Sciatica refers to the neurological symptoms (such as burning pain, tingling and numbness) down the back of the leg.
These symptoms are a result of irritation of the Sciatic Nerve.
This blog post contains exercises that will help you get pain relief from Sciatica.
The 3 main causes of Sciatica that will be addressed in this blog post:
1. Bulged Disc/Joint compressing on Nerve Roots (Most common)
2. Piriformis Syndrome
3. Irritated Sciatic Nerve
(Although there are different causes of Sciatica, the exercises shown in this blog post can be applicable and beneficial for most causes. However – please consult a healthcare professional if you have any doubts.)
The Best Exercises For Sciatica
STEP 1: Avoid Aggravating Activities
STEP 2: Reduce Inflammation
STEP 3: Gentle Movements
STEP 4: Nerve Medication
STEP 5: Nerve Root Compression
STEP 6: Piriformis Syndrome
STEP 7: Irritated Sciatic Nerve
STEP 8: Seek Professional Guidance
STEP 1: Avoid Aggravating Activities
Ongoing exposure to any aggravating activity, movement and/or position will cause further irritation to the Sciatic Nerve.
This may lead to an increase in the pain experienced in the back of the leg.
Frequent aggravations of the Sciatic Nerve will make it very challenging to address this issue.
Common Aggravating Activities
- Prolonged sitting
- Bending forwards
- Lifting/Carrying a heavy object
- Sitting on the floor with legs stretched out in front
- Walking up stairs/hill
My Recommendation:
Minimize your exposure to any aggravating activities to give your body the best chance to recover.
(Keep in mind – I DO NOT recommend completely resting in bed all day! This may lead to de-conditioning of your entire body. Keep as active as you are able to.)
STEP 2: Reduce Inflammation
If there is a significant amount of inflammation, this can increase the sensitivity and pain in the back of your leg.
This may limit the ability to perform the suggested exercises on this blog post and potentially prolong the time it takes to recover.
Here are ways to reduce inflammation:
a) Anti-Inflammatory Gel
Apply an anti-inflammatory gel to the lower back and/or back of the hip.
Do this 3 times per day.
b) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
It is recommended that you take an anti-inflammatory medication consistently for at least 7-10 days.
Keep in mind – there are different strengths/types of NSAIDs and is best used if the prescribed medication is appropriate to the severity of the inflammation.
(Note: Please consult your Primary Care Provider before taking any medication.)
c) Cold Therapy
Apply an ice pack to the lower back and/or back of the hip. at least 10-15 minutes.
Do this 3-5 times per day.
(Note: Do not apply the ice pack directly to the skin as you may develop an irritation on the skin.)
Once the pain has subsided, consider applying heat (via heat pack, hot shower and/or deep heat) to help relax the region.
d) Try Natural Products
It is suggested that taking turmeric, ginger, chia seeds and/or fish oil capsules are natural ways to help reduce the inflammation.
(To be honest – I am not 100% how effective this is! … But it might be worth a shot.)
e) Cortisone Injection
The cortisone injection consists of a steroid (cortisone) and an analgesic substance.
The aim of the injection is to reduce the inflammation and reduce the pain by numbing the area.
(Note: Talk to your Primary Care Provider to see if the cortisone injection is appropriate for your shoulder injury.)
STEP 3: Gentle Movements
It is important to perform gentle movements of the body to help with your recovery.
(… Even gentle exercises performed in bed can help!)
a) Keep As Active As Possible!
It is important that you try to stay as active as much as possible.
This is to reduce the amount of deconditioning that may occur in the body due to the reduction in normal activities/movements.
My Recommendation: Aim to walk as much as you are safely and comfortably able to tolerate.
(If you have difficulty with walking long distances, consider walking in a heated pool (Hydrotherapy) or walk shorter distances more frequently.)
b) Lumbar Roll
Instructions:
- Lie on your back with your knees in the bent and feet on the floor.
- Let your knees drop all the way down towards one side.
- Move as much as you can comfortably manage.
- Alternate sides.
- Repeat 20 times.
c) Knees To Chest
Instructions:
- Lie down on the floor.
- Hug both knees with your hands.
- Completely relax your legs and allow the arms to take the full weight of the legs.
- Pull your knees towards your chest.
- Move as much as you can comfortably manage.
- Continue for 20 repetitions.
- Note: If desired, you can perform this exercise using one knee at a time.
d) Standing Extension
Instructions:
- Stand up right.
- Place your hands on your hips.
- Slowly arch your lower back backwards.
- Move as much as you can comfortably manage.
- Aim to feel a gentle tension across your lower back.
- No pain should be experienced.
- Repeat 20 times.
e) Standing Side Bends
Instructions:
- Stand up right.
- Slowly bend towards one side.
- Make sure that you only go far as you are comfortable.
- Repeat on the other side.
- Repeat 20 times.
STEP 4: Nerve Medication
There are several medications that can be used to specifically address nerve-related symptoms.
If your Sciatica is debilitating and persisting despite following the previous steps, you may need to consider taking nerve medication to manage the symptoms.
You will need to get a review with your Primary Care Provider to see if taking nerve medication is appropriate for the treatment of your Sciatica.
(Note: If possible – Aim to avoid getting to this stage where you require nerve medication. Keep in mind – sometimes this is not always avoidable.)
Do you know the CAUSE of your Sciatica?
If you know the exact cause of your Sciatica, I will be able to point you towards the right direction to help address this issue.
(Click the appropriate link below to see the respective exercises.)
Causes of Sciatica:
1. Bulged Disc/Joint Compressing on Nerve Roots (Most common)
2. Piriformis Syndrome
3. Overstretched/Irritated Sciatic Nerve
However – if you are not sure why you are experiencing Sciatica, I’d firstly suggest getting a review from a healthcare professional to help you determine this.
Keep in mind – You can still perform all of the exercises and assess how it affects the pain down the leg. From here – you can focus on the specific exercises that appear to give you the best results.
STEP 5: Address Nerve Root Compression
The L4-S3 nerves in the lower back (Lumbar Spine) converge at the back of the hip to form the Sciatic Nerve.
Compression of these nerves in the lower back can refer pain down the leg.
Test for Nerve Root Compression
a) Get a MRI scan of the Lumbar Spine to determine if there is a compression of the nerve.
b) If lower back movements reproduce your leg symptoms, this suggests that there may be an impingement of a nerve.
The 2 main reasons for nerve compression in the Lumbar Spine are:
(In some situations – you could also have a combination of both Foraminal Stenosis AND a Disc Bulge.)
1) Foraminal Stenosis
Lumbar Foraminal Stenosis refers to the narrowing of the hole (Foramina) between the bones (Vertebra) of the lower back.
Nerves run through these holes and can get compressed/squashed/pinched if the gap becomes too narrow.
I have a complete guide on the best exercises to address Foraminal Stenosis:
See Post: Lumbar Foraminal Stenosis.
If you don’t want to check out the above blog post straight away, feel free to start with the following 3 exercises:
(The aim of the exercises is to increase the size of the gap between the bones of the Lumbar spine to reduce pressure on the nerve.)
a) Decompression with Ball
Instructions:
- Lie facing downwards on top of a large exercise ball.
- Support your body by placing your hands onto the floor.
- Position your body so that your lower back is in line with the top of the ball.
- Allow your legs to completely relax.
- Your toes should either be gently resting on the floor.
- Aim to feel a stretch sensation in the lower back region.
- Hold this position for 30 seconds.
b) Side Stretch
Instructions:
- Stand up right.
- Completely lean your torso towards the opposite side of where your painful leg is.
- Allow your painful leg to lift and dangle.
- Keep this leg completely relaxed throughout this stretch to allow gravity to pull your leg down.
- Do not let your pelvis rotate.
- Aim to feel a stretch in the side of your lower back.
- Hold this position for 30 seconds.
c) Core Exercise
Strengthening the core muscles will help support and stabilize the joints of the lower back.
This can shift some pressure onto the core muscles and away from the lower back.
Starting position:
- Lie down on your back with knees bent and feet on the floor.
- Keep your neck and chest completely relaxed throughout the whole exercise
- (If required – You can use a pillow underneath your head.)
Instructions:
1. Take a deep breathe in through your nose.
2. Breathe out through your mouth.
3. As you are breathing out:
- Slowly push out ALL of the air out of your lungs.
- Engage your core muscles:
- (“Draw belly button in AND very gently tense your abdominal muscles”)
- Your lower rib cage should drop down as you exhale completely.
- Flatten your lower back completely on the floor.
- Aim to feel a strong contraction in the abdominal region.
- Whilst keeping your lower rib cage in the dropped position, take a breath in through your nose.
- Repeat 3-5 cycles.
To see more core exercise, check out this blog post:
See Post: Deep Core Exercises
2) Disc Bulge/Herniation
There are fibrocartilaginous structures called “discs” which are located in between the vertebra of the spine.
Simply put – The function of these discs is to act as a shock absorber for the spine.
A disc bulge occurs when this disc extends further than its normal position due to a weakness in the disc structure.
If the disc bulge is prominent, it may lead to compression of the adjacent nerve which can lead to Sciatica.
I have a complete guide on the best exercises to address a Disc Bulge:
See Post: Bulged Disc Exercises.
To get you started – I recommend the following 3 best exercises for a disc bulge.
(The aim of these exercises is to help encourage the disc bulge to retract to a more normal position to reduce pressure on the nerve.)
a) Lower Back Extension
Instructions:
- Lie down on your stomach.
- Place your forearms onto the floor with your elbows directly underneath the elbows.
- Keep your lower back and legs completely relaxed throughout this exercise.
- Use the arms to push your torso backwards.
- Aim to feel a gentle bunching sensation in your lower back.
- Make sure that you are not moving into any pain.
- Hold this position for 5 seconds.
- Perform 20 repetitions.
b) Pelvic Tilts
Instructions:
- Lie down on your back.
- Bends your knees and keep your feet on the floor.
- Tilt your pelvis forwards.
- Your lower back should arch as you move your pelvis forwards.
- Perform 20 repetitions.
c) Decompression
Instructions:
- Lie down on the floor.
- Have someone to hold both of your ankles and gently pull on both of your legs.
- Keep your legs completely relaxed.
- Hold for 30 seconds.
STEP 6: Piriformis Syndrome
The Piriformis is a small muscle that is located at the back of the hip.
(The Sciatic Nerve is located directly next to this muscle.)
Piriformis Syndrome refers to the Sciatic Nerve being compressed/irritated by an injury involving the Piriformis muscle as it enters the hip region.
An injury to the Piriformis is usually associated with over use, direct trauma, compression (prolonged sitting) and/or muscular tightness.
Note: In a small percentage of people, the Sciatic Nerve pierces directly through the Piriformis muscle. (… which may increase the likelihood of compression of the Sciatic Nerve if there is an issue with the Piriformis.)
Here are some exercises to help address this issue:
a) Releases To Piriformis
Instructions:
- Sit down on the floor.
- Place a massage ball underneath the back of the hip.
- Apply an appropriate amount of your body weight on top of the massage ball.
- Keep your leg relaxed throughout this release.
- Perform gentle circles on top of the ball.
- Continue for 2 minutes.
Note: Make sure that you do not press directly on top of the Sciatic Nerve. This will cause the symptoms in your leg to get worse.
b) Piriformis Stretches For Sciatica
Stretching a tight Piriformis can give pain relief from Sciatica.
Here are 3 different ways to stretch it out:
Focus more time on the Piriformis stretch that gives you the most relief.
(Note: If your Piriformis is already elongated, performing stretching exercises may increase the pain in the leg. In this situation – you may benefit more from strengthening the Piriformis instead.)
1. Seated
Instructions:
- Sit up right on the edge of a chair.
- Place your ankle on top of the other knee.
- Place both hands under the knee.
- Pull the knee towards the opposite shoulder.
- Whilst keeping the lower back extended, lean the torso forwards.
- Aim to feel a deep stretch in the back of the hip.
- Hold for 30 seconds.
2. Supine
Instructions:
- Lie down on your back with your knees bent.
- Place the ankle (on the same side that you would like to stretch) on top of the other knee.
- Grab and pull the knee towards the chest.
- Maintain an arch in your lower back.
- Aim to feel a deep stretch in the back of the hip.
- Hold for 30 seconds.
3. Floor
Instructions:
(Movements are described in terms of stretching the Right side.)
- Position your right leg in front of you as shown above.
- By moving from your pelvis, lean your torso forwards so that the left shoulder moves towards the right knee.
- Aim to feel a deep stretch in the back of the right hip.
- Hold for 30 seconds.
c) Piriformis Strengthening Exercise
(Note: If there is a lot of tightness in the Piriformis, this exercise may increases the pain in the leg. In this situation – you may benefit more from stretching the Piriformis instead.)
Instructions:
- Lie down on the side with the painful leg on the upper side.
- Keep your knees in a bent position.
- Lift your upper leg.
- Aim to feel a contraction in the back of the hip.
- Perform 20 repetitions.
STEP 7: Irritated Sciatic Nerve
An irritated Sciatic Nerve will often lose its ability to tolerate being stretched.
Test for Irritated Sciatic Nerve
Instructions:
(You’ll need a helper to assist with this test.)
- Lie down on your back.
- (Do not use a pillow for your head.)
- The helper is to place one hand underneath the heel (to support the weight of your leg) and the other hand on top of the knee (to keep the leg completely straight).
- The helper raises the leg until the leg symptoms are reproduced down the back of the leg.
- Take note of the leg angle to the horizontal.
- The helper then maintains the position of the leg whilst pushing the ankle towards you.
- Compare with the unaffected side.
Results:
If the symptoms are reproduced at the back of the leg and increased with the added ankle movement as compared to the unaffected side, this suggests that the Sciatic nerve is irritated.
(Keep in mind – this test may also be painful in people with Lower back and/or Piriformis Syndrome.)
Sciatic Nerve Stretches
The goal with the following exercises is to gradually expose the Sciatic Nerve to a stretch load to reclaim the normal stretch tolerance.
This can help reduce Sciatica-related pain in the back of the leg.
I go through multiple ways to stretch the Sciatic Nerve in this blog post. Feel free to check it out:
See Post: Sciatic Nerve Stretches.
To get you started, check out 3 ways to stretch the Sciatic Nerve:
NOTE:
- The following Sciatic nerve stretches are designed to be pain-free.
- Aim to feel a deep (but comfortable) stretch along the back of the leg.
- Reduce the stretch intensity if tingling/pain/numbness is produced.
- Stretching can make Sciatica worse! If the stretches are too intense, it may suggest your condition is too irritable and not ready for them yet.
a) Floss
Instructions:
(You will require assistance with this stretch.)
- Lie down on the floor.
- Keep the leg completely straight throughout this exercise.
- Position 1:
- Get your helper to lift your leg as high as possible as you point your foot forwards.
- Position 2:
- Get your helper to lower your leg slightly as you bring your foot backwards.
- Aim to feel a very gentle stretch sensation at the back of your leg in both positions.
- Alternate between these 2 positions.
- Perform 30 repetitions.
b) Glide
Instructions:
- Lie down with your back on the floor.
- Keep your leg completely straight throughout this exercise.
- Raise your leg as high as possible until you feel a firm (but comfortable) stretch in the back of your leg.
- Lower the leg slightly and place the heel on an object that can support the weight of your leg.
- Position 1: Whilst keeping the leg locked straight, bring your ankle backwards.
- This should reproduce the stretch sensation in the back of the leg.
- Position 2: Proceed to point the foot forwards.
- This should completely eliminate the stretch.
- Alternate between these 2 positions.
- Perform 20-30 repetitions.
c) Stretch
Instructions:
- Lie down with your back on the floor.
- Keep your leg completely straight throughout this exercise.
- Raise your leg as high as possible.
- Using a strap to wrap around the foot, pull the foot backwards.
- Aim to feel a strong stretch sensation in the back of the leg.
- Hold for 30 seconds.
STEP 8: Seek Guidance
If there has been nil improvements in the pain in the back of the leg after persisting with the suggested exercises for at least 2 weeks, I strongly encourage you to see a healthcare professional.
In fact – It is probably better to see a professional as soon as you notice any symptoms!
(Addressing nerve issues is not an easy task!)
Conclusion
Follow the exercises (and the pictures that accompany the instructions) recommended on this blog post to help address the symptoms associated with Sciatica.
What to do next
1. Any questions?… (Leave me a comment down below.)
2. Come join me:
3. Start doing the exercises!
Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before attempting any exercise. For more information: Medical Disclaimer.