Diagnosis Explanation:

Sciatica is pain, numbness, or tingling that radiates along the sciatic nerve, which runs from the lower back through the buttocks and down the legs. It is often caused by a herniated disc, spinal stenosis, piriformis syndrome, or degenerative disc disease. Symptoms include sharp, burning, or shooting pain in one leg, worsened by sitting, bending, or standing for long periods.

Specific Work Modifications:

• If your job requires standing or walking: Use shock-absorbing shoes, take breaks to sit, and shift weight frequently.
• If your job involves lifting: Avoid heavy lifting, bending forward, and twisting. Use a brace if needed and lift with your legs, not your back.
• If your job is desk-based: Use an ergonomic chair with lumbar support, keep feet flat on the floor, and take standing breaks every 30-60 minutes.
• Avoid: Prolonged sitting or standing, bending at the waist, and twisting motions.

Specific Activity Modifications:

• If you run or play sports: Reduce high-impact activities and switch to swimming, cycling, or walking on soft surfaces.
• If you hike: Use trekking poles, avoid heavy backpacks, and choose flat terrain.
• If you do weightlifting: Avoid deadlifts, heavy squats, and leg presses; focus on core stability exercises.
• Avoid: High-impact activities, excessive bending forward, and twisting.

Recommended Supplements:

• Collagen Peptides – 10g daily to support discs and ligaments.
• Magnesium – 300-400mg daily to relax muscles and prevent spasms.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin D3 + Calcium – 1000 IU/500mg daily for bone and nerve health.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Eat Anti-Inflammatory Foods (salmon, leafy greens, turmeric, berries, nuts) to reduce nerve irritation.
• Increase Lean Protein (chicken, fish, tofu, eggs) to support nerve and muscle healing.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tissue hydration.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep spinal discs hydrated.

Home Exercise Prescription (Rehabilitation for Sciatica)

Early Phase (0-2 Weeks, Reducing Pain & Nerve Compression):

• Pelvic Tilts – Lie on your back, flatten your lower back against the floor, hold 5 seconds, repeat 10 reps, 2x/day.
• Knee-to-Chest Stretch – Lie on your back, pull one knee toward chest, hold 20 seconds, switch sides, repeat 3x/day.
• Piriformis Stretch – Sit or lie down, cross one ankle over the opposite knee, hold 20 seconds, 3x/day.
• Cat-Cow Stretch – On hands and knees, arch and round your back, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Core & Hip Stability):

• Glute Bridges – Lie on back, lift hips while engaging core, 10 reps, 2x/day.
• Bird Dog Exercise – On hands and knees, extend opposite arm and leg, hold 5 seconds, repeat 10 reps, 2x/day.
• Seated Rows (Resistance Band) – Pull band toward chest while keeping back straight, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Enhancing Mobility):

• Side Planks (Modified if Needed) – Hold for 10-20 seconds, increase gradually.
• Standing Hamstring Stretch – Place foot on an elevated surface, lean forward slightly, hold 20 seconds, 3x/day.
• Stationary Cycling or Swimming – 15-20 minutes/day for low-impact strengthening.

Helpful Books:

1. Treat Your Own Back – Robin McKenzie (self-treatment exercises for spinal health).
2. The Sciatica Relief Handbook – Chet Cunningham (lifestyle and exercise strategies to manage sciatic pain).

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.