This is a pretty detailed post. I know you asked for tips and I don't want to be too intrusive so feel free to ignore some of the questions I ask, if you don't want to answer them. If you just want some quick tips I've listed them at the bottom.
Any kind of persistent pain is the result of the brain perceiving some sort of threat. This threat may be real (e.g. current fracture, heartbreak, wound, break up, burn, loss of a loved one, etc.), or remembered (e.g. an old injury, traumatic memory), or anticipated (e.g. a fear of moving or harming yourself due to some sort of belief you have about your body, fear of something bad happening in life). Basically, signals that are coming from the body are being interpreted as threatening, leading to hypertonicity or weakness or restricted blood flow (or all 3) in the low back and sciatic area. The key is to identify what your unconscious mind still perceives as threatening.
Lifestyle Considerations
You may get an insight into where this began by completing this sentence: 'I haven't felt quite the same since...'
This should point you in the right direction but you should also consider any major changes in the 6 to 12 months leading up to this time. Sometimes there's simply an accumulation of stress in one's life and there's a sort of breaking point. You focus on the breaking point but what really matters are the events and life circumstances leading up to that point.
Physiological Considerations
What is your breathing like? Do you breath through your mouth (frequently or when stressed)? Do you struggle to breathe through your nose? Do you snore? What is your sleep quality like? Any history of significant dental work (braces, root canal, major dental surgery)?
Nerve health is very dependent on the body having appropriate levels of CO2 and all of the potential issues I've listed in the previous paragraph are common causes of hyperventilation (which causes the loss of CO2). Also, I've never come across someone with chronic pain of any kind who didn't have an issue with their breathing.
What is your diet like? What does an average day of eating look like? Do you do any fasting or regularly have large gaps between meals (6+ hours)? Do you get cold hands and/or feet?
I ask these questions because there are also nutritional reasons why the body may not be producing adequate CO2.
Mechanical & Postural Considerations
If breathing is restricted this will restrict the movement of the spine, typically encouraging it to hyper extend. When the spine is hyper extended the gluteal muscles and muscles of the sciatic area are at a mechanical disadvantage. If they're at a mechanical disadvantage and they are consequently unable to do their job, other muscles will have to overwork to create movement, which may lead to pain. Usually the muscles that overwork are the Quadratus Lumborum and lumbar erectors.
Restoring diaphragm length and
restoring mobility to the spine should go a long way to resolving any mechanical issues.
VIDEO Back Pain: A Structural Perspective
VIDEO Back Pain: A Psychological Perspective
Emotional Considerations
Muscles have related organs and in Traditional Chinese Medicine most organs have related emotions.
- Glutes & Piriformis are potentially implicated in sciatica and are related to the sex organs. In TCM I can't find a specific emotion related to these but it may be related to any fears or shame or worry relating to organ function. Unresolved shame is quite common when it comes to chronic pain. You can try a meditative technique to focus on the pain and the problem and see if certain emotions come to mind. These may be bread crumbs to the deeper issue.
- Quadratus Lumborum & Hamstrings are potentially implicated in sciatica and are related to the large intestine. In TCM the large intestine is related to grief. Grief is also related to the lungs and the lungs are very directly influenced by breathing issues. You may ask yourself if there is any unresolved grief that you're still dealing with. A simple exercise is to see if you can recount experiences of grief while remaining unaffected. Can you recount them in a matter of fact way, without any emotion? Or does the emotion still show itself in your voice, in your tone, in your facial expressions, in your breathing, in your body, etc.? The exercises in the Tell Your Story episode will help if unresolved emotions are an issue for you.
Quick Shotgun Approach
- Nasal Breathing. Learn how to slow down and control your breathing. The key is to learn to lengthen your diaphragm by focusing on lengthening the exhalation phase.
- Bag Breathing. Use a paper bag to re-breath carbon dioxide. Seal the bag well so that carbon dioxide builds up. This will help build up carbon dioxide levels in your body which will promote oxygenation of the body and better nerve health. Use your own judgement with this. Don't do it so long that you're likely to faint or go unconscious. Be smart about it. Aim to do it for no more than a minute between 4 to 6 times spread out in the day. It should be hard at first. You may be gasping for air. Find a balance where it's challenging but you're able to cope with the lack of air.
- Restore Spinal Movement. Specifically videos 5 to 11 in this playlist. Move as much as you can pain free in order to reassure your brain that its safe to move. Convince it gradually and provide a new, more accurate frame of reference.
- Tell Your Story. Write the story of your pain. Write anything and everything that comes up for you. See where your thoughts take you and use this as an opportunity to lay things to rest and let your body move on.
