The problem with lower back pain and sciatica is that the lower back and the surrounding area are very important to any movement or activity you engage in. It’s not like when you’ve injured your arm or leg, where you can rest your arm in a sling or use crutches for your leg to allow healing to take place, with low back pain you can’t afford that.
With regard to functional activities, the first thing that needs to be addressed is to divide them into two categories:
Yo) Those that cause or aggravate low back pain or sciatica.
ii) Those that don’t cause you pain or don’t increase your pain at all.
Most likely, there is a common factor linking the components of each of these two groups.
For example, let’s say sitting aggravates your lower back pain, but standing up and walking around relieves your pain. Let’s think along the lines that flexion activities are the aggravating factor of your low back pain and extension type activities are the relaxation factor.
With this example above, first and foremost, we need to modify or temporarily avoid the aggravating factor, i.e. sitting. Now, I’m not suggesting that you don’t sit at all during the day, but rather that you try sitting in a more upright chair, say with a rolled-up towel for lower back support. In addition to this, I would also recommend that you spend no more than a maximum of 15-20 minutes sitting without a break, i.e. getting up from the chair.
Moving on to encouraging the relaxation factors, and again using the example above, I suggest that you try taking a short walk several times throughout the day. This can be anywhere from a few minutes to 20 to 30 minutes, depending on the severity of your pain. The important thing is that your back likes this activity and that is why it is important to provide it, since you will be providing the optimal conditions for it to heal itself.
NB. You can get too much of a good thing, so don’t walk just for the sake of it. For example, if your lower back pain eases after 5 minutes of walking, but gets worse after 10 minutes, feel free to walk for 5 minutes, but not much longer (otherwise you’ll just be interfering with the healing process again). .
With respect to aggravating and mitigating factors, it is important to be as specific as possible. So, using the example I just gave, walking for 5 minutes is a relaxation factor, but walking for 10 minutes is an aggravating factor.
The main principle is little and often throughout the day. Linking the previous two, the logical thing to do with regard to sitting is every 15 minutes or so, stand up and walk from one side of the living room to the other. By taking the above principle into account, you will result in less stress on the structures responsible for your lower back pain and therefore give your body a chance to heal itself. As the healing takes place, the structures responsible for your pain will become stronger, and if they are stronger, you will find that you can start to do more and more.
A positive cycle will now result, whereby encouraging relaxation factors will promote further healing, which in turn will make your lower back stronger and therefore less easily aggravated. If you get less aggravated, it means more healing will occur and so you can become more active and your back will get stronger…and so on.
Sound too simple?
Well, no doubt I have simplified things a bit just to make a point. However, it’s also not too difficult as the underlying principle is the same. The most important aspect is to first analyze your daily activities and then divide them into aggravating and relaxing. When you have established this, start by temporarily avoiding/modifying aggravating activities and encouraging facilitating ones. By doing this, your lower back pain or sciatica will begin to ease and you will be able to become more active.
At this stage, it will be important to consider addressing any muscle imbalances that are present (as there almost certainly are). A simple but effective exercise program to strengthen weak muscles and stretch tight ones will soon allow you to perform those functional activities that are difficult for you right now without pain…