Sciatica: Exercises to Try and to Avoid

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Sciatica is a debilitating condition that affects millions of people every year, preventing them from working, socializing, or even performing simple daily tasks. According to experts, up to 40% of people will experience sciatica at some point in their life, and those with prior back pain are more susceptible to developing sciatic nerve pain. Fortunately, there are many exercises, and sciatica stretches that you can try at home to alleviate your sciatic nerve pain.

What is Sciatica?

Sciatica is pain caused by damage to or compression of the sciatic nerve. The sciatic nerve is the largest nerve in the body running from the lower back through the buttocks, down the back of each leg and ending at the knee. There are various causes of sciatica, such as:

  • A herniated disc, in which the intervertebral disc slips out of alignment.
  • Degenerative disc disease.
  • Spinal stenosis, or narrowing of the spinal canal, which compresses the sciatic nerve.
  • Lumbar spinal tumor.
  • Infection or virus.

Symptoms of Sciatica

Sciatic nerve pain is considered a symptom rather than a condition. However, other symptoms associated with sciatica can include:

  • Tingling or numbness in the buttocks and legs.
  • Intermittent pain that feels like an electric shock which radiates from the lower back down to the knee.
  • Pain in the buttocks or legs that becomes worse when sitting.
  • Difficulty moving legs and hips due to muscle weakness.
  • A constant dull ache in the hips or buttocks.

The symptoms of sciatica typically only affect one side of the body and can occur anywhere ranging from the lower back to the knee. In some cases, the foot can also be affected depending on where the sciatic nerve is damaged.

Treatment for Sciatica

Treatments for sciatica generally combine pain-relieving methods with techniques used to address the underlying cause of the nerve pain.

Spinal Manipulation

Spinal manipulation is not only an effective technique for relieving nerve pain but also an important diagnostic tool for chiropractors. There are various techniques that chiropractors use, including manual and mechanical manipulation, and with or without the assistance of a specialized table or apparatus.

Spinal manipulation allows the chiropractor to correct poor spinal alignment, facilitate a better range of motion, and restore your body to its optimal function.

Deep Tissue Massage

Tense muscles in the lower back and hips can contribute to pressure on the sciatic nerve. Deep tissue massage, which uses strokes that go across the grain of the muscles, is often used to access the deeper layers of muscle to minimize pressure on the sciatic nerve and relax tense muscles.

Heat and Cold Therapy

Heat and cold therapy have been proven effective for relieving painful sciatica symptoms. Cold packs help to reduce the inflammation of the muscles in the lower back reducing the pressure on the sciatic nerve, while heat boost blood flow to the tissue flooding the area with nutrients to aid healing.

Exercise and Stretching

As an important part of your treatment program, your chiropractor at Michigan Chiropractic Specialists will recommend a carefully controlled exercise program. Exercise ensures that the muscles of the lower back, core, and legs remain in good condition as weak muscles can increase the load on the spine and sciatic nerve and in turn, increase the painful symptoms.

Exercises to Try

The areas predominantly affected by sciatica are the soft tissues of the lower back and hips, and in particular, the piriformis muscle that connects the thigh bone to the base of the spine and the large psoas muscle group in the hips.

Stretches and exercises that lengthen tense muscles and strengthen muscles weakened from lack of use are ideal for relief from the symptoms of sciatica. However, some exercises are better suited to different causes of sciatica, and the exercises need to be performed consistently with the proper technique to be as effective as possible.

Piriformis Stretch

1. Lie on your back with knees bents and feet hip-width apart.
2. Place your right foot across your left thigh just above the knee.
3. Clasp both your hands behind the left leg and gently pull the knee toward your chest. You should feel the stretch through your buttocks.
4. Hold the stretch for 30 seconds, pulling the leg closer to your chest if the stretch does not feel deep enough.
5. Lower your legs and repeat on the other leg. You can repeat the stretch multiple times throughout the day.

Psoas Muscle Group Stretch

1. Begin in a half-kneeling position on the floor with your right leg in front and the thigh perpendicular to the ground.
2. Squeeze your right buttock and rotate the right knee slightly outward.
3. Lean forward from the hip (not the lower back) until you feel a stretch in the left hip.
4. Hold the stretch for 30 seconds.
5. Change legs and repeat on the other side.

Knee to Shoulder Stretch

1. Lie on your back with your legs extended, and your feet flexed.
2. Raise the right knee and hold with both hands.
3. Draw the knee gently towards the left shoulder while keeping both shoulders on the ground.
4. Hold for 30 seconds then return to starting position and repeat on the opposite leg.
5. Repeat cycle 3 – 5 times.

Hamstring Stretch

1. Lie on your back with your legs stretched out.
2. Raise the right leg, grasping the leg with both hands behind the knee or thigh.
3. Flex your right foot, and gently straighten the leg while pulling it towards your chest.
4. Hold the position for 30 seconds, then repeat on the other leg.

Back Extension for Sciatica Due to Herniated Disc

1. Lie in a prone position on your stomach on the floor with feet together and hands beside the shoulders.
2. Squeeze the glutes, push your legs into the floor and slowly push up so that your forearms are on the floor and your shoulders are stacked over your elbows.
3. Hold this position for 10 -20 seconds, then slowly lower the body back to the starting position. Depending on the severity of the sciatic pain, you may only be able to hold this position for a maximum of 5 seconds. Slowly build up your strength and flexibility so you can hold it for the full 20 seconds. Repeat the exercise 2 -3 times.

Advanced Back Extension

There are two advanced variations of the back extension that can be performed once your symptoms have reduced, and your core muscles are strengthened.

Variation 1: Full Extension

1. Lie in the prone position with your hands beside your shoulders.
2. Push down and slowly raise your upper body until your arms are fully extended in slightly in front of your body in line with your hips. Keep your pelvis in contact with the floor.
3. Hold for 1 -2 seconds, then lower your body down. Repeat 5-10 times.

Variation 2: Unsupported Extension

1. Lie in the prone position and bring your hands to touch behind your head with the elbows extended out to the side.
2. Squeeze your glutes and activate your core muscles to raise your chest and shoulders off the ground.
3. Hold for 5 seconds, then lower the body. Repeat 5-10 times.

Back Flexion Exercise for Sciatica Due to Spinal Stenosis

1. Lie on the ground with your knees bent and hip-width apart.
2. Grasp both your legs behind the knees and gently pull your knees towards your chest while bending your head forward towards your knees.
3. Hold the position for 30 seconds then return to the starting position. You should feel the stretch across the lower back. Repeat 3-5 times.

Pelvic Tilt

1. Lie on the ground with knees bent and hip-width apart.
2. Tighten the abdominal muscles and draw the navel towards the spine.
3. Flatten your lower back against the floor and tilt your pelvis towards your chest.
4. Hold for 20 seconds, then relax back into the starting position. Repeat 5-10 times.

Single Leg Raise

1. Lie on the ground with knees bent and hip-width apart.
2. Perform a pelvic tilt as directed above.
3. While the pelvis is tilted, stretch your right leg out until it is straight on the floor. Flex the foot and raise the leg approximately 6-inches off the ground, then lower it slowly. Repeat 10 times.
4. Repeat exercise 10 times on the opposite leg.

Child’s Pose

This effective yoga pose for sciatica relief help to decompress the lumbar spine.

1. Begin on your hands and knees with your back flat.
2. Lower your buttocks to your heels, then extend your hands in front of your body, lowering your head to the floor.
3. Bring your arms around the side of your body so that they touch the sides of your legs and turn your palms up.
4. Hold for 10-20 seconds and repeat 2-3 times.

Exercises to Avoid

While improving your physical conditioning is a great way to alleviate the symptoms of sciatica, some exercises can further strain the lower back and exacerbate inflammation to the sciatic nerve. To reduce the risk of increasing sciatic nerve pain, avoid the following exercises:

Double Leg Lifts

Exercises involving lifting both legs simultaneously in isolation can cause you to engage your core muscles too strongly before they are ready. This places an undue load on the muscles of the lower back, causing increased tension and pressure on the sciatic nerve.

Leg Circles

Similar to double leg lifts, moving your leg in a full circle, such as with some Pilates moves, or with a large range of motion, such as kicking a soccer ball, can over-extend the hamstrings causing tension to already weakened muscles and risking injury.

Full Body Squats

While squatting is excellent for conditioning the large leg muscle group, it also causes compression in the spine and puts the delicate tissues of the knees at risk, especially when performed with added weights.

Bent Over Rows

The position required for a bent over row strains the lower back, which can be exacerbated by poor technique. Combined with excessive weight, the bent over row can cause increased inflammation in the areas around the sciatic nerve inhibiting the healing process.

Straight Leg Sit-Ups

It is necessary to improve core condition when treating sciatica, however, performing straight leg sit-ups creates a situation where you are performing the largest movement from your lower back which risks damaging already weak lower back muscles.

Lying Leg Curls

Whether you are using a machine or free weights, lying leg curls should be avoided if you suffer from sciatica. Leg curls rely heavily on strong lower back and glute muscles to lift the weight, but too much weight can cause muscle damage and increased sciatic nerve pain.

High Impact Sports

High impact exercises such as sprinting, high intensity interval training, or cross-fit, cause jarring of the spine and may require you to use muscles that are not strong enough leading to injury.

Tips for Exercising with Sciatica

Apply Heat Before Exercise

Heat packs can be used to relax tense muscles and relieve pressure on the sciatic nerve before exercising, allowing you to perform the exercises with a greater range of movement. Heat packs are also an effective form of pain relief. Simply apply a heat pack to the lower back for 15-20 minutes before starting your exercise routine.

Do Low Impact Aerobic Exercises

Just as certain stretches and exercises can exacerbate sciatic nerve pain, so too can high impact exercises such as jogging or mountain biking can jolt the spine around creating pressure on the sciatic nerve, especially if the pain is a result of a herniated disc.

Low impact aerobic exercises such as walking, riding a stationary bike, or using the elliptical machine should be included as part of your sciatica exercise regime. They can help to remove the pressure on the spine while still increasing blood flow to aid healing and conditioning the core and lower back muscles.

Swimming is another effective way to incorporate aerobic exercise into your treatment program. The water holds the weight of your body while you exercise and can also help to decompress the spine.

Don’t Overdo It

While exercise is great for alleviating pain and improving muscle conditioning, excessive stretching, and exercise can have the opposite effect by increasing inflammation and nerve irritation. Only perform the exercises recommended by your chiropractor and only for the recommended number of repetitions. You can consult your chiropractor about changes to your program as your body heals and becomes stronger.

Final Thoughts

Always consult a healthcare professional before starting any exercise routine if you suffer from sciatica. If you are experiencing any back pain and suspect you may have sciatica, please contact Drs. Adam and Amanda Apfelblat for a free consultation. After your evaluation, together, you can create an effective exercise plan to alleviate your sciatic nerve pain and let you enjoy life again.