In order to achieve pain relief from sciatica it is first necessary to be aware of some important details that are often not included in general information about sciatica.
Sciatica is an umbrella term for multiple conditions that results in pain in the leg caused by nerve irritation. Since the causes of sciatica can be varied between individuals it is impossible to provide a one size fits all exercise or stretching regime that will get every person better with sciatica.
For some people one exercise might be fantastic at getting relief from symptoms, for another in might actually make their symptoms worse.
The overriding principle to be aware of regarding sciatica treatment and exercises is that anything you do should result in a reduction in leg symptoms. If you are doing an exercise that is resulting in an increase in leg symptoms, then this exercise is not the correct the exercise for you at this time.
Generally speaking the following can be useful in achieving pain relief from sciatica:
There are a number of things you can do to get relief from sciatica, including:
Rest: The first step in getting relief from sciatica is to rest. This means avoiding activities that put stress on your back, such as lifting heavy objects, bending over, and standing for long periods of time.
Heat: Applying heat to the affected area can help to reduce muscle spasm. Some people suggest using ice in order to reduce inflammation. I do not recommend ice because I think that the structures involved in sciatica are too deep to influence the inflammatory process in sciatica.
Medications: There are a number of medications that can help to relieve the pain and inflammation associated with sciatica. These medications include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, and muscle relaxants.
Physical therapy: Physical therapy can help to improve your range of motion and strength, which can help to reduce pain and improve function.
Epidural steroid injections: Epidural steroid injections can help to reduce inflammation and pain.
Surgery: In rare cases, surgery may be necessary to relieve sciatica.
The following are common exercises that people are prescribed for sciatica:
It is important to repeat the fact that some of these exercises may be helpful,and some may increase your symptoms. Do NOT persist with exercises that increase your symptoms.
This exercise is a relatively unloaded position which Safely helps the structures of the back to get moving. Most people with sciatica can successfully do this exercise without a significant increase in their sciatica symptoms. It may be that only one direction a spinal movement is comfortable in this continue with the comfortable direction and avoid the direction that increases the leg pain.
Start in a neutral four point position on your hands and knees. Round your back from an arched position as you pull in your abdominal muscles. It should feel like a gentle stretch to your lower back. Don't over-arch your back; keep it comfortable, there should NOT be an increase in leg pain. After you have rounded your back, form an arch with your lower back.
Single Leg Hip Flex
Lie flat on your back, and bend your knee towards your chest. Hold this position for 5 seconds and feel a gentle stretch in your back.
Lie on a bed or the floor. Bend your knees and keeping your feet flat on the bed or floor, rotate your hips to one side creating a rotation through your lower back. Only go as far as feels comfortable, you do not need to get your knees to the floor. Return to the opposite side. This is an excellent lower back mobility exercise. There should NOT be an increase in leg symptoms. Alternate to both sides unless there is clearly a direction that feels relieving - if this is the case, only move to the comfortable side, then return to the central position each time.
Lie flat on your back, and engage your stomach muscles by drawing your belly button inwards (towards your spine), while flattening your spine against the floor, then relax. There should NOT be an increase in leg symptoms. Do not continue with this exercise if there is an increase in leg symptoms.
Lie on your front, and rest on your forearms. Straighten your arms making your back very arched. Minimal hold. Start gently with this exercise as it can cause some back stiffness when you first begin.
Kneel down on the mat, and rest your buttocks on your heels. As you keep your buttocks on your heels, roll forwards and slide your arms forward creating a gentle stretch and lengthening in your back.
Lie on your back, and bend your knee. Place your ankle across your knee. To make the stretch stronger, pull your ankle towards you, while pushing away with the opposite knee (the side getting stretched). You should feel a stretch in your bottom.
The Sciatica Stretching Myth
Most generic information about sciatica will include stretching. I do not believe that this represents helpful advice because stretching can often increase symptoms considerably if not done correctly. When an individual is suffering from sciatica, some degree of nerve irritation is present. This irritation often results in a restriction of movement in the nerve system. It is therefore likely when stretching, that the nerve is being pulled against a restriction. This will likely result in an increase in leg symptoms.
If you have sciatica I would not advise the following, especially if your sciatica symptoms are severe:
Excessive or repeated bending forwards
Sit and reach stretches
Nerve Glide (flossing) exercises
When sciatica symptoms are nearly resolved, the exercises mentioned above can become useful.