Thursday, July 4, 2013

Low Back Pain, Sciatica and the Hamstring Muscles


Muscles play a crucial part in the normal functioning of the lower back and sciatic nerve. If any of the muscles in this area become too tight or too weak, they have the potential to cause pain. This is typically referred to as muscle imbalance. The hamstring muscles are a common culprit for this and it is usually tightness which is the problem.

In a similar vein to which I have mentioned in an article on the piriformis muscle ("Low Back Pain & Sciatica - The Role of the Piriformis Muscle") tight hamstring muscles can also have an influence over the lower back, sacro-iliac joint and sciatic nerve.

Low Back Pain

With regards to the lower back, the hamstring muscles are attached to the bottom of the pelvis, in a similar area to the bony points of your buttock you sit on. If this muscle is tight, it will pull on the bottom of the pelvis and encourage it to rotate backwards. If there is also tightness around the low back itself, this backwards rotation movement of the pelvis will be resisted by the back and therefore the increased stress will be taken up in and around the bottom of the lower back or the sacro-iliac joint. This increased stress is likely to lead to pain.

Alternatively, if there is no particular tightness about the lower back and maybe even some weakness, the increased pull resulting from the tight hamstrings may well encourage the lower back to flex too much, this time potentially leading to literally from the lower back pain as opposed to sacro-iliac joint. Either way, pain in the region of the lower back can occur as a result of tight hamstring muscles.

Sciatica

It is slightly different as far as sciatica is concerned. The sciatic nerve is formed from 5 nerve roots which leave the lower back from the lumbar spine and sacrum. Once formed, the sciatic nerve passes through the buttock region and down the back of the leg to the back of the knee. As it passes down the back of the leg, the sciatic nerve also passes through the hamstring muscles. Consequently, if the hamstring muscles are tight, they can place increased stress upon the sciatic nerve, leading to pain.

In either of the above examples, the aim of treatment is to gently stretch the hamstring muscles in order to relieve the stress being placed across the low back, sacro-iliac joint or sciatic nerve.

There are numerous ways of stretching the hamstring muscles. I shall now describe a very gentle way of stretching them. Only when you feel that this stretch is too easy, should you consider progressing on with more aggressive stretches.

While lying on your back with your knees bent, gently hold behind the knee of the side to be stretched and pull your knee towards your chest, stopping when your knee is pointing directly up towards the ceiling.

When in this position, gently straighten the same knee so that your lower leg begins to point towards the ceiling as well.

NB If your hamstrings are tight, you will not be able to get your foot to point towards the ceiling!

As you are doing this, stop as soon as you begin to feel a stretching sensation at the back of your leg.

Hold: approximately 20-30 seconds.

Repeat: 2-3 times.

Repeat: 2-3 times per day.

As you begin to gently stretch the hamstring muscle it will become more supple. This will result in tension being taken from the lower back, sacro-iliac joint and hamstring muscles, which in turn will encourage correct function of these areas, therefore healing will take place. As a result, your pain will also begin to resolve.

Be careful when performing this stretch, as it is important you do not allow your back to flatten too much into the floor/surface you are lying on. A simple way to prevent this is to keep your low back in a neutral position and then gently tighten your abdominal muscles.

The abdominal muscles play an important role with regards to stability of the lower back and associated structures, and therefore by gently working these while performing this exercise, you will be helping to provide your lower back and pelvis with more stability as well.

It is unlikely, although not impossible, that your low back pain will resolve as a result of performing hamstring stretches alone. The chances are however, that you may need to perform one or two other exercises as well, be they stretching or strengthening exercises.

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