If you’ve had a case of sciatica you know it.  It’s an ice pick in your glute that can extend down to your foot depending on its severity.    I’m going to explain to you what it is, what causes it, and what to do about it.

What Sciatica Is

It all comes from the tenuous construction of the human pelvis, specifically, the sacrum bone at the base of the spine.  My friend, a chiropractor in Sausalito used to say, “God made two mistakes:  the sacrum and the pit of the avocado.”  Because here you have a very large bone, situated like an upside down pryamid at the bottom of the spine, with the body’s strongest muscles attached, and guess what?  There’s no solid joint.  Yes.  The sacrum floats between the iliac crests, settling wherever the malestrom of compensating tug of wars between the muscles permits it to land.

Add to that the construction of the joint between the sacrum and the lowest lumbar vertebra, L5, and what you’ve got is like a piece of dowel balancing on the edge of a dinner plate–what could be less solid to be supporting the entire human torso?

Typically, the nerve gets pinched where it emerges between the crooked upper edge of the sacrum and the lumbar vertebra, but it sends pain that is felt in the middle of the butt cheek and may travel down the leg.  A clear symptom of sciatica is when the two toes are different lengths,  which case the short side is the one that’s jammed up into the hip.

What Causes Sciatica

Like everything musculoskeletal in the body, the joint is at the mercy of the balance between competing  muscle groups:  those that would pull it forward vs. backward, as well as side to side, and combinations thereof.  The muscles were intended to move the body about and never to go rigid in an attempt to do the job of the bones, except that they get habituated early in life, and can learn to hold a constant muscle spasm (that’s another story).

In the case of sciatica, the culprits are usually the iliopsoas which pulls (usually) the painful hip up, while the opposite gluteus medius pulls the low side down.  Iliopsoas is very deep and runs along the lumbar spine, through the pelvis to the top of the femur.  It is the muscle responsible for our standing upright and has very little nerve ennervation (not many nerves running to and from it).  Gluteus medius, on the other hand, is very lateral on the other hip and can pull it downward toward the outer aspect of the femur.  It has a lot of leverage because of how it’s positioned.

What to Do About Sciatica

I use a three step process that you can practice on yourself, once you understand it.

Step 1:  Loosen the “Tent Stakes”

This is done by pushing the ends of the iliopsoas together and shortening it so it can spin out of its tautness, and then by massaging the gluteus medius.  (The reason you can’t massage the iliopsoas directly is that because of its depth,  you’d have to put an elbow through the person’s intestines to get to it!)

Step 2:  Make a Ramp

Now that the bones are freer to move back to where they belong, you can lie face up and put something (I use my own fists, or stones or fruit or soup cans or tennis shoes or wine bottles or tennis balls) beneath the lumbar back on the high side, and something under the fold between the butt and the leg on the low side.  So you’re pushing the high side down from above and the low side up from below.  You picture the bones moving the way you want them to, over the peaks and valleys in the bones.  This can take a few minutes until  your toes become even.

Step 3:  Do a Spinal Twist

Now that the bones are within striking distance, you can pin your shoulders down while dropping one knee across the opposite extended leg.  If the bones are ready, and if they need to, you will feel a heavenly pop and also much relief.  Do this on both sides.

Preventive Care

All of the above is only remediative.  The one thing you should do on a daily basis is this:  Before you hop out of bed, put your knees up with your feet on the bed and do some pelvic thrusts.  Don’t lift  your butt off the bed, just tilt your pubic bone up and down.  This helps the sacrum find it’s place before the stress of the day  begins to wreak havoc.

A Caution

I put myself into sciatica rushing through my yoga on the way to receive a massage.  As it hurt, I would stretch it, which made it feel better at the time, and the next day it was worse.  I advise to avoid yoga in this condition because until the bones are straight, you are scraping the nerve across a ragged edge of bone.

How The Protocol Came to Be

Through two years of experimenting on myself and many years after of keeping my bones aligned.  I can say that now, 12 years later, I don’t have sciatica any more, ever.  I hope the same is true for you!

Gwendalyn Gilliam practices healing bodywork at her day spa, The Aloha Skin Spa Tahoe in Incline Village, Nevada