years of pain!). She said that two big things were helpful for her which included getting her abdominals (she called it “tummy”) strong, and losing weight. The Good Morning America article also discusses a few strategies to improve Sciatica pain. This article had some really great nuggets, especially with the various different options available for sciatica pain.
Here’s how I would help Adele if she were a client of mine:
1) We look at her posture. The reality is that there truly is no agreed upon perfect posture. However, too much of anything can cause an issue. Meaning that if you are standing slouched all day that can lead to issues in the back, shoulders, hips and neck; But that also means if you are standing extremely arched for too long there will be problems as well. Adele is a concert performer and is often seen with heels. I wouldn’t be surprised that prolonged standing and heels can result in an increase in pain. This step provides us good information on where to go next.
2) What positions and stretches make her feel the best? This is paramount in dealing with any active state of pain. There are over 21 million articles out there on the internet right now helping you fix your pain, but they are often conflicting. The biggest difference between an effective program and non effective program is the consistent evaluation of effectiveness. Ask yourself “am I feeling better as a result?” This will actually improve movement, reduce pain, and also improve what is called the pain threshold. The pain threshold is the amount of stress we can handle before we experience pain.
3) Activity modification for activities and stretches that make the pain worse. The simple statement “if it hurts, don’t do it” has a ton of validity. Every time we do an activity that increases the pain (increases the intensity vs just an intense stretch), it causes more inflammation, sensitivity and it lowers our pain threshold. I would recommend that she completely remove said activity from her routine (for now); or if she really has to do these activities, we would come up with strategies on how to do these activities without the production of pain. We have to look at these activities so that we can problem solve together.
4) Strengthen the muscles. There is a lot of research saying that core strength is helpful in the management of sciatica pain, in both reduction of pain and prevention. Strength has three major functions: to initiate movement (force production), to prevent movement, and to coordinate movement. It is important to have all three components of strength to maximize its effects. Not only would I teach Adele how to brace, but also teach her how to squat (sit to stand) and how to deadlift (hinge) so that she can do her normal every day activities without fear of flaring it up.
5) Come up with a plan to be independent. The healthcare industry is incentivized to keep you in the system. If you are fixed, you no longer need care. (A lifetime of treatment is preferable to a cure, Dr. Emily Rosenthal, MD). It is technically bad for business for patients to be discharged for full independence. I truly believe that people can and should have the basic knowledge and tools to care for themselves; if they need a professional like myself at times when it requires more help, so be it; But even upon the first session working together, we are already thinking about exit plan for independence, in the absence of fear, and on her own terms.
If you have any questions about how to manage your sciatica pain, reply to this email. Let’s make it happen.
And if you want to really get started on your own sciatica pain relief journey, check out the Sciatica Protocol. It is designed for you to follow through on your own plan at your own time without having to wait for a clinician. You can take the free survey to get started here.