Intelligence in Action
The Cause & Cure of Sciatica
by Graeme Lynn, CFP, CSTAT, AHSE
If you have ever had - or if you have - sciatica, you would want to know the cure. To understand the cure of sciatica, first consider its cause, which is twofold: chronic hyper-lordosis of and chronic scoliosis of the lumbar spine or lower back.
Almost everyone has a natural lordotic or forward curve of the spinal column between the ribcage and the sacrum - the wedge-shaped bone at the base of the spine. When, because of chronic muscle contraction of the paraspinal musculature, this lordotic curve is exaggerated, there is compression of the intervertebral disc space. The vertebral discs provide spring and cushioning of the spinal vertebrae in movement and provide space through which the spinal nerves enter and exit from and to the respective tissue they innervate.
(Very often there is a further complication in those of us who chronically over-contract the back musculature, that is, more than is minimally necessary to rightly respond to gravity. In this event, a compensating habitual pattern of contraction of the frontal musculature may occur in order to prevent the body from being pulled over backward in upright movements. Thus, there is often a co-contraction of the anterior and posterior musculature, which co-contraction further compresses the body as a whole, further compresses the spine in particular, and therefore further compresses the intervertebral disc space.)
When, in addition to over-action of the back musculature bilaterally, there is extra unilateral or one-sided muscle contraction of the spinal (and deep lateral) musculature, a sideways bending is added to the excessive backward bending of the spine in the lumbar area - a scoliosis. This scoliosis does not have to be much or even visible to the uneducated eye. But, combined with the hyper-lordosis, this scoliosis further compresses the disc space and squeezes the disc sideways and outwards. The disc then impinges upon the nerve roots near their joining to the spinal chord that runs through the spinal column.
The sciatic nerve splits near the spine and enters the spinal column between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebra and the sacrum. Here, at the base of the spine, is added the weight of the entire trunk, head, and arms. The sciatic nerve root is approximately an inch in diameter and, given conditions of chronic bilateral and unilateral muscle contraction of the back musculature and of the weight-bearing of this large body mass, the sciatic nerve is positioned for trouble - namely, sciatic pain.
These chronic bilateral and unilateral patterns of muscle contraction can have myriad causes in the past, but typically the causes are the habituation of reflex responses to stress or poor body use developed over many years (for the bilateral pattern), and injury, trauma, or surgery on one side (for the unilateral pattern).
The cure, in theory, is simple: to release the patterns of muscular contracting!
This can be achieved by addressing, not the past causes, but the present causes. The present cause of undue muscle contraction anywhere in the body is the person not knowing or, rather, not feeling or sensing that he or she is doing it. That is to say, the muscles are contracting unconsciously; their direction has been taken over by subcortical neural mechanisms.
Now ideally, muscles are subject to voluntary, that is, conscious, cortical control. And most of us most of the time and in most of our selves possess this control. But not where we are in pain or where we are not flexible and integrated. When a person has lost such conscious control of the musculature for whatever past reasons, he or she must learn to feel or sense again these muscles of which he or she is no longer aware and no longer in control. This learning is an event in our nervous system or intelligence and cannot be addressed by adjusting the skeleton as in chiropractic or softening tissue as in massage, because no learning takes place in these practices.
The Feldenkrais Method, the Alexander Technique, and Hanna Somatics are methods of sensory-motor learning that renew this awareness and control and they accomplish this through uniquely different handling strategies.
As a Feldenkrais practitioner, I use primarily gentle passive movements and mirror, 'go with', or support the client's habitual pattern of coordination (a strategy Feldenkrais drew from Judo of which he was a black belt master). By thus sensitively reflecting to the client his or her own characteristic patterning, I enable the person to become aware of, and thereby think and feel through, and so release, those very motor patterns that limit the quality of muscular control and movement. This growing awareness and this release are the foundation of coming to sense yourself better, and thus to move better, and thus to free yourself from undue muscle contractions, and thereby obviate the creation of compression, inflammation and pain.
As an Alexander teacher, I guide the client through primarily gentle active movements while always finding the easier way, by skillfully and sensitively working to rightly coordinate the person's core dynamic around which all movement is organized. At the same time, I enlist the person's innate capacity to attend to him- or herself and become aware of habitual patterning. And, through gentle manipulation and instruction, I stimulate the person's sensory-motor self-exploration and growing capacity for freedom and control of the physical mechanism. Such freedom and control are the essence of ease, movement health, and freedom from functionally based pain problems.
In Hanna Somatics, I use primarily vigorous active movements, sensitively directed, to re-awaken held areas deadened to sensing, feeling and movement, thereby re-awakening there the capacity for conscious sensation and voluntary control.
Each of these methods has its appropriate application depending on the presenting limitations and their nature and severity. A practitioner of any of these methods is uniquely trained to sense subtleties of movement and tension through respectful and gentle exploratory handling. In so coming to a clear sense of the person's limiting patterns, an address can then be made to resolve the chronic nature of these patterns, in the case of sciatica, the undue and unbalanced contraction of the musculature of the back (and often the front). The problem of sciatic pain can be thereby disappeared at source and the new manner of coordinating the back in movement, and the body in general, can then become an option available for any future action, thereby obviating the causes of any future pain.
Of course, theoretical considerations are always easier to follow through to a resolution than real applications. Each of us organizes our patterns of contraction in unique ways depending on our unique histories and ways of responding. And some patterns are more tenacious than others. The intervertebral discs are resilient to some six hundred pounds of pressure. So, sciatica and, in fact, bodily pain in general that is functionally based, are only the tip of the iceberg in terms of chronic coordination limitations. In order to resolve such inveterate patterns, generally much work must be done beyond just eliminating the symptoms of pain if further problems are to be prevented in the future. It is the sensitivity and skill of the practitioner in any of these disciplines combined with the understanding of the general nature of the presenting problems that will facilitate the individual successfully growing through and beyond any such limitations permanently.
To schedule lessons, please contact Graeme in Toronto, Ontario, at 416-964-7026, or click to email.