Sciatica

The term sciatica describes the symptoms of leg pain—and possibly tingling, numbness, or weakness—that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of each leg.

Sciatica is often characterized by one or more of the following symptoms:

    • Constant pain in only one side of the buttock or leg (rarely in both legs)
    • Pain that is worse when sitting
    • Leg pain that is often described as burning, tingling, or searing (versus a dull ache)
    • Weakness, numbness, or difficulty moving the leg, foot, and/or toes
    • A sharp pain that may make it difficult to stand up or walk
  • Pain that radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot)

The sciatic nerve is the largest single nerve in the body and is made up of individual nerve roots that start by branching out from the spine in the lower back and then combine to form the “sciatic nerve.” Sciatica symptoms occur when the large sciatic nerve is irritated or compressed at or near its point of origin.

    • The sciatic nerve starts in the lower back.
    • At each level of the lower spine a nerve root exits from the inside of the spinal canal, and each of these respective nerve roots then come together to form the large sciatic nerve.
    • The sciatic nerve runs from the lower back, through the buttock, and down the back of each leg.
  • Portions of the sciatic nerve then branch out in each leg to innervate certain parts of the leg—the thigh, calf, foot, and toes.

Physiotherapy exercises incorporating a combination of strengthening, stretching, and aerobic conditioning are a central component of almost any sciatica treatment plan.

When patients engage in a regular program of gentle exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of pain.

Sciatica exercises usually focus on three key areas: strengthening, stretching, and aerobic conditioning.

  • Strengthening exercises

Many exercises can help strengthen the spinal column and the supporting muscles, ligaments, and tendons. Most of these back exercises focus not only on the lower back, but also the abdominal (stomach) muscles and gluteus (buttock) and hip muscles.

Strong core muscles can provide pain relief because they support the spine, keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.

  • Stretching exercises

Stretching is usually recommended to alleviate sciatic pain. Stretches for sciatica are designed to target muscles that cause pain when they are tight and inflexible.

Hamstring stretching is almost always an important part of a sciatica exercise program. Most people do not stretch these muscles, which extend from the pelvis to the knee in the back of the thigh, in their daily activities.

Another stretch that is often helpful in easing sciatica is the Bird Dog move: After getting on their hands and knees, individuals extend one arm and the opposite leg. The arm and leg extensions are then alternated. A more advanced version of this exercise is the Plank Bird Dog move, in which the extensions are done once the person is in the plank position on their hands and toes.

  • Low-impact aerobic exercise

Some form of low-impact cardiovascular exercise, such as walking, swimming, or pool therapy is usually a component of recovery, as aerobic activity encourages the exchange of fluids and nutrients to help create a better healing environment.

Aerobic conditioning also has the unique benefit of releasing endorphins, the body’s natural pain killers, which helps reduce sciatic pain.

These types of exercises may be done separately or in combination. Examples of types of exercise that may include both strengthening and stretching include yoga, and Pilates.

For anyone in chronic pain or with a relatively high level of sciatica pain, one option for gentle exercise is water therapy, which is a controlled, progressive exercise program done in a warm pool.