For most instances of sciatica pain, a specific, controlled, progressive exercise program that is tailored around the underlying cause of the sciatic pain will be part of the recommended treatment program. The specific sciatica exercises serve two main purposes:
- Reduces the sciatic pain in the near term
- Provides conditioning to help prevent future recurrences of the pain
A physical therapist, chiropractor, physiatrist (PM&R, or Physical Medicine & Rehabilitation physician), certified athletic trainer (ATC), or other spine specialist who treats the leg pain and other symptoms will typically prescribe specific exercises and teach the patient how to do them.
Exercise Provides Sciatica Pain Relief
While it may seem counterintuitive, exercise is usually better for relieving sciatic pain than bed rest. Patients may rest for a day or two after their sciatic pain flares up, but after that time period, inactivity will usually make the pain worse.
Without exercise and movement, the back muscles and spinal structures become deconditioned and less able to support the back. The deconditioning and weakening can lead to back injury and strain, which causes additional pain. In addition, active exercise is also important for the health of the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy and prevent pressure on the sciatic nerve.
Typical features of any sciatica exercise program include:
- Core muscle strength. Many sciatica exercises serve to strengthen the abdominal and back muscles in order to provide more support for the back. Stretching exercises for sciatica target muscles that cause pain when they are tight and inflexible. When patients engage in a regular program of gentle strengthening and stretching exercises, they can recover more quickly from a flare up of sciatica and are less likely to experience future episodes of pain.
- Specific diagnosis. Most exercise programs will be tailored to address the underlying cause of the patient’s sciatic pain, such as a lumbar herniated disc or spinal stenosis
- Hamstring stretching. Regardless of the diagnosis, most types of sciatica will benefit from a regular routine of hamstring stretching. The hamstrings are muscles located in the back of the thigh. Overly tight hamstrings increase the stress on the low back and often aggravate or even cause some of the conditions that result in sciatica.
- Exercise correctly. As an adjunct to the above point, doing the right exercises but doing them without proper form can make the exercises relatively ineffective, and possibly may lead to continued or increased pain. It is generally advisable to learn the exercises under the guidance of an appropriately trained health practitioner, such as a physical therapist, chiropractor or physiatrist.
- Doing the wrong type of exercise can worsen the sciatic pain, so it is important to get an accurate diagnosis prior to starting a program of sciatica exercises.
- Aerobic exercises. In addition to specific sciatica exercises, aerobic conditioning may also be encouraged for general body fitness. Walking is an excellent form of exercise for the low back because it is relatively low impact but can provide all the benefits of an aerobic workout. If possible, it is best to gradually progress to doing up to three miles of exercise walking at a brisk pace each day.
- Caring for sciatica should be considered part of one’s daily living, not just something to add to the routine at the end of the day. In addition to an exercise routine, patients with sciatica should minimize everyday stress on the lower back, including using appropriate ergonomics while lifting, maintaining good posture, making sure the lower back is supported while sitting, and avoiding sitting or standing for long periods of time.
Before beginning any exercise program, patients should see a health professional to get a correct diagnosis for their pain and to rule out any more serious problems. The proper exercises differ based on the condition that is causing the sciatic pain, so patients should not try to self-treat their sciatica before consulting a health professional.