Sciatica worse when I stand up… If that’s you, then this article is specifically written for you. As an Edinburgh osteopath specialising in sciatica treatment and in lower back pain, let me explain. If you want more general help you’ll find a lot of value in our online course for lower back pain and sciatica.

What is sciatica?

It’s worth a quick view of this video “Have I got sciatica?”  Essentially “sciatica” is a description and not a diagnosis.  There are a number of possible causes of sciatica.  Depending on the underlying cause of your sciatica, it may be worsened, relieved or not affected by changing your position.

What happens when you stand up?

The act of standing up from sitting or lying down affects you in a number of ways.  Muscles have to contract to push you up. Other muscle have to stretch to allow that to happen. There is a re-distribution of the load on your vertebrae and your discs. It’s very likely these bones and discs will come to a different alignment standing compared with in other positions.

So why is sciatica worse when I stand up?

This re-distribution of load can result in greater load on muscles.  Some muscles can cause referred pain along the sciatic distribution. By putting stress on these struggling muscles your sciatic pain would increase.

The re-distribution of load on your discs can cause any bulge in the perimeter of the disc to shift a bit.  This could result in the disc putting more pressure on the adjacent spinal nerve.  Irritating this spinal nerve, if it’s a tributary of your sciatic nerve, would lead to more sciatic pain.

There are other possibilities.  Big picture, many tissues can cause referred sciatic pain and so if there’s more pressure on any one of those tissues when standing, you’ll get more pain.

What to do if sciatica is worse when you stand up

Well, you could try not standing up, but I wouldn’t recommend total inactivity.  Try to stand up in a different way.  When you get up from a chair, shuffle to the front edge first.  Then stand straight up, without leaning forwards.  Sometimes it’s leaning forward from sitting at the back of the seat that increases sciatica. So – based on the principle of Use it or Lose it, but Don’t Abuse it – don’t do that!

Try standing differently.  You may need to lean to one side. You might need to use a stick for a while. Just try not to do things that aggravate your pain. But try to stay as mobile as you can.

Self-help

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