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March 29, 2007

Sciatica Be Gone

Michael Blowhard writes:

Dear Blowhards --

One of the most tangible benefits I've gotten from yoga has been relief from piriformis pain. Piriformis syndrome is a variety of sciatica, caused by spasming muscles pinching the sciatic nerve. The pain tends to start in the hip -- OK, in the very undignified butt-muscle area -- and then shoot down your leg.

I'd been bugged by piriformis pain for years and years. No idea how I develped it initially, and in my case it never became anything debilitating. But it was enough: a constant ache in my hip that was occasionally amplified by electric-bolt-like zingers. Like many with sciatica, I found it annoying not just for the pain itself but also for how the pain affected me and my habits. Sciatica typically disrupts how you're comfortable, as well as how you find comfort. Your favorite sleeping and sitting positions might well become unavailable to you; your nightly sleep might be interrupted, over and over, because the pain wakens you and obliges you to find some new position to settle into.

Over the years I'd tried a variety of treatments for my piriformis syndrome, but I obtained a little relief from only two sources: ceasing carrying my wallet in my back pocket (wallets can throw your back and hip alignment off), and acupuncture. Conventional exercise and stretching didn't help much, nor did a number of visits to health-insurance-style physical-therapy outfits. Acupuncture sometimes took the edge off the pain, except when it didn't.

My very first Bikram yoga class was a head-turner in many ways. After it, I felt weird but wonderful: wrung-out and emptied, yet freed-up inside too. It was such an overwhelming experience both physically and mentally that it took me a few hours to notice what was missing from my normal state of being: my chronic sciatic pain. It was gone, poof, like that. That night, for the first time in years, I slept in whatever position I felt like and I slept the whole night through.

I've been going to yoga three times a week ever since. Yoga hasn't been a complete cure for my sciatica. If I let four or five days go by without a yoga class, the pain starts to knock on my consciousness again. But so long as I do yoga regularly, I experience no piriformis pain. It ain't a part of my life any longer.

Actually, doing yoga regularly means considerably fewer aches and pains generally for me. (Over the decades those little aches and pains that won't go away build up in vast, vast numbers ...) I feel more fluid and happy in my body -- ten years younger than I otherwise do in terms of flexibility, ease, and cheeriness. Aches and pains still show up, but then they go away. I'm as creaky as ever when I roll out of bed, but yoga works out that rust too. That tweak in my left knee that I picked up trying to learn how to swim the butterfly still lets its presence be known. And my tennis-battered rotator cuffs are as tender as ever. But life isn't perfect and yoga isn't a cure-all, and both of those facts are OK with me.

Since I've been a yoga regular for three years now, I feel I can offer one tip beyond just "try yoga, you may like it." So here it is: It doesn't matter if you ever get better at yoga. It doesn't matter if you ever progress; there's absolutely no need to advance to higher and higher degrees of it. It isn't a competition or a contest. In my own case, despite the three faithful years I've logged in, I still can't touch my toes without bending my knees, and sitting crosslegged on the floor is something I still can't manage unless I've just put in 90 minutes of yoga. I've only recently begun to experiment with headstands. But none of that matters. My body is toned and calm. It's happier than it otherwise would be, and so am I.

Though on a fizzy day I'll let myself join a Basics-Intermediate class, Intermediate classes themselves are 'way beyond my reach and probably always will be. (I'm in my early 50s. It isn't as though my physical abilities are going to be growing any more robust than they currently are.) This also doesn't matter. Basics classes suit me fine. I get a workout, I enjoy the calming and the breathing, and I don't hurt myself. While I leave a conventional gym workout these days feeling bruised and resentful, I leave my Basics yoga class feeling refreshed and cheered-up. While I moan and groan about getting myself to the gym these days, I have no problem at all finding my way to the yoga studio. Yoga classes are some of my favorite parts of the week. I'd go every day if my schedule allowed it.

Yoga Journal reports that a lot of people with sciatica find yoga helpful. I raved a bit about yoga back here and supplied a lot of links. I wrote about my first Bikram yoga class here. (It's a pretty lively piece of writing, if I do say so m'self.) I interviewed the very gifted yoga teacher Margi Young: Part One, Part Two, Part Three, Part Four.



posted by Michael at March 29, 2007


"Health-insurance-style physical-therapy outfits" -- you should trademark this phrase. I've visited such places, usually on a physician's recommendation when I was suffering some vague, soft-tissue exercise injury or other. Always a waste of time and money because the treatments never addressed the causes of the problems (typically something structural like leg-length discrepancy or weak abs). I'm sure conventional physical therapy works well for some kinds of problems, but for others one is on one's own. In such situations, unfortunately, as you seem to have discovered for yourself, there is no substitute for experience and self-knowledge.

Posted by: Jonathan on March 29, 2007 2:16 PM

Yoga, when I do it regularly, absolutely changes my physical awareness. I sit up straighter, I don't bob up and down when I walk, I fell like I move more gracefully and efficiently. And best of all, my back and neck, which hurt constantly, feel great. My only gripe is that I'm almost always the only guy in the class.

Ideally I'd mix in some strength and cardio training with the yoga, but I just don't have the time or money to do that, so if I have to pick one (and I do), it's yoga.

What Michael says about going at your own pace is absolutely true. I'm not in it to wrap my leg around my head, I just want my back and neck not to hurt and to remain flexible. Yoga does the trick. It's interesting how differently yoga is approached depending on geography. I live in a fairly small town that is very conservative and Christian. The instructors treat yoga as a purely physical workout. The few classes I took in the Bay Area were more of the stereotypical holistic method. I personally don't care either way, I get benefit out of both approaches. I just found it interesting and I guess not all that surprising.

Posted by: the patriarch on March 29, 2007 2:21 PM

Bicycling has provided a huge improvement in my life over the last two years. Weight reduction, stress control, sciatica relief, improved energy - and neat looking socks!

Posted by: Don McArthur on March 29, 2007 3:20 PM

I've found physical therapy exceptional for acute injuries and worthless for chronic ones.

Posted by: JewishAtheist on March 29, 2007 4:52 PM

Don, but in the Wiki article MB linked to they say specifically the activities like running and bycicling are triggering sciatica pain and therefore are not recommended.

Posted by: Tatyana on March 29, 2007 4:56 PM

Bikram yoga is the best physical exercise I've discovered since college. That said, I'm not good at it and I treat it like an oil change, only going in every two months or so. But, you know what? Bikram yoga doesn't care that I'm a deadbeat yoga person, it still takes care of me when I go.

What I haven't heard discussed though is the personal qualities of the instructors. My experience is limited but I do find these people unique. They're not yoga-y. They may not even like herbal tea. But, they combine the positive energy of you-go-get-em-boy! traditional "Rocky" style coach without all of the Alpha Male competitive posturing.

Oh how I've come to loathe Alpha Males.

Bikram is just no nonsense fun that sustains your heart beat for 90 minutes high enough to do real good, but not so high that it takes effort that makes you tempted to skip the next one. Effortless effort?

The Holzbachian

Posted by: The Holzbachian on March 29, 2007 6:12 PM


Agreed on the running, I had to give it up after back surgery in 1992. Disagree regarding the bicycling. Personal experience should always trump wiki, especially for the person. ;^)

Posted by: Don McArthur on March 29, 2007 6:21 PM

Oh how I've come to loathe Alpha Males.

Hmm. Have I heard that before ... no, guess not.

Posted by: Peter on March 29, 2007 10:20 PM

Pain in general but especially back pain read:

Pain Free: A Revolutionary Method for Stopping Chronic Pain (Paperback) by Pete Egoscue (Author), Roger Gittines (Author)
(107 customer reviews) List Price: $16.00 Price: $10.

It worked for me and I avoided back surgery during the summer of 2001 when my Neurosurgeon suggested I try the exercises given in the book. My disk was at L5-S1 and two things made the difference 1) Celebrex and 2) The Book Pain Free.

Good luck.


Posted by: Dan Kurt on March 29, 2007 10:41 PM

Thank you very much for this post. Not sure if I ha ve exactly what you had, Piriformis Syndrome, but the dull. then quite acute jolt I feel dancing down my leg and up again sounds awfully familiar. I'll have to see if there are similar yoga clases like the Bikram yoga that you mentioned.

Anything to cut out the constant presence of the sicatic pain.


Posted by: DarkoV on March 30, 2007 7:00 PM

BTW, I tried yoga. not sure what kind it was. But I do remember that I was in uncomfortable positions for longer than I could bear and spent the whole session looking at my watch waiting for it to end. Am I just a wimp, or am I missing something here? A lot of people get something out of yoga, so maybe I was just in the worng place...

Posted by: SFG on March 31, 2007 8:01 PM

Ah, yes, The Piriformis. Man, what a nagging lil' nuisance it can be if it's not happy!

Well, will try yoga some more, and meanwhile off to do some more stretches.

(Found you via Gawain, BTW.)

Posted by: Lori Witzel on April 1, 2007 7:41 PM

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