For those who have had sciatic pain, you well know the discomfort associated with the issue. Sciatica is caused by impingement of the sciatic nerve — a nerve that runs from the lower spine, across the buttocks, down the leg, and across the top of the foot.

The sciatic nerve supplies both feeling (sensation) and strength to the leg and foot muscles. The sciatic nerve can become irritated if it gets pinched from a tight muscle such as the piriformis muscle in the buttocks, or from a herniated or bulging disc in the back.

Other issues that can irritate the sciatic nerve are structural in nature, such as spinal stenosis (spinal stenosis is a condition, mostly in adults 50 and older, in which your spinal canal starts to narrow) or spondylolisthesis (spondylolisthesis is a condition in which one bone in your back slides forward over the bone below it).

Sciatica typically affects one leg, wherein people may feel sharp pain, numbness, tingling, and possibly weakness along one leg, the calf and the toes. Sometimes, bowel or bladder incontinence or a foot drop (inability to lift the foot on the affected side) can occur.

These serious symptoms need to be treated by a physician, and sometimes the answer requires surgical intervention. The good news is that in most cases when properly cared for, with conservative treatment, sciatic pain can resolve in a matter of weeks.

Sciatica often is a result of muscle imbalances — tight and shortened muscles in the front of the thigh (the psoas or the quadriceps themselves) can result in a tug of war between the muscles in the front of the leg and the muscles in the back of your hips.

The result is a lack of support for the spine and therefore, consequently the muscles surrounding the spine and the vertebral discs may place pressure on the sciatic nerve causing irritation. Driving is also a problem for those who can easily slip into a sciatic flare up. Sitting on tight muscles through which an irritated sciatic nerve flows, can send those painful impulses across your butt, down the leg and across the top of your foot. Backs like to move!

In most cases, a specific, controlled progressive exercise program that is tailored around the underlying cause of the sciatic pain is part of the treatment. This approach reduces the sciatic pain, and also provides the conditioning to help prevent future flare-ups.

You should work with a physical therapist, a chiropractor, a physiatrist, or a certified athletic trainer or other spine specialist who treats back and leg pain in order to ensure that the exercises that you do are specific for the cause of the sciatica and also properly executed.

While it may seem that taking it easy and resting is a good solution for easing the pain, inactivity will usually make the pain worse. Without movement and the proper exercises, the back muscles and spinal structure, become de-conditioned and less able to support the back. This can lead to further back injury and strain. Movement and exercise also is important for the health of the spinal discs, because it helps exchange nutrients and fluids within the discs.

Many sciatica exercises serve to strengthen the abdominal muscles as well as the back muscles. Stretching exercises for tight muscles is also usually part of the recovery program. Doing the wrong type of exercise without regard for the origin of the sciatic pain can worsen the pain, therefore it is imperative to get an accurate diagnosis prior to starting any exercise program.

Regardless of the diagnosis, most types of sciatica will respond to a regular routine of hamstring stretching. Because overly tight hamstrings increase the stress on the low back and often aggravate or cause sciatica. However, these stretches should be supervised by a therapist or other trained health care providers so that they improve the condition rather than irritate it. Walking is generally a good form of exercise for the low back, because it is low impact and gets the back up and moving.

Caring for sciatica should be part of your everyday living. In addition to a sound and strategic exercise program, you should take care to minimize the stress placed on the back by using appropriate ergonomics while lifting items, maintaining good posture, and ensuring that the low back is supported while sitting, as well as avoid sitting or standing in one spot for lengthy periods of time.

Alleviating sciatic pain caused by degenerative disc disease includes finding the most comfortable position for the lumbar spine and training your body to maintain this position during activities. By doing this, you can improve your own sense of movement and reduce excess movement at the spinal segments, thus reducing pain. Wishing you the very fondest Aloha!

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Dr. Jane Riley, EdD., is a certified personal fitness trainer, nutritional adviser and behavior change specialist. She can be reached at janerileyfitness@gmail.com, 212-8119 cell/text and www.janerileyfitness.com