As many as 40% of people will get sciatica, or irritation of the sciatic nerve, at some point in their life. This nerve comes from either side of the lower spine and travels through the pelvis and buttocks. Then the nerve passes along the back of each upper leg before it divides at the knee into branches that go to the feet.
Anything that puts pressure on or irritates this nerve can cause painthat shoots down the back of one buttock or thigh.
The sensation of pain can vary widely. Sciatica may feel like a mild ache; a sharp, burning sensation; or extreme discomfort. Sciatica can also cause feelings of numbness, weakness, and tingling.
Pain may be made worse by prolonged sitting, standing up, coughing, sneezing, twisting, lifting, or straining. Treatment for sciatic pain ranges from hot and cold packs and medications to exercises and complementary and alternative remedies.
Physical Therapy for Sciatica
Sciatica pain may make it difficult to be active. But bed rest is not recommended as a mainstay treatment. To manage new sciatica pain, you may find that certain positions and activities are more comfortable than others.
If symptoms are not severe but persist beyond a couple of weeks, your doctor may recommend physical therapy. The proper exercises may actually help reduce sciatic pain. They can also provide conditioning to help prevent the pain from coming back.
The exercises recommended will depend on what’s causing the sciatica. It’s important to work with a specialist who has experience working with people with sciatica. It’s also important to do the exercises exactly as directed.
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. 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.
- 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.
- 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.