What Is Sciatica?
If you’ve ever felt an intense pain or discomfort running from your low back to your foot, you may be experiencing sciatica or sciatic nerve pain.
The term sciatica is described as the irritation of the sciatic nerve.
Your sciatic nerve is the longest nerve in your body and runs from your low back or hip area to the hamstrings, and branches off into two sections that extend to your feet.
Sciatica pain can often feel like numbness or tingling in the buttocks area or sharp pain in the lower back.
Unfortunately, back pain is the leading cause of disability in the United States, preventing many people from working or engaging in everyday activities (1).
Although the root cause of sciatic nerve pain may be different from person to person, a regular physical activity program can help with pain relief and prevention (2).
What Causes Sciatica Pain?
A common cause of sciatica is a herniated disc, or bulging disc (3).
Our vertebrae are separated by disks that have a gel-like center and a firm outer wall. When the center of these disks breaks through the outer wall, it can compress on the nearby nerves, often times the sciatic nerve (3).
A herniated disk can cause extreme inflammation, resulting in numbness, tightness, or muscle weakness.
Spinal Stenosis: Nerve Compression Disorder
Spinal stenosis is a nerve compression disorder that usually causes leg pain.
Our spinal nerve roots branch outward through passageways made of bone and ligaments (3).
When these passageways for the sciatic nerve become smaller or clogged, it causes leg pain that can extend down to the heel.
Spondylolisthesis: Spine Instability
Spondylolisthesis is a condition that affects the lumbar spine.
It occurs when one vertebra slides forward over an adjacent vertebra (3).
When this slip occurs, it causes nerve compression in the low back and causes sciatica. Usually, this condition is developed during childhood, or from trauma (3).
Piriformis Syndrome: Piriformis Muscle Spasms
Piriformis syndrome is named for the tiny piriformis muscle that can often cause nerve irritation.
The piriformis muscle is located in the lumbar spine and runs through the buttocks to connect to the thigh bone.
When the piriformis spasms, it can compress the sciatic nerve and cause intense irritation (3).
To get an accurate diagnosis, be sure to consult healthcare professionals or a physical therapist about your sciatic nerve pain.
Because lower back pain is so prevalent in sedentary people (2), a regular exercise program can help with sciatica pain relief and prevention.
Exercises for sciatica should include low-impact exercises and should be done with the supervision of a physical therapist or spine specialist.
Sciatic Nerve Exercises
Effective sciatica exercises should focus on flexibility of the piriformis, mobility of the hip, and strengthening of the low back, hips, buttocks, and core.
Below is a routine therapeutic exercise for a beginner who is struggling with sciatica pain.
1. 90/90 Stretch
As mentioned before, sciatica pain relief is something that can be achieved by a simple stretch and improving flexibility.
Increasing range of motion can help to improve your quality of life and help you move through the day with less limitations.
This stretch can improve joint mobility in the hips because they will both internally and externally rotate. The 90/90 stretch can be done seated on the floor or even on a bed!
This exercise will focus on stretching the piriformis muscle, improving joint mobility, and stretching the low back.
- First, sit on a firm surface. Bring your right leg out in front of your body and bend it so that your hip is externally rotated (the knee is pointed outwards).
- Position it so that both your knee and lower leg are resting on the floor. Do your best to keep this top knee on the floor.
- At this point, your leg should form a 90-degree angle with your right foot pointed straight out in front of you.
- Then, position your left leg beside you with your hip rotated inward. Your shin and ankle should be touching the floor, also forming a 90-degree angle.
- Now that you’re in the starting position, keep your back straight and sit up tall with your chest pointed forward. For an added challenge, let your torso fall forward over your right leg, and support yourself with your elbows.
- Hold this position for up to 60 seconds and breathe deeply, then switch legs. Repeat for 2 repetitions of this exercise on each side.
2. Hip Bridges
A hip bridge also called a glute bridge, is a great way to rehabilitate any form of back pain, especially sciatica.
This therapeutic exercise is done easily on the floor or supportive bed and can be made easier or harder depending on your fitness level and muscular strength.
Hip bridges help to relieve lower back pain by increasing blood flow to the area and strengthening the hamstring muscles, glutes, and core.
- Lie on the floor or bed with your knees bent and feet planted, while your lower back stays firm to the ground.
- With your arms extended by your sides, your fingertips should be 1-2 inches away from your heels. This is your starting position.
- Keeping your core engaged, press through your heels to lift your buttocks off the floor and into hip extension. At this point, your body should create a straight line from your knees to your chest.
- Hold this position for 1-2 seconds while squeezing your glutes, and slowly lower yourself back down to the ground. Try to avoid any anterior pelvic tilt (arch in the lower back) as this may worsen the pain and diminish the benefits of the exercise.
- Repeat 10-15 repetitions of this exercise for 3 sets. Take at least a minute break between sets.
For an added challenge, try this exercise with your feet on a slightly elevated surface!
3. Prone Leg Lifts
Prone leg lifts may be a slightly awkward exercise, but they are incredible for strengthening the low back and relieving sciatic nerve pain.
However, if you have a herniated disk, talk to your spine specialist before attempting this exercise as it does involve slight lower back extension.
This exercise is used to increase the muscle strength of the glutes, core, and lower back muscles.
- Lay on the floor facing down with your arms at your sides and legs fully extended. Your face should also be facing the floor, hovering slightly above. If this is too challenging, rest your forehead on a towel or pillow. This is your starting position.
- Then, slightly raise your right leg so that it hovers 4-5 inches above the ground. This will engage your glutes and lower abdominal muscles, put your leg in hip extension. Hold this position for 1-2 seconds, and slowly return to starting position. Then switch legs and repeat with the left leg and so on.
- Like the glute bridge, try to avoid anterior pelvic tilt here. It may be difficult but imagine “tucking your tailbone”.
- Complete 8-10 repetitions of this exercise on each side, with a 1-minute rest between sets.
4. Seated Nerve Glide
Nerve glides, or “nerve flossing”, is a method often used in physical therapy that takes your body through a certain range of motion that helps to free up injured nerves and improve mobility .
Nerve glides are great for relieving pain in nerves that are entrapped by surrounding soft tissues.
This exercise will help your sciatic nerve move freely when walking or doing daily activities, and help to decrease overall pain.
- Sit in a chair with a slouched posture with both feet touching the ground and arms at your sides.
- Then, tilt your head down so that you’re looking at your lap. Staring with your right knee, extend your right foot out in front of you while simultaneously looking up to the ceiling or sky.
- At this point, your right leg should be straight. Immediately lower your leg and head back to the first position.
- Instead of a hold, these glides will be more like presses or pulses. Repeat on the right leg for 5-8 repetitions, then switch to the opposite knee. After a few weeks of repeating this exercise every day, you should feel a decrease in tingling.
5. Dead Bugs
Dead Bugs are a great low-impact exercise for improving muscle strength in the lower abdominal muscles and core. These are a great alternative to a double leg lift!
Although it takes some intense concentration and coordination, this exercise is also great for improving blood flow throughout the body and neutralizing any pelvic tilt.
- Start by lying on the floor or on a supportive bed. Extend both arms so they are pointed at the ceiling, and raise both knees so your shins are facing the ceiling. This should look like you’re on all fours but on your back.
- Then, extend your right arm behind you until it is parallel with the floor, while simultaneously extending your left knee so that your left leg becomes straight and parallel to the floor.
- In this position, your left arm and right leg will stay in the starting position. Think about extending the opposite arm and opposite knee during this movement.
- Slowly return to starting position and repeat on the opposite side. Be sure that your low back stay pinned to the ground by tucking your pelvis.
- Switch to the opposite side each rep for a total of 10-12 repetitions. Rest for 1 minute and repeat for 3 sets.
If you have degenerative disc disease or a medical condition that prevents you from exercising, please seek medical advice from your doctor to create a plan that works for you.
What Sciatica Exercises Can Do For You
Although the exercises for sciatica pain listed above are low-impact exercises, it is beneficial for people with sciatic pain for a multitude of reasons.
Aside from pain relief, regular exercise can increase blood flow throughout the body.
This helps the necessary nutrients get to where they need to be in the body to promote healing and overall health.
Blood flow also prevents any extreme stiffness in a given area and can reduce soreness.
Additionally, physical activity can release endorphins in the brain and help to prevent the depression-like symptoms that sciatica often causes.
Strengthening and stretching the lower abdominal muscles may also improve pelvic tilt.
The pelvic tilt is a deviation in the pelvis bone that causes an arch in the back or rounding of the low back. With too much pelvic tilt, the sciatic nerve could become irritated.
Not to mention, regular physical activity can aid in weight management, which is important considering that obesity is a potential cause of sciatica nerve pain.
In fact, a study found that obese patients had significantly worse nerve function than people with a healthy weight (5).
Regular exercise can help tremendously with preventing obesity, and therefore, prevent the chances of developing sciatica.
Although the benefits of exercise for sciatica far outweigh the risks, any new pain that develops with exercising should be reviewed by a doctor or physical therapist.
What To Avoid With Sciatica
Although therapeutic exercise is a great way to treat and prevent sciatica, there are a few movements that should be avoided to ensure the sciatic nerve isn’t irritated further.
For example, unsupported forward flexion of the torso may put too much stress on the hamstring muscles or cause pain in the low back.
Not only does this refer to exercise, but also daily activities like emptying the dishwasher or tying your shoes.
Additionally, “double leg” exercises should be done with caution. A double leg lift can place a lot of pressure on the low back, and weak abdominal muscles can lead to injury.
With physical therapy and strengthening of the abdominal muscles, bending over may be done with more ease.
Twisting of the spine or torso should also be avoided in people with sciatica.
This can put too much physical stress on the spinal discs and cause the potential for injury. If you are suffering from degenerative disc disease, twisting at the spine should absolutely be avoided.
Although standing can be particularly painful for people with sciatica pain, sitting for prolonged periods of time can be detrimental to low back and leg pain.
Because the sciatic nerve runs from the low back to the heel, sitting on a hard, or even soft, surface directly puts pressure on this nerve.
The piriformis muscle can place pressure on this nerve, and cause more irritation.
Along with sitting, bed rest should be avoided in people with sciatic nerve pain.
For the same reasons as prolonged sitting, too much pressure on the nerve itself will cause pain.
Instead of bed rest, try going for a slow walk or doing a supine piriformis stretch.
Additionally, to prevent further irritation and pain, make sure that the surface you are sleeping on is a soft, but supportive bed.
The term sciatica may sound like a long and painful journey, but luckily, plenty of research has been done to find ways to treat and prevent this condition.
Unfortunately, up to 70% of people will experience back pain in their lifetime, and almost 10% of those are cases of sciatica (6).
These cases of sciatica are often caused by an issue in the spinal discs, a sedentary lifestyle, prolonged sitting, or obesity.
Unfortunately, this radiating back and leg pain won’t be avoidable by everyone, so it is important that sciatica exercises become more common in everyday activity.
Keeping your spinal disks in a healthy condition and participating in regular exercise can help to reduce the pain and suffering that comes along with sciatic nerve pain.
Stretching and strengthing the piriformis muscle, abdominal muscles, glutes, and hamstrings can help you live a pain-free, comfortable life!
- “Patients.” American Chiropractic Association. Web. 02 Sept. 2021.
- Kääriä, Sanna, Päivi Leino-Arjas, Ossi Rahkonen, Jouni Lahti, Eero Lahelma, and Mikko Laaksonen. “Risk Factors of Sciatic Pain: A Prospective Study among Middle-aged Employees.” European Journal of Pain. No Longer Published by Elsevier, 15 Dec. 2010. Web. 02 Sept. 2021.
- Written by Jean-Jacques Abitbol, MD and Mary Kate Phan; Reviewed by Brian R. Subach. “Causes of Sciatica and Sciatic Nerve Pain.” SpineUniverse. Web. 02 Sept. 2021.
- “Try It: Nerve Gliding.” Furthermore from Equinox. Web. 02 Sept. 2021.
- Nisargandha, Milind Abhimanyu, and Shweta Dadarao Parwe. “Does Obesity Lead to Sciatica Pain: A Comparative Study.” International Journal of Current Research and Review 12.23 (2020): 120-25. Print.
- Koes, B W et al. “Diagnosis and treatment of sciatica.” BMJ (Clinical research ed.) vol. 334,7607 (2007): 1313-7. doi:10.1136/bmj.39223.428495.BE