5 Exercises to Help Sciatica

From health.usnews.com

The right exercises can make it easier to manage sciatic pain

The main nerve in your leg is called the sciatic nerve. It also happens to be the largest nerve in your body. The sciatic nerve goes from the rear of your pelvic area down through the back of your thigh. If you have pain in this area of your body, it's called sciatica or lumbar radiculopathy.

The nerve pain from sciatica also can affect several muscles, including:

• The piriformis muscle, which is a muscle that attaches the hip to the spinal area.
• The gluteus medius and gluteus maximus, often called your glutes.
• The hamstring muscles in your legs.
• The calf muscles.

If you've ever had sciatic pain, you're not alone. An estimated 40% of people in the U.S. experience the discomfort of sciatica at some point. There are certain exercises that can help manage the pain.

Those exercises for sciatica include:

• Piriformis stretch.
• Nerve mobilizing stretch.
• Leg raise.
• Trunk rotations.
• Back extension.

                                                                       (Getty Images)

Symptoms and Causes of Sciatica

The symptoms of sciatica can range from mild pain in one specific area along the sciatic nerve region or intense pain along the entire nerve. Some people describe it as a shooting pain or pain that feels like an electric shock. The pain can be bad enough to affect your daily functioning, says Dominique Gummelt, a certified personal trainer in Berrien Springs, Michigan, who works with the health and fitness app Verv.

Other symptoms of sciatica include:

• Tightness or soreness.
• Numbness on the affected side of the body.
• Muscle weakness.
• For severe cases, trouble controlling your bladder or bowels.

The most common cause of sciatica is a problem with a disc in your spine, such as a bulging or ruptured disc. The bones in your spine are called vertebrae. Between each vertebrae is a disc that helps to cushion the bones and prevent them from rubbing together. A bulging disc has moved somewhat outside of its normal position. A ruptured disc has protruded further because of a tear in the spinal column.

In both cases, the injured discs can end up leading to pain in the sciatic nerve, says physical therapist Dean Volk, of Volk Physical Therapy, in Charleston, South Carolina. Volk is also the author of "Sciatica Relief Now." The pain can shoot down from the area with the disc injury to the sciatic nerve.

Other things can also aggravate sciatic pain, including:

• Aging. "As we get older, we don't move freely like children do anymore," says Neil Holmes, a licensed massage therapist at MuscleEze Medical Massage Therapy in Bradenton, Florida.
• Too much sitting or a sedentary lifestyle. Prolonged sitting on top of a degenerated area can irritate the sciatic nerve, says chiropractor Allen Conrad, of Montgomery County Chiropractic Centre in North Wales, Pennsylvania.
• Activities that involve excessive twisting or lifting. Some examples of sports that include a lot of twisting include tennis or golf, Conrad says. This excessive twisting or lifting can be harmful if you don't have proper form.
• Not having strong core muscles. You may think of your core as only your ab muscles, but the core actually includes your back, abs, glutes and hip flexors. A lack of flexibility or lack of range of motion in your core can make you more prone to sciatica, Gummelt says.

If you have sciatic pain, you should see your primary care doctor. They may refer you to a specialist in pain management, neurology or orthopaedics. Some people will see a chiropractic doctor or a physical therapist for sciatica pain. If you've gone multiple days in a row with shooting pain or if the pain wakes you up, it's time to seek professional help, Holmes says.

Some people have sciatic pain severe enough that they have to go to an ER.

Finding Relief for Sciatica

Typical treatments for sciatic pain include:

• Medications, such as pain relievers or nerve-blocking drugs.
• Chiropractic adjustments.
• Medical massage.
• The use of a foam roller or tennis ball rubbed in the glute area to release those muscles and provide pain relief. Holmes has seen this work well for many patients.
• Surgery in severe cases.
• Exercise. The right exercises can help lead to more permanent results in tackling sciatica, Volk says.

A full exercise program that includes low-impact cardio activity, such as walking or swimming, to get the heart pumping faster, strengthening exercises and stretches are ideal, Gummel recommends.

Check with your doctor first to make sure you're OK to exercise. If needed, work with a health professional such as a physical therapist to tailor an exercise program for you. Once you're cleared to exercise, here are a few stretches that can provide relief and help prevent future flare-ups.

5 Exercises for Sciatica

Here are five exercises that can help you manage pain from sciatica. Some health professionals recommend stretching the side of your body affected by sciatica. Others, such as Volk, believe the exercises should be done on the side of your body not affected by sciatica. You'll find examples below of both approaches. Always modify these exercises per your doctor's recommendations.

1. Piriformis Stretch
Stretches that focus on your piriformis muscle, located in your buttocks and connecting the hips to the spinal area, can reduce sciatic symptoms, Conrad says.

Lie on your back and cross the leg of the side affected by sciatica on top of the other leg – with the ankle of your crossed leg roughly sitting above the knee of the leg that is flat on the floor. Put your hands on the knee and ankle of the crossed leg on top to pull it toward your body. Hold for 30 seconds and then repeat with the same leg.

To perform this sitting down, cross the affected leg over the other, with your ankle resting on the top of your knee area. Lean forward for 30 seconds and repeat.

Another variation is to perform this stretch with the side of your body that is not affected by sciatica (your non-painful side). While sitting, you can also perform this by gently bouncing the top of your body up and down 20 times instead of statically holding the stretch.

2. Nerve Mobilizing Stretch
Lie on your back. Bend both knees toward your chest, placing an arm around each knee. Hold for 20 to 30 seconds. Remain on your back and relax one leg while bending the knee of the other leg toward your chest. Use your arms to pull that leg toward your chest. Repeat two to four times for each leg.

3. Leg Raise
While sitting down, stretch out the leg on the painful side of your body, placing your heel on the floor and toes pointing up. Try to raise the leg up to see how high it will go. Don't try to lift that leg if you are in active pain. After this, return that leg to a relaxed and regular seated position.

Next, stretch out the leg on the non-painful side of your body. Put your arms around the back of the leg, slightly above the knee area. Pull that leg toward you, and lift it as high as you can. Do this 25 times. Repeat for two sets of 25. If there is any pain while doing this, stop. If needed, you can do fewer reps. After each set of 25 reps, check on the leg on the side of your body affected by sciatica to see if you can lift it any further than you previously did.

4. Trunk Rotations
While sitting with your feet flat on the floor, try twisting your trunk toward the side of your body affected by sciatica. Stop immediately if there's any pain. Next, twist as far as you can to the other side of your body not affected by sciatica. Twist toward that side of your body 20 to 25 times. Repeat for a second set of 20 to 25 times. When finished, return to the opposite side of your body to see if you're able to twist any further.

5. Back Extension
Lie on your stomach and push yourself upward with your arms extended. Keep your neck and head neutral, aiming to get an arch in your back. Keep your arms at a 45-degree angle. Hold for 20 to 30 seconds. If this is difficult for you, lift your upper body for only two to four seconds, return to the ground and repeat 10 times.

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