Tuesday, July 23, 2013

Butt out, you buttinsky! My accidental remedies for sciatica

    (July 2013) Does anyone else find the thought of sciatica kind of embarrassing? Do you think of funny old folks in the 1950s, griping about their rheumatism, their bunions, their corns and carbuncles, warts and bursitis, their impacted bowels and ill-fitting dentures?
    I got hit with sciatica on my left side when I was in my thirties. I was a weight-lifter, and a jogger, who was outside before dawn, stomping along to "Pretty Fly for a White Guy." I was very fly for a white girl! Way too fly for sciatica! I was pissed off, and determined to rid myself of this stupid, unfair affliction. 
    Thirty years later, after having tried every remedy I could find, I still had it, only now it was on both sides.
    About six months ago, I stumbled upon a remedy that has worked magic for me -- and it's free. I have devised other complementary strategies since that have almost put me in remission. It feels like a miracle.

I was in the searing grip of this big, bad, sadistic nerve.
     I waited as long as I did to write about this to see if my "remission" continued. It has. I didn't want to mislead anyone, or raise false hopes. Indeed, the method that worked for me may only help some people, and it's possible that no one else will experience the relief that I have.
    The most reputable web sites inform us that an estimated 20 percent of the nation's millions of back patients suffer from sciatica, a debilitating condition that causes sharp pain, tingling, weakness and numbness, originating in the lumbar and sacral spine, moving through the buttock and groin, extending down the back of the leg and often into the foot. 
    The sciatic nerve is the longest and largest of all the body’s nerves (it can be as wide as your thumb). Each sciatic nerve is made up of five smaller nerves that branch into the thigh, knee, calf, ankle, and foot. Sciatica occurs when this nerve is compressed, irritated, or inflamed. 
    Sciatica, the experts say, usually resolves on its own within a few weeks.
When you sit down, your butt screams bloody murder.
     But you'd never know that based upon the online message boards, which are filled with tales of unabated misery and pleas for advice from people who have been in chronic pain for years.
    And a multimillion-dollar industry has burst forth to address the persistent debility caused by sciatica. Hordes of desperate people have tried one doctor-recommended remedy after another -- many of them very expensive and time-consuming -- and have gotten no relief. Quack cures, that are advertised on TV and the Internet -- including pills, salves and newly invented devices -- become irresistible to those whose lives are so limited by sciatic pain. 
    Physical therapists, hypnotherapists, yoga instructors, chiropractors, acupuncturists, massage therapists, and "pain specialists" aggressively advertise remedies that often involve repeated visits over weeks or months, and frequently fail. Gurus who preach about the mind-body connection offer sessions in meditation, stress reduction, "spiritual realignment," and overall mindful living. New clinics are popping up that offer laser, ultrasound, trigger-point treatments and various magical "wraps" that infuse your back with healing herbs or vapors. 
Don't let the fanciful design fool you. It's a bitch!
     I'm sure that some of these approaches help some people. Many of those who provide the treatments are well-meaning and well-trained. But in my experience, a lot of them view their practices as highly efficient money machines, and they know damn well that their patients often -- if not usually -- are not going to achieve any benefit. A number of these treatments are not covered by insurance, and some aren't recognized as "safe and effective" by the FDA.
    As soon as I realized I had developed sciatica, I conscientiously researched it, and began doing everything the experts advised. I was determined to rid myself of this condition, which I thought the good lord (or whomever) had dumped on me by mistake. 
"What have I done to deserve this?" (The Pet Shop Boys, 1987)
    It didn't make sense that someone with my youth and lifestyle should be dealing with this stupid handicap, but nothing I did gave me any relief. 
     I spent hours on heating pads and ice packs. Every morning and evening, I did the recommended "poses" and stretches, some of which did momentarily ease the pain of my two herniated discs, but had no effect on the sciatica (actually, they seemed to inflame it). I developed a profound relationship with a deeply tortured chiropractor, but even he acknowledged that we weren't making any progress. 
Cauda equina, named for a horse, takes you out of the saddle.
    I was referred to a neurosurgeon after I developed numbness in my groin, which an orthopedist feared might be cauda aquina, a nerve-impingement condition that can lead to a permanent loss of bowel and bladder control. In men, it can cause impotence. She readily determined that I did not have this condition and dismissed me without any advice on how to cope with the numbness. A $3,000 injection of cortisone into my spine -- which was a last resort for me -- had no effect whatsoever on the misery that affected the entire bottom half of my body. 
    Those with sciatica are encouraged by web sites such as the Mayo Clinic to exercise -- particularly walking and stationary biking -- and it never occurred to me to decrease my activity level, but exercise did not alleviate my pain. The worst part for me was that I could not sit comfortably, since the inflamed nerves extend through the buttocks. It was excruciating just to have dinner and watch the news. My feet were so numb much of the time that standing (or running) were pure misery. I felt as if I were on stumps. Obviously, this can wreak havoc on your quality of life.

Numb feet make you feel stomping mad.
    I was also extremely upset that the sciatica, which for years now has extended down both legs, pretty much ended a stretching regimen that I had enjoyed for 40 years. I was told that I should never again bend forward from the waist. ("If you need to pick something up off the floor, squat.")
    The centerpiece of my stretching involved bending forward and down, touching the floor with the palms of my hands, and pressing my head against my knees.
When you're doubled over, you feel twice as good.
    I also clasped my hands behind my back and bent over, bringing my arms all the way over my head. I sat on the floor, with my legs extended, grasped my feet with both hands, and brought my head down to my knees. I did a number of yoga poses that involved bending and twisting.
I loved this. It freaked people out.
     I was proud of my flexibility. I believed I had established and persevered with a regimen that would help me maintain strength and functionality as I aged. I also loved the sensation of these stretches, which had always felt to me like something my body was supposed to do. I achieved a sense of euphoria as my muscles lengthened and loosened. My endorphins were released even more by stretching than they were by jogging.
Every part of you is on fire, in a good way, when you stretch like this.
    I felt quite devastated when I had to give this up after four decades. I devised some alternative stretches that didn't violate the doctors' advice, but they were never remotely as rewarding or useful as my former routine.
    So when I found a way -- totally by serendipity -- to relieve my sciatica, I was ecstatic.
     Briefly, here's how it unfolded: I tore the cartilage in my knee a year ago, and was unable to jog for some time. In order to maintain my cardiovascular fitness, and my leg strength, I began walking on a treadmill, with the incline turned all the way up.
    Before this, I had never used my treadmill except when air quality was too poor to jog outside, and I had never gotten the incline over 6.5. Most of the time I had it at 3.5 to 5. I had no desire to mess around with the incline.
It was an uphill battle, but I reached the mountaintop!
    But in this situation, I cranked it up to 10 -- the highest incline available on my machine, so that I could get a good, challenging workout for my heart and lungs, even though I was walking rather than running. I swung my arms, bent at the elbow, to increase my exertion and also to help me maintain my straight-ahead trajectory.
    Striding briskly "uphill" certainly does the trick. I was red-faced, breathless and sweaty -- my favorite condition.
    At first, walking at such an extreme incline really hurt my back -- not the lumbar area, where I usually ache, but rather in the thoracic area, above my waist. I was very dismayed that I might not be able to continue.
    I found that if I stood up very (very) straight, tightened my abdominal muscles, tucked in my butt, lifted my chest (way up) and held my shoulders back (way back), the sharp pain in my mid-back  resolved quickly. The posture I adopted to accomplish this reminded me of the extreme bearing you see in beauty pageants, or on "Dancing with the Stars."
Suck it in and stick 'em out. That's what it's all about!
    I really proffered my boobs, as if they were broiled game hens on a serving platter, and pulled my deltoids way back and down. My head was held high. There is no way I would do this in public, so it's a good thing I've got a treadmill in the basement.
    Before long The Great Thing happened. I think I had been doing the treadmill workout for about two weeks when I realized that my sciatica was essentially gone. 
    There was no shooting pain down my legs. My feet were no longer numb. Quite joyfully, I plunged back into my former stretching regimen. I could tell immediately that the treadmill workouts had not just resolved the sciatica -- they had also strengthened my hamstrings, glutes, quadriceps and abdominals. The stretching felt so beautiful! The dog known as "moi" could downward-face once more!
At last, my butt was back up in the air, where it belongs.
    I assume that the treadmill work provided me with something akin to traction, as well as stimulating the fascia in the lumbar area and perhaps providing some lubrication. But I had tried conventional traction before, and while it felt great, it had no effect on the sciatic inflammation. I think there is something about the combination of the treadmill incline, the controlled posture and the exertion of walking (firm, defiant, determined) that enabled things, at long last, to click.
    I would be so happy if this experience proved helpful to others who are at their wits' end from the scourge of sciatica. Please let me know if you have a helpful outcome.
    (UPDATE: This remedy worked beautifully for me for about six months. Then the awesomeness of its impact began to fade a bit, although I was able to keep the flexibility that had meant so much to me. I began having numb feet intermittently, and some sciatic pain flared back in my piriformis area, but it never became a chronic issue, the way it was before.)
   Even so, I find that if I do the inclined treadmill workout (I carry hand weights to work my upper body) at least 30 minutes several times a week, it still prevents about 90 percent of the numbness and pain. It has also increased my quad and hamstring strength, flattened my abs, and improved my posture.
    On days when I  have some pain or numbness, I use a TENS unit, which uses mild electrical impulses to target nerve fibers. It cost me $50 ($35 on Amazon), and I have had amazing results with it, on my herniated disc pain as well as the sciatica. The clinical literature on TENS says it provides temporary relief at best, but that hasn't been true for me. The benefits endure for at least a couple of days, and then I just put the electrodes back on, turn the device up all the way, and enjoy the tingle. I rarely have disc pain any more, even though I have annular tears, which chronically leak inflammatory fluid. )
    I guess I'd be derelict if I didn't remind you to consult your doctor first. He'll probably tell you it's a waste of money, though. Mine did. So does Consumer Reports. But a lot of people are getting relief from all sorts of pain via a TENS unit. They are especially popular in helping to strengthen quad muscles, although I prefer to do a quad lift of 80 pounds. Screaming pain. It makes the TENs approach seem kind of girly.
    Sitting on a heating pad helps, too.

UPDATE DECEMBER 2014: I only have occasional twinges of sciatic pain now. I have developed a stretch that really helps me. Actually, it is inspired by a yoga pose that I have nowhere near the balance to perform:
This is what I do, but I have to hold onto a counter. I lift my leg higher.
 Stand arm's length from a kitchen counter. Lean forward and grasp the counter with your arms straight. Raise your leg as high behind  you as you can, feeling the stretch in your glutes, hamstrings and deltoids. Put your head down against your chest to stretch and relax your neck. Do the other side, and repeat. I believe this stretch relieves pressure in my spine and piriformis areas, doing wonders at keeping the sciatic pain at bay. I do this several times throughout the day. You will get a great stretch of your hamstrings, back and glutes even if you don't have sciatica. 

The child's pose also helps me:
Keeping everything flexible and lubricated.
 Overall, my back and my sciatica cause me less pain and discomfort than they have in 20 years. 

    (UPDATE March 2015: I got one of the much ballyhooed NordicTrack X7I treadmills that provides up to a 40 percent incline. I rapidly went up to 32 percent, at which my head began banging into the basement ceiling. Either the incline or my extreme stretching has reignited my sciatica somewhat. I intend to keep going nevertheless, and see if the pain subsides. The new model has several design flaws, in my opinion, but I am excited by the challenge of the steep "terrain." 
    (UPDATE MID-APRIL) My persistence with the steep incline has paid off. The sciatic pain that began to resurface when I first began my high-level trudges has gone away. 


    I am also getting great enjoyment and spine health from using the rollers that are so popular now for massaging the back. I have had a foam one for 25 years and recently bought the magnificently medieval Rumble Roller. Both are excellent for a variety of uses, but regarding sciatica specifically, I find that if I sit on the roller and roll over my hips, glutes, sacral area, the side muscles adjacent to the lower spine and my hamstrings, it beautifully complements everything else I'm doing. Don't massage the piriformis spot, if that area is inflamed. I believe that the maneuver which benefits my sciatica the most is to roll over the area surrounding my two herniated discs (L4 & L5), but especially to deeply and slowly massage the upper part (the top and sides) of the ilium as well as the sacrum, where I also have nerve impingement. The Beastie Balls are good for this as well. This routine has really had miraculous results for me. It also leaves you with a tingly feeling of well-being.

    I am so in love with the Rumble Roller, I do my whole back, from neck to calves, several times a day. 
The Rumble Roller is a "meat grinder." It's brilliant!
     Rogue Fitness, the manufacturer, calls it a "meat grinder." I love being ground! I roll back and forth over and over again, shifting to emphasize each rotator cuff area, and to get my whole back engulfed with this painful fabulosity. When I finish, and it's actually kind of hard to stop, I feel different all over. I believe endorphins are released, but I also believe this provides a deep tissue massage that realigns my whole body, relaxes my muscles, and kicks the sciatica right in the ass.
    I suggest you begin with a cheap foam roller. They are quite miraculous, in my experience. The one I've had since the 1980s has given me great relief from chronic back pain.
    But recently, I decided I was "ready to rumble."
    Lots of people can't initially tolerate the pain of the "Rumble Roller," but I quickly got used to it.  I love both. I originally bought the black Rumble, which made me scream so loud, the neighbors called Homeland Security. The blue model is something I was able to tolerate right away, although it hurt enough to be exciting and stimulating. Within a few weeks, I got the black one again. I am in love with these rollers. They do things for your body that you would never have imagined. 

Massaging areas adjacent to the sciatic nerve has helped me.
I think everyone would benefit from this exercise. It relaxes spinal muscles beautifully.
   Or massage your sacral and glute area animalistically, using a kitchen or bathroom counter. When no one's around, give your butt and hips a good rubdown. It is amazing how deeply you can massage. The videos on these are hilarious, and they seem to know what they're doing. Our buttocks and lower backs are crying out for attention. When we provide it, they calm down:

     Consider becoming the boss of your own body and giving it a try. Good luck: