Sciatica is the name that is given to a common type of pain that radiates along the sciatic nerve, a large nerve that runs down the back of the leg. This article will help to explain what causes sciatic pain, and which exercises for sciatica may be of benefit.
What is Sciatica?
Sciatica is not a medical diagnosis as such, but rather a way to describe a particular set of symptoms that can occur due to an underlying medical condition that causes compression of the sciatic nerve.
These symptoms of sciatica are usually only on one side, and may be one of, or a combination of:
- Pain that runs from the lower back down the back of the leg or buttock. The pain can vary from a mild ache to a sharp, burning or shooting pain that can become debilitating.
- Pain that is worse when sitting.
- You may experience numbness, tingling or weakness in the affected leg.
- The pain can be made worse by coughing or sneezing.
- Sharp pain that can make it difficult to walk.
The sciatic nerve is the largest nerve in the body and is about the diameter of your thumb. It runs from the lower back all the way down your leg and as well as being the biggest, it is also the longest nerve in the body. It is derived from the spinal nerves that exit the spine from L4 through to S3 joining together.
The symptoms of sciatica occur when the any one of these nerve roots that form the sciatica nerve is being compressed or irritated in the lumbar spine. This is what people classically think of as a ‘pinched’ nerve. It is not usually the result of a single injury, but an accumulation over time.
Most cases of sciatica will do away over time. How ever you should seek urgent medical attention if the pain has a sudden onset, is the result of a bad injury such as a car accident, it is not getting better after a week, or if you ever have trouble controlling your bowel or bladder.
What Causes Sciatica?
Compression of the sciatic nerve is most commonly caused by a herniated disc at the L5-S1 spinal level.
Other causes of sciatica are:
- Degenerative disc disease (breaking down of the spinal discs.)
- Spinal stenosis (narrowing of the spinal nerve canals in the lumbar spine, usually as a result of calcification/bone spurs.)
- Spondylolysthesis (a condition where one vertebra slips forward on the vertebra below.)
- Piriformis Syndrome (a muscle in the buttock that can compress the sciatic nerve if it spasms.)
- Sacro-iliitis (Dysfunction of the sacro-iliac joint can irritate the L5 nerve root)
- Rarer causes of sciatica may include pregnancy, spinal tumour, scar tissue, or infection.
Exercises For Sciatica
It is important to obtain an accurate diagnosis from your health care professional before starting any exercises, particularly if you are suffering with sciatica. There is not much point in stretching your Piriformis muscle if you have a disc herniation! And this is exactly why you have to be very careful before attempting any exercise regime. There is a real possibility that you could aggravate your condition if you do the wrong thing.
Below are some exercises that will help to relieve sciatica, relevant to the cause. Try to start exercising as soon as possible, within a few days of the sciatica flaring up. The longer you leave it the worse the condition becomes.
Sciatica Exercises for Piriformis Syndrome.
If the piriformis muscle, which is located in your buttock, is to tight or spasming, it can compress the sciatic nerve causing sciatica like symptoms.
By stretching the piriformis you can help to relieve this nerve pressure and get some relief.
Lie on your back with your legs stretched out flat. Cross the foot on the affected side over the other knee, then pull the unaffected leg towards your chest. Hold for 10-30 seconds then relax back down. You will feel a stretch, but it should not be painful, if it is then just back off a bit.
Sciatica Exercises for a Herniated Disc.
Often relief from sciatica that is caused by a herniated disc can be achieved by extending or arching the spine.
First off, try this in a standing position with your hands on your hips, and just gently arch backwards over your hands.
If you have any pain aggravation then do not do this exercise. If it is okay, after doing this for 2-3 days you can progress to doing extension exercises on the floor.
Lie on your tummy, and gently lift your head and shoulders off the floor using your back muscles and propping your self up on your elbows for 10 seconds.
Begin this one very carefully and slowly as it can be quite painful at the start.
For some people, raising their painful leg is beneficial.
Lying flat on your back, slowly attempt to raise the affected leg 6 to 12 inches off the floor and hold there for 10 seconds.
This is also good to strengthen the abdominal muscles, which are important spinal stabilisers.
Sciatica Exercises for Degenerative Disc Disease.
The best exercises for DDD are stretching exercises to help to improve spinal flexibility.
Low Back Stretch
Start in a kneeling position, then sit back onto you feet.
Stretch your arms out in front of you along the floor.
Feel the stretch in your low back and hold for 10 seconds.
Move back onto your hands and knees, then gently lift one leg behind you as far as you comfortably can.
Kneeling Leg Raise
Hold for 10 seconds then do the same on the other side.
All the previous exercises are also helpful for Degenerative Disc Disease, as is walking.
Sciatica Exercises for Spinal Stenosis
Spinal stenosis is often a result of degenerative changes in the spine, so all the above exercises can be of benefit.
Try them all, you should find that some feel good and some feel bad. Simply, don’t do the bad ones, and do the good ones! Everybody is different, so try them for yourself.
Sciatica Exercises for Spondylolisthesis.
The idea of these exercises for spondylolisthesis is to teach the spine to be more stable in flexion and extension movements (backwards and forwards). Abdominal strength is key!
Start lying flat on your back, slowly attempt to raise the affected leg 6 to 12 inches off the floor and hold there for 10 seconds.
Repeat with the other leg.
Lie flat on your back with your knees bent. Notice that your lower back is arched up off the floor slightly.
Suck your tummy in, and press your lower back onto the floor and hold for 10 seconds.
Sit-ups are great for really getting your abs strong.
Lying on the floor as above, lift your upper body (head and shoulders) off the floor by curling up.
Don’t try to lift to high, just enough to get your shoulders slightly off the floor. Repeat 10 times.
You can do more sets of 10 as you get better!
Sciatica Exercises for Sacroiliac Joint Dysfunction.
Inflammation of the Sacro-iliac joint can cause sciatica like symptoms. This is usually the result of abnormal joint movement and can be assisted by stretching.
Lie on your back with your knees bent. Pull the knee on the affected side up to your chest as far as you can, then hold for 10 seconds.
You can also pull the knee across your body towards the opposite shoulder to amplify the stretch.
Before beginning any exercise program, particularly exercises for sciatica, you should see a health professional to get a correct diagnosis for your pain to rule out any potentially serious problems.
The proper exercises differ based on the underlying condition that is causing the sciatic pain, so patients should not try to self-treat their sciatica before consulting a health professional.