From verywellhealth.com
Learn which ones can help or make sciatica worse
Sciatica is a painful condition that may be relieved by specific stretches and exercises that target the lower back and lumbar spine. Doing so can reduce pain in the back, hip, and outer leg caused by compression of a sciatic nerve. This includes sciatic pain commonly experienced by older adults, people with pregnancy, or those with obesity.
With that said, there are exercises that can help and those that can make sciatica symptoms worse.
This article will help you understand the causes of sciatica and some of the sciatica stretches and exercises that are safe and effective. It will also list some of the exercises to avoid while recovering from a condition that may affect up to 40% of people at some point in their life.
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Verywell / Nez Riaz
What Is Sciatica?
Sciatica occurs when the compression of the bones of the spine or the narrowing of the spinal canal (which houses the spinal cord) places pressure on the sciatic nerve, resulting in a pinched nerve. This may be due to slipped disc, bone spurs, or a lower back injury.
The sciatic nerve is the longest nerve in the body. It runs from the lumbar spine of the lower back down the leg and to the foot. When it is compressed, irritated, or inflamed, it can cause symptoms like:
- Sharp burning pain in the upper buttock
- Shooting pain in the back, hip, and outer side of the leg
- Tinging or pins-and-needles sensations
Sciatica Risk Factors
The modifiable and non-modifiable risk factors for sciatica include:
- Being over 50
- Obesity
- Smoking
- Pregnancy
- Occupations or sports where back muscles or heavy weight are involved
Sciatica often gets better on its own with time, but some stretches may help speed up the process. Gentle stretching can help loosen lower back muscles that tend to "seize" following an injury. They can also help if you've been sitting for a long period and are overweight (or are carrying extra weight during pregnancy).
There are certain rules you should follow to reap the benefits of gentle stretching for sciatica:
- Always warm up with light aerobic activity before stretching.
- Avoid stretches that involve bending forward or rotating at the torso.
- Do not force a stretch. If you feel resistance, don't push yourself.
- If you feel the muscle tense up, stop, relax the muscle, then try again.
- Never stretch cold muscles. If you can't do warm-up exercises, apply moist heat for 15 to 20 minutes before stretching.
- If you experience pain doing a particular stretch, stop doing it.
The recommended stretches used to relieve sciatica are all done on the floor lying on your back. The only equipment you would need is a belt.
Single Knee-to-Chest Stretch
The single knee-to-chest stretch is done on the side of the body with sciatica as well as the side of the body without.
To do the single knee-to-chest stretch:
- Lie flat on your back.
- Wrap your hands around one knee and gently pull to your chest as close to your chest as possible until you feel a stretch in your lower back.
- Keep the opposite leg relaxed in a comfortable position, either with your knee bent or your leg extended.
- Hold for 15 to 30 seconds.
- Lower the leg and repeat on the opposite side.
Double Knee-to-Chest Stretch
This is a variation of the single knee-to-chest stretch. For this stretch, you need to focus on keeping your back fat on the floor.
To do the double knee-to-chest stretch:
- Lie flat on your back with your knees bent and your feet flat on the floor.
- Wrap your hands around both knees and gently pull to your chest as close to your chest as possible until you feel a stretch in your lower back. Do not force the stretch.
- Keep your back flat on the floor. Avoid curling up into a ball. This helps centre the stretch on the lower back muscles.
- Hold for 15 to 30 seconds.
- Lower your legs and relax.
Side-to-Side Knee Stretch
This stretch is particularly useful for people with a pinched spinal nerve as it gently rotates the lumbar spine.
To do the side-to-side knee stretch:
- Lie flat on your back with your knees bent and your feet flat on the floor.
- Extend your right arm level with your shoulder.
- Gently bring both knees to the left as far as you can go without pushing.
- Hold for 15 to 30 seconds.
- Return your knees to a central, neutral position.
- Repeat with the opposite, extending your left and twisting to the right.
Supine Hamstring Stretch
The supine hamstring stretch activates the lower back muscles and hamstring muscle with the aid of a belt.
To do the supine hamstring stretch:
- Lie flat on your back.
- Lift your right foot and wrap either a belt or towel under the arch of the foot. (The belt would need to be long enough so that you can hold the ends and keep your leg straight.)
- Bend the left knee and rest that foot comfortably on the floor.
- Holding both ends of the belt, gently pull and lift your right foot toward the ceiling, keeping the leg straight.
- Keep your back flat on the floor. Avoid twisting to the side or pulling too hard. You should feel a stretch without any pain or discomfort.
- Hold for 15 to 30 seconds.
- Lower the leg and repeat on the opposite side.
Gentle Exercises for Sciatica
Once you've warmed up, there are some gentle exercises that can further help ease sciatica pain. These same exercises can be used to help prevent sciatica in the future by keeping your lower back strong and flexible.
Exercises for sciatica are really no different than for any other training program. It should involve both aerobic activities to improve endurance and strength training to activate core muscles that provide lower back stability.
Low-Impact Aerobics
Low-impact aerobic activity increases circulation and helps to loosen stiff muscles. Start by warming up with 10 to 15 minutes of low-impact aerobic activity, such as:
- Riding a stationary bike
- Swimming
- Walking
- Water exercises
Your lower back, legs, or hips may feel stiff or a little achy when you start your warm-up. This is normal. The muscles should loosen up after a few minutes.
You should do a low-impact aerobic activity at least five times a week and slowly increase how long you do it. As long as you are not feeling pain, you can do this type of exercise daily.
Strength Training
For sciatica, strength training does not mean resistance training or weight training. Rather, it means using focused movements against gravity to build the muscles that support the spinal column.
The trick is to add activity gradually and to slow down if any pain or discomfort is felt. This approach is known as symptom-guided exercise.
After stretching and warming up with aerobics, move on to exercises that strengthen core muscles. All of the recommended exercises are done on the floor.
Pelvic Tilt
The pelvic tilt is one of the most effective ways to strengthen the muscles of the lumbar spine. It is also very safe to do even if you are pregnant.
To do the basic pelvic tilt:
- Lie on your back with your knees bent and your feet flat on the floor.
- Place your arms alongside your torso, palms facing down.
- Gently tilt your tailbone toward the ceiling, tightening your stomach muscles.
- Hold for three to five seconds.
- Lower your tailbone.
- Repeat for a total of eight to 12 reps.
The Bridge
The bridge requires a bit more strength and is something may need to ease into. If you have trouble, start with one or two only and add another rep every day.
To do the bridge:
- Lie on your back with your knees bent and your feet flat on the floor.
- Place your arms alongside your torso, palms facing down.
- Gently lift your buttocks and back, arching your back as far as it can comfortably go.
- Hold for several seconds.
- Lower your buttocks and back.
- Repeat for a total of eight to 12 reps.
Modified Plank
The modified plank is a holding exercise that strengthens the abdominal muscles and, in turn, the back, obliques, and pelvic floor muscles.
To do the modified plank:
- Lie on your stomach.
- Raise yourself up so that you're resting on your forearms and knees.
- Position your elbows directly under your shoulders, and keep your head and neck aligned with your spine
- Tighten your abdominal muscles.
- Without moving your elbows or knees, create resistance by pressing them toward each other. You should feel tension without pain in all of your core muscles.
- Hold for five to 10 seconds.
- Relax and return to the start position
- Repeat for a total of eight to 12 reps.
As you get stronger, you can do two or more sets of these and add other core-strengthening exercises to the routine.
Strengthening exercises for sciatica should be done three or four times a week, but never two days in a row.
Exercises to Avoid If You Have Sciatica
Keeping active can loosen tight muscles and help you feel better. However, some activities and movements can put pressure on the lower back, hips, and/or thighs and make symptoms worse.
As a general rule, you should avoid squatting, twisting, running, jumping, or any high-impact activity if you have sciatica. You should also avoid bending forward with straight legs or any seated or lying exercise that requires you to lift both legs off the ground at the same time.
Here are specific exercises to avoid if you have sciatic nerve pain:
- Bent over row: This s a weightlifting exercise that strengthens muscles in the back. It can place extreme stress on the sciatic nerve, particularly if your back is rounded.
- Seated hamstring stretch: This is done with one leg stretched and the other leg bent. As you bend forward to stretch the hamstring, the sciatic nerve can be pulled and hurt.
- Forward bends: Avoid exercises that require you to bend forward from the waist, such as the downward dog used in yoga. This can hyperextend the back and sciatic nerve.
- Double leg lifts: Exercises that require you to lift both legs at the same time while lying can aggravate the sciatic nerve because the lower back takes on the weight of your legs.
- Squats: Full body squats put pressure on the lower back, aggravating sciatic pain. Squats also put pressure on the thighs and legs, worsening the sciatic pain in the leg as well.
- Deadlifts: Straight leg deadlifts (or Romanian deadlifts) stretch on the hamstrings and lower back with powerful force, placing undue stress on the sciatic nerve.
- Abdominal stretches: Abdominal stretches, including the cat-cow and cobra poses in yoga, create pressure on the lower back. This can stress the spine and worsen sciatic pain.
- Leg circles: Exercises that involve swinging your leg in a full circle can wrench the hamstrings suddenly, which can make sciatica symptoms worse.
- High-impact exercise: Exercises that put stress on the hips and pelvis can also aggravate sciatica. You should avoid running, jumping, high-impact aerobics, and horseback riding.
Summary
Sciatica often goes away on its own over time, but some kinds of exercise can help the pain and some can make it worse. Exercises that relieve sciatica include low-impact aerobic activities like walking, certain strengthening exercises, and gentle stretching.
Exercises that can make sciatica worse include high-impact activities like running and aerobics, hamstring stretches, and some core-strengthening exercises.
A Word From Verywell
The most important thing to remember about exercise and sciatica is not to overdo it. Once the sciatic nerve is already irritated, it doesn't take much to trigger symptoms. Listen to your body and stop or slow down if you experience any pain.
If you aren't sure how to do exercises on your own, talk to your healthcare provider. They may refer you to a physical therapist who can design an exercise program that's best for you.
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