What Sciatica Is

spinal stenosis

Many people often misunderstood sciatica. Sciatica is the pain in your lower back that travels down your leg. It is a set of symptoms that occur somewhere along the path of the sciatic nerve. It describes the type of pain you might be having, but it doesn't explain why you have it.

Dancers are vulnerable to sciatica because of the amount of focus on turning out their legs. This often leads to piriformis syndrome. Dancers also move in a large range of motion at the spine, which result in undue pressure on the spinal discs when alignment or body mechanics is poor. This can lead to herniated discs. Poor body mechanics, arthritis, and scoliosis can be factors in spinal stenosis which leads to sciatic pain.

Common causes of sciatica

1) Piriformis syndrome
2) Herniated disc
3) Spinal stenosis

Piriformis syndrome

Piriformis syndrome is a condition where the piriformis muscle, the largest of the 6 deep lateral rotators, irritates the sciatic nerve. The sciatic nerve typically passes underneath the piriformis muscle, but in about 15% of the population the nerve goes through the piriformis muscle increasing it's potential for compression. When dancers overwork their turnout, their piriformis muscles may be excessively contracted and can press on the sciatic nerve. This is a functional syndrome.It isn't easy to diagnosis through a MRI or CT scan.

Symptoms include pain in the low back and buttocks, pain that can radiate down the back of the leg and difficult and uncomfortable sitting.

Treatments include physical therapy which focuses on stretching and strengthening the rotator muscles at the hip, and ultrasound to the inflamed side to release and soften the piriformis muscle. Anti-Inflammatory medication, (such as ibuprofen), is also administered to decrease inflammation of the nerve. For more acute cases, a cortisone injection may be suggested. Deep massage can also help to release the tension in the turnout muscles as well as surrounding pelvis and hip muscles. After a lengthy period of unsuccessful conservative treatment, surgical release is the last resort.

Herniated disc

Spinal discs are soft cushions of cartilage with a gel-like center between the boney vertebrae of the spine. It's where the movement and flexibility of the spine is created. Discs often lose elasticity with age and become more vulnerable to injury. A herniated disc bulges out between the vertebrae where it compresses the spinal nerves. This causes pain in the lower back, often traveling down the leg. A herniated disc is confirmed through a CT imaging scan or a MRI. It is also commonly called a slipped disc, or bulging disc.

You are suffering from herniated disc if you have leg pains usually over the outside of the thigh and lower leg and foot. Sometimes shooting down the leg, felt like an electric shock. Other symptoms include persistent pain no matter whether you are standing or sitting, tingling or numbness down the leg and muscle weakness. The worst is if bowel or bladder problems occur. This time see physician as soon as possible with these symptoms.

Anti-Inflammatory medication (such as ibuprofen) is given to decrease inflammation. Physician may choose to do a steroid injection. Physical therapy is also used to redevelop muscle balance and proper spinal alignment. If less invasive measures do not help, surgery is a last resort.

Spinal stenosis

Stenosis means a narrowing of an opening. Sciatic pain can occur from lumbar (lower back) spinal stenosis, while numbness and problems in the arms can occur from cervical (neck) spinal stenosis. The area where the nerves come out from the spinal column can inflame and narrow. This creates pressure and pain on the nerve. Older ones are most commonly affected on this type of nerve due to chronic poor body mechanics such as a swayback or tucking under, being overweight, having arthritis and/or scoliosis.

Symptoms include pain in the buttocks, thigh, and calf, weakness of one leg and pain that often increases with movement and walking, and decreases when sitting or lying down.

Diagnostic tests such as x-rays and CT scans or MRI will be used to confirm the diagnosis. Anti-inflammatory medication along with physical therapy is prescribed for mild cases.Surgery may be necessary to remove the pressure from the nerve, if less invasive measures are unsuccessful.

Tips for Prevention

If you have sciatic symptoms and a dance teacher, don't be so depressed. It is a curable disorder. However, you have to adapt your teaching style temporarily. Since teachers have bad habits of showing a movement without being fully warmed up, it is necessary to pull back on demonstrating.

Below are some steps that can help:

• Stand easily in a turned out first position, Are your gluteal muscles rock hard? It may be a sign of overworking the turnout and hip joint muscles. Periodically, sit on a chair with one leg crossed over the opposite thigh in an open position and lean forward. You'll feel the stretch deep in the gluteals of the bent leg.
• Are you standing in a swayback? Then stretch out the hip flexors in the runners lunge. Often the hamstrings, gluteals and turnout muscles become overly contracted as they counter the pull of the hip flexors.
• Notice what's happening on your feet. Pronation means your weight is not centered and your feet are rolling in - which then creates more muscular tension in the turnout muscles.
• Give your turnout muscles a break! Stand with your feet turned in towards each other. Bend your knees then lean into one hip before switching to the other hip. It may look strange, but is a quick reminder that the turnout muscles need to be both strong and flexible.
• Make sure your weight is appropriate for your height and activity level. Extra weight can put strain on the lower back and discs.
• Are your hamstrings weak or tight? Pay attention to the muscle balance around the hip joint and address any obvious weakness and/or tightness.
• Rest for a few minutes on your back over a large physioball. This helps to decompress the spine.
• Stand up straight without tension. When sitting and standing, do not slump as it keeps the spine aligned and the discs and spinal cord happy!

How to release Tension

To release stubborn muscular tension, you can work with a pinkie ball. Begin by placing a small 2-2/15 inch rubber ball between the back of your pelvis and the wall. The farther your feet are from the wall the more weight you place on the ball and the deeper the pressure. To start, roll on the ball from sacrum (base of the spine). Then roll around the sides of the pelvis and down to the sits bone. The piriformis and other turnout muscles are in the middle of the buttocks and that area may be tender. Work slowly and easily and comfortably to loosen the muscles. If you notice any nerve signs, such as pain radiating down the leg, move away from that spot, or stop all together. Five minutes before or after class can make a big difference in decreasing excess muscular tension!