What is Sciatic Nerve Pain?
Sciatica, or sciatic nerve pain, is a painful condition caused by the irritation of the sciatic nerve. This is a large nerve formed by nerve roots coming from the spinal cord, extending into the lower back, through the buttock, and down the back of the leg, ankle and foot.
Irritation of the nerve roots leads to tingling, weakness pain or numbness of the lower back, leg and foot. Pain is worsened by sitting, standing for long periods of time and movements that flex the spine.
Causes of Sciatic Nerve Pain
Many conditions may cause irritation of the sciatic nerve such as:
- Herniated disc – bulging or ruptured disc in the spine presses against the nerve roots that lead to the sciatic nerve
- Spinal stenosis – narrowing of the spinal canal
- Bone spurs – small, bony growths that form along joints related to arthritis
- Nerve root compression – pinched nerve caused by injury
These conditions may be seen using X-rays and magnetic resonance imaging (MRI), and when related to pertinent medical history and physical examination, a diagnosis of sciatica may be made.
Treatment of Sciatica
Most cases of sciatic nerve pain improve with oral medications, rest and exercise. One must avoid sitting and standing for long periods of time. Instead, one must alternate lying down with short walks, increasing walking distance as one is able to without pain. Medications include acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).
Other forms of physical therapy like the alternating use of heating pads and cold compresses every 2 or 3 hours can help relieve pain.
Recommended Exercises for Sciatica
Sciatic nerve exercises consist of a specific, controlled, progressive exercise program that is suited to the underlying cause of the sciatic pain. These exercises are part of the treatment recommended by a physical therapist, chiropractor, physiatrist, certified athletic trainer or other spine specialist.
Exercises for sciatic nerve pain are done to relieve lower back pain, leg pain and other symptoms like numbness and tingling. They are also done to strengthen back and leg muscles and help keep the spinal discs healthy, thus preventing pressure on the sciatic nerve.
Types of Exercises for Sciatica
- Aerobic exercise – conditions the heart and other muscles, maintains health, and speeds recovery
- Strengthening exercises – focus on the back, stomach, and leg muscles
- Stretching exercises – keep muscles and other supporting tissues flexible and less prone to injury
Walking is an excellent form of exercise which provides all the benefits of an aerobic workout. It is good for the lower back and legs because it is relatively low impact. It is recommended to gradually progress to doing up to three miles of walking at a brisk pace daily.
Water exercises are helpful in strengthening the lower abdominal muscles, and this can be done by just walking in waist-deep water.
Exercises for Pain Related to Herniated Disc
- Do the backwards bending position, called extension exercises or press-ups by gently placing the lower back into extension while lying on the stomach (prone position). Prop the upper body up on the elbows, keeping hips on the floor. Start slowly and carefully. Hold the position initially for five seconds, and gradually work up to 30 seconds per repetition. Aim to do ten repetitions.
- A more advanced form of the extension may be done by pressing up on the hands while the pelvis remains in contact with the floor. Keep the lower back and buttocks relaxed for a gentle stretch. This position is typically held for one second, repeated ten times.
Exercises for Low Back Muscle Strengthening
- In the prone position, clasp the hands behind the lower back then raise the head and chest slightly against gravity while looking at the floor. Hold the position for five seconds, and gradually work up to 20 seconds. Try to complete eight to ten repetitions.
- While lying prone with the head and chest lowered to the floor, raise an arm and opposite leg slowly, with the knee locked, two to three inches from the floor. Hold this position for five seconds, and complete eight to ten repetitions. aim to hold for 20 seconds as you build up strength.
Exercises for Abdominal Muscle Strengthening
- For the upper abdominal muscles, lie on your back (supine position) with knees bent, arms folded across the chest, and the pelvis tilted to flatten the back. Curl-up lifting the head and shoulders from the floor but do not lift the head up too high. Hold this position for two to four seconds, then slowly lower to starting position. Try to complete two sets of ten curls.
- For people with neck pain, use the hands behind the head to support the neck.
- For the lower abdominals, lie supine, tighten the lower stomach muscles and slowly raise the straight leg about a foot from the floor. Hold this for eight to ten seconds, then slowly lower to starting position. Aim to complete two sets of ten lifts.
Exercises for Sciatica From Spinal Stenosis
- Flex the lower spine by bending forward to allow the nerve irritation or impingement on to resolve.
- Lie on the supine position and gently pull the knees to the chest until a comfortable stretch is felt. Hold for 30 seconds then slowly return to starting position. Aim to complete four to six repetitions.
- Lying supine, press the low back into the floor by tightening the lower stomach muscles while pulling the navel in and up for 10 seconds. Aim to do eight to ten repetitions.
Lumbar Stabilizing Exercises
- While lying supine with knees bent and arms at sides, tighten the stomach muscles and slowly raise alternate legs three to four inches from the floor, as if marching. March for 30 seconds, for two to three repetitions, with 30-second breaks in between repetitions.
- As a variety, try raising and lowering the opposite arm over the head while doing the above exercise.
- While lying supine with the knees bent, slowly raise the buttocks from the floor in a bridge position. Hold for eight to 10 seconds, then slowly lower to starting position. Aim to complete two sets of ten bridges.
Words of Caution
These are just some possible exercises for sciatic nerve pain relief. Before doing any of these it is best to consult a medical professional for proper evaluation and management since most exercise programs are tailored to address the underlying cause of a patient’s sciatic pain.
Some exercises such as these can worsen back pain and must be avoided:
- Straight leg sit-ups.
- Bent leg sit-ups or partial sit-ups (curl-ups) when one has acute back pain.
- Lifting both legs while lying supine (leg lifts).
- Lifting heavy weights above the waist (standing military press or biceps curls).
- Touching the toes while standing.
Finally, it is important to remember that doing the right exercises but doing them without proper form can render the exercises relatively ineffective, and possibly may lead to continued or increased pain. It is best to do these under proper medical guidance.
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