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Guide Physio & Rehab

The 6 uncommon questions I ask everyone with sciatica


Happy Wednesday,

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This one gets a little into the weeds, but it’s about nerve pain, so stick around if you’ve ever dealt with sciatica, numbness or tingling, or pain that just doesn’t seem to add up.

Here's a little background about your nervous system:

Your nervous system attaches your brain to each of your limbs and all parts of your body. It is the communication superhighway that allows you to react so quickly in an emergency.

When you grab a hot pan for example, the heat is registered in tiny receptors in your skin, communicated at lightning speed to your brain, your brain registers that as a risk, and then sends another message back to your muscles to say, “MOVE” to get you away as quickly as possible. Just think about how quickly all of that is happening. This is an example of your sympathetic nervous system at work. Your body and brain are fully focused on getting your OUT of that situation.

Your parasympthatic nervous system (same nervous system, acting on different parts of your body) has a similar communication style but is communicating information to your body about “resting and digesting.” This is the system that communicates that it is safe to stop and recover, to eat a bite of food, and digest that big meal.

Now think about your sciatic nerve, a huge nerve which runs down the back of your leg and communicates sensation on the back of your leg as well as muscle activation of major muscles in your legs.
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Structurally these components of communication are all the same thing, and different pieces of information have their own mini tracks within the larger system. The physical nerves (branches from your spinal cord) are sensitive to pressure (this is why sitting can be sooo irritating to a sciatic nerve).

Many people live with a heightened sympathetic nervous system that is frequently carrying pain and stress signals. If you haven’t had time or space to let your sympathetic nervous system take over and help you recover your nervous system can become extremely activated making it even more sensitive to pressure and more reactive to pain.

Treating nerve pain is sometimes it’s about getting actual pressure and physical stress off your nerves. We can do this with gentle stretching or nerve flossing, strengthening other muscles for stability, and finding out what bothers it so you can change your habits (such as sitting on a hard chair all day.)

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But what often gets overlooked is that your nervous system also needs an opportunity for recovery and allowing your body to spend time in that ‘rest and digest’ place is so critical for nerves to become less sensitized. All the physical interventions in the world won’t help if the real issue is that your nervous system isn’t recovering properly. ​
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These are the questions I ask my clients to help us uncover if there is a parasympathetic component to their nerve pain symptoms:

  • Are you dealing with high stress at work or home?
  • Are you getting enough sleep and how is the quality of your sleep?
  • Are you eating and drinking enough water?
  • Are you doing things to take care of your body that allow for movement?
  • Are you making time to see friends and spend time on hobbies or interests?
  • Are you spending a lot of time on screens engaging with social media?

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Often these questions will help us see where nerve pain can be getting exacerbated with daily habits. Your nervous system needs the chance to drop into the rest and digest phase so it can help you, your brain and your body, recover from the everyday stress of life.

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I’m curious if you’ve dealt with nerve pain if any of these questions strike a chord with you?

Katy

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Katy Kelly, PT, DPT

I’m a physical therapist and injury rehab coach based in Helena, MT. If you have been struggling with an injury or life constraints that are holding you back from accomplishing your goals I would love to help you get back to your favorite activities. Depending on your needs and goals I may be able to help no matter where you are located.

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Guide Physio & Rehab

Every other week I answer common questions my clients ask about their injuries, share tips that help you get ready for bucket list adventures, and make sure you’re able to stay active and healthy as you get older.

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