7 Best Exercises for Sciatic Nerve Pain
It often starts with a dull/burning pain in the low back area. After lingering for a while, it gets worse and gradually spreads to the butt and thigh area on one or both sides. For others, it's more than just pain. Burning sensations, numbness and even leg weakness join the fray. For the more unfortunate ones, it may hit both legs with unrelenting pain among a host of other symptoms which fail to respond to treatment. If you're experiencing something similar, know that you're part of the global sciatica epidemic affecting up to 40% of people in their lifetime.
Understanding sciatica and knowing what to do to help with symptoms and eliminate the cause is a huge part of management. Exercise remains a key part of management, and knowing which moves to go for goes a long way in the recovery process. This article will look at some of the most effective exercises for sciatica. We'll set the foundation with a quick look at its nature and causes before delving into key exercises for pain relief and better movement.
So what is Sciatica(Sciatic Pain)?
As the name suggests, this is pain associated with the Sciatic Nerve: located at the back of your pelvis, thighs and foot areas. The nerve originates from the lower portions of your spine through tiny branches known as nerve roots, and extend downwards along the back of your leg all the way to your foot. It activates a number of muscles at the back of your leg and provides sensation to skin areas along the side and back of the leg.
When the nerve's structural and functional integrity is compromised anywhere along its course, it can cause pain and other symptoms like burning sensations, numbness, and sometimes muscle weakness.
Causes of Sciatica
Let's dive into the key culprits behind sciatica before getting into some of the best exercises for optimal recovery. The reason is that sciatica is a descriptive term for a condition that's often secondary to a wide range of causes, and the choice of exercise largely depends on the underlying cause.
Most of sciatica comes from compression due to structures in close proximity to its origins in the lumbar spine, known as nerve roots. Another fairly less common cause is tightness in muscles along its length, especially in the pelvis and leg. Common culprits include:
Disc herniations
This is perhaps the most common cause of sciatica. Your discs are fibrous structures stacked between your spinal bones(vertebrae). They act as cushions, or shock absorbers for the spine, which allows it to easily handle your bodyweight and transfer the load to your pelvis and legs.
Each disc has a tough outer exterior, known as Annulus Fibrosus, which encloses a jelly-like interior, known as the Nucleus Pulposus. Failures or ruptures in the tough outer exterior cause weak spots which allow the inner jelly-like material to bulge in and cause what's known as a disc herniation or bulge.
Sometimes this bulge can compress the sciatic nerve roots, causing irritation, pain and other symptoms along its route.
Spondyloslisthesis
This is when a spinal bone/vertebrae shifts forward relative to its lower counterpart. It may be caused by high impact trauma or develop naturally as a complication of a degenerative condition i.e Spondylosis. When this happens, the tiny spaces which allow passage of the sciatic nerve roots get narrow, and when this is too much, it may cause compression and irritation of the whole nerve.
Piriformis syndrome
The Piriformis is a tiny muscle located at the back of your pelvic bone. It originates from the inner parts of the pelvic bone and moves sideways to join the upper parts of the thigh bone. In most people, the sciatic nerve pierces through this muscle before travelling down the back portion of your thigh. When this muscle gets overly tight, it may cause compression to the nerve, leading to symptoms of sciatica from the buttock areas going down the leg.
Hamstring Tightness
Hamstrings are a group of three muscles located at the back portion of your thighs. They all originate from a bony protrusion at the back of your pelvic bone and insert on the upper parts of your Tibia(shin bone) and its smaller counterpart, the fibula. The sciatic nerve also passes through these muscles before exiting the upper leg to supply the lower leg and foot. Again, when these muscles are overly tight, they can compress the nerve, leading to signs and symptoms of sciatica from the thigh areas going downwards.
Other less common causes include:
Tumours/growths: These may grow within and around the spinal column press on the sciatic nerve roots, causing sciatica. Sometimes they may develop within the pelvic area close to the areas along its length, causing symptoms of sciatica.
Infections: Spinal infections, like Potts Disease, may cause structure derangement along the lower portions of the spine, which may compromise the size of tiny passages for the nerve's roots. This may cause sciatica as part of a range of symptoms associated with the disease process.
Postural abnormalities: Postural issues like Scoliosis(side curvatures) can compromise load bearing mechanics of the spine. In the long run, this may cause structural issues like disc herniations, leading to sciatica.
Treatment Overview
Sciatica treatment can be conservative or invasive depending on the underlying cause and other related factors.
Conservative Management
This is often the first line of treatment for a wide range of underlying conditions associated with sciatica. There are two main treatment approaches associated with this:
Physiotherapy: Focuses noninvasive methods aimed at reducing symptoms and correcting underlying deficits. It often combines corrective exercise, manual therapy, and a range of complimentary passive treatments chosen based on the condition.
Medication: Involves a range of medication aimed at reducing symptoms and promoting nerve health. Nonsteroidal Antiinflammatory drugs(NSAIDS) and certain anticonvulsants such as Gabapentin are typically used to reduce pain. B-complex vitamins may also be prescribed to deal with any potential nerve health deficiencies.
Spinal decompression: This is a techniques that uses gentle, sustained stretching to the affected segments of the spine to reduce pressure on the affcted nerve roots. The stretch creates a negative pressure on the target spinal segments, which facilitates retraction of bulging discs. This is typically achieved by a specialized motrized table controlled by a computer. Check out our spinal decompression program here.
Surgery
Surgery is usually the last resort for sciatica, reserved for when conservative treatments have failed or when there's severe structural derangement. The choice of surgery depends on the underlying cause and other individual and environmental factors.
Best Exercises for Sciatic Pain
Before we bury ourselves into exercises for sciatica, it's best to know the list below isn't a one-size-fits-all solution for everyone. What works for someone with sciatica due to a series of disc herniations may be completely different from what works for someone with sciatica due to a tight pelvic muscle.
The exercises below are selected based on their value in dealing with some of the commonest forms of sciatica. All in all, consult your physiotherapist before committing here. Treat this list as an inspiration to build on. Talk to one of our seasoned physiotherapists here if you're looking to get professional help.
Lumber Extensions (Cobra Pose)
What it's good for
This is a great exercise if you're dealing with sciatica caused by a disc bulge or herniation due to its ability to reverse the mechanics in favor of the trapped nerve.
Starting Position
Lie face down, with your belly resting on a medium sized pillow.
Rest your palms on the mat/floor, just in front of your shoulders.
Take your time. Rest in that position for 4-5 minutes. Your pain should reduce significantly at this point, or retreat from your legs to the mid part of your lower back. This is called centralization.
The movement
Gently, lift your head and shoulder as high as you can.
Hold the top position for about 3 seconds.
With control, return to the starting position.
Repeat for another rep, aim for 10-12 reps.
Note: Pay attention to your body's response. If the pain gets worse, or starts shooting down one or both legs with extension, you'll probably need to reduce the range of movement. Instead of going full extension, start with just propping up on your elbows to achieve a partial range.
Supine Sciatic Nerve glides
What it's good for
Improves nerve mobility along its course, which helps with decreasing overall tension and compression.
How to do it
Lie down on your back.
Raise the affected leg to a vertical position. Hold the thigh for extra support.
Extend the knee.
The movement
Gently, bend your toes and the whole foot down wards.
Return to the starting position.
Repeat the movement for 8-10 reps.
Seated Sciatic Nerve Glides
This is an alternative to the lying version with the same goal in mind:
Starting position
Sit on a chair or bench, feet flat on the floor at shoulder width apart.
Extend the affected leg.
Bend your foot back and forth.
Note: Stop the exercise if it's making the pain worse, or causing it to radiate to your foot.
Hamstring Stretch
Aim:
Reduce/prevent tightness in your Hamstring muscles, which is a common complication of an irritated sciatic nerve.
How to do it
Lie down on your back.
Raise the affected leg, and hold the thigh for extra support.
Extend your knee joint until you feel a gentle stretch along the back of your thigh.
Hold the stretch for 20-30 seconds. Repeat 3-4 times.
Glute Stretch
Aim
Reduce/prevent tightness in your Glutes(butt muscles), another common complication of a pinched sciatic nerve.
How to do it
Lie down on your back.
Bend both legs and get both feet on the flat on the floor.
Crossover the affected leg on the other leg's knee. Make sure you rest the side portion of its ankle on the outside portion of the unaffected knee.
Using the unaffected side's hand, gently push the affected side's knee towards the unaffected side. You should feel a gentle stretch in the Glute area at the end of the range.
Hold the position for 20-20 seconds, repeat 3-4 times.
Plank
Aim:
Build core strength, which improves spinal stability.
How to do it
Lie face down on the mat or floor, feet at shoulder width apart.
Prop up on your elbows.
Lift your whole body to a straight, horizontal plank position.
Hold for 10-15 seconds.
Return to the starting position. Repeat 3-4 times.
Bird dog exercise
Aim:
Build core strength.
How to do it
Kneel down in an all-four position. Make sure you maintain a neutral spine and brace your abdominal muscles.
Raise your left arm to shoulder level, fingers pointing forward.
Raise your right leg to hip level, stretching it backwards.
Hold the position for 15-20 seconds, relax. Repeat on the other side.
Aim for 3-4 times each side.
Conclusion
Book Now
Have you been battling sciatica and looking to incorporate a helpful exercise routine to your arsenal? The moves above should give you a great start towards something meaningful. However, most sciatica is hardly a solo quick fix. You need professional help. Our physiotherapists specialize in treating sciatica and a host of other orthopedic problems affecting the spine. Fill up the form below, or simply give us a call today. Looking forward to hearing from you.
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