Learning the causes of your lower back pain and becoming motivated to heal is half of the battle

Dear Colin: I’m 71 years old and in terrible shape. I used to play tennis and garden, but was hit by an annoying bout of sciatica that hurts when doing activities. Even though my doctor told me there’s no “real” damage, he recommended staying away from tennis and gardening. This has reduced the sciatica, but now I’m getting depressed from not doing things I enjoy, and getting chubbier. Is there a physical therapy program that can help me?

— Ted, Portland

A variety of conservative methods can help you return to an active lifestyle. As with any health problem, however, there isn’t a universal program that works for everyone.

Sciatica is shooting pain/numbness that travels down the back of your leg (often to the foot). It is often caused by nerve irritation in the low back, which can be from disk damage, narrowing of the canal housing your spinal cord, trauma and/or tumors. While prognosis is good for most people, up to 30 percent continue to have symptoms for longer than a year. by: SUBMITTED - Getting started - Stretching the left hip muscles in the sitting position is an excellent way to address sciatica and lower back problems.

Although controversial, studies suggest that surgery can be helpful in certain cases for those who have a herniated disk, while pain medication is generally not effective. The consensus, though is that sciatica should be conservatively treated using physical therapy (primarily in the form of focused, purposeful exercise) before surgery is considered.

A carefully conducted clinical examination may reveal impairments that could very well be the cause of your sciatica. For example, if your symptoms (shooting leg pain/numbness) worsen with bending backward but improve with bending forward, this suggests mechanical sciatica that may be effectively treated using physical therapy that helps you to better control your pelvis using not just your abdominal/low back muscles, but leg and arm muscles too.

Along the same lines, abnormally tight glute muscles are also linked to sciatica symptoms, so performing low load, prolonged stretching of these muscles may be helpful to reducing sciatica symptoms.

Given that the vast majority of back pain-related disorders (including sciatica) are strongly associated with poor body mechanics and/or sedentary lifestyle, it’s crucial to adopt a sound attitude from the outset. One thing we know for sure: Doing less will make you worse in the long run.

The key is to find a customized program designed to overcome your specific impairments. Once you’ve spent some time (usually six to eight weeks) getting these impairments under control, you should be able to slowly return to gardening, playing tennis or doing whatever activities you need to be able to do live happily.

Even if a conservative attempt fails initially, you’ll need to initiate a safe, effective exercise therapy regimen to help increase the probability of a successful surgical outcome.

Strengthening your entire body (especially your hip and leg muscles), while enhancing flexibility and endurance, will help reduce forces on your spine during activity, therefore reducing the probability of inflammation and a return to sciatica symptoms.

It’s easy to feel victimized by any form of low back pain. But learning what the likely causes of your pain are and how to motivate yourself to take charge of these issues are the keys to full recovery, with or without surgery.

Colin Hoobler is a certified physical therapist and writes this column for a number of Portland-area publications

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