8 Physical therapy exercises for sciatica

Radiating pain caused by sciatica can be enfeebling to manage in daily tasks as it does not get better with rest. The sciatic nerve is of considerable length and the body's most extended spread out nerve. It starts from the lower back, hips and then branches out to both legs. It is the widest nerve in the body at 2cm in diameter.

The pain of sciatica is excruciating and shooting pain that travels down the leg. It is an umbrella term and symptom of underlying pathology. The pain is usually caused by a pinched nerve in the lower back or due to inflammation of the piriformis muscle surrounding the sciatic nerve.

Suffering from sciatica can affect your daily activities; simple tasks like walking, getting up from a chair or sitting down can trigger pain down the leg in an instant.

How can exercises help me ease sciatic pain?

Sciatica is a broad term and accompanies many musculoskeletal disorders under its umbrella. People tend to focus on over the counter drugs, whereas it can be easily prevented and managed by adding simple exercises to your life routine.

Exercise helps increase muscle strength, increase blood flow in all muscle fibres, enhance soft tissue health, and prevent nerve impingement. Spending 30 minutes a day or performing exercises intermittently between work can have remarkable effects on your health.

Improve and increase muscles strength; strengthening the surrounding muscles and targeting those muscle fibres that are atrophied helps reduce the load on the lumbar disc. It also helps push the discs back into their place and relieve pressure on your sciatic nerve.

Increase blood flow; increasing blood flow to dormant muscle fibres helps reduce inflammatory substances and increase the supply of nutrients in those muscles.

Improve soft tissue health; prolonged sitting in the same posture and decreased joint mobility adds more negative pressure on the discs. The pressure is targeted at one point only, which causes herniation over time. Some mobility and simple exercises can reduce the incidence and occurrence of these problems.

Prevent nerve impingement; when you adopt the same posture, some muscles have increased load compared to other muscles. As a result, they are inflamed with increased pressure. This inflammation pinches the sciatic nerve at any level in the lower limb. Physical therapy exercises reduce stiffness, inflammation and enhance flexibility in the nerve.

Release hormones; Exercise also improves mood, release happy hormones and helps clear up mind fog during work. It gives your energy to finish work on time efficiently.

8 Exercises to prevent sciatica

Lower trunk rotation (hook lying position)

• Lay down on your back in a supine position

• Your knees should be bent in an upright position

• Both of your feet must be flat on the ground

• Hold both of your knees with hands and rotate on one side

• Hold for 5 seconds

• Gentle stretch should be felt on the opposite side of the back

• Then to engage abdominal muscles, contract the abdominal muscles and hold for 3 seconds

• Repeat 10 times

Pelvic tilt (hook lying position)

• Lay down on the exercise mat in the supine position

• Bend the legs

• The arms should be on your side

• Tighten up your stomach muscles and exhale air

• Press your back on the floor

• Tilt your pelvis a bit upward

• Hold on to this position along with holding your breath

• Hold for a 3 to 5 seconds

• Release and relax

• Repeat again

• There should be at least 10 repetitions

Extension exercise

• Lie in prone position on your stomach

• Hold your trunk upwards with elbows bent on your sides supported with floor

• Palm facing downward

• By engaging the abdominal muscles, inhale air pulling your belly inward

• Gradually raise your trunk supported by elbows

• Hold for 15 to 20 seconds and take deep breaths during this time

• Repeat 5 times

Sciatic stretch

• Lie in a supine position

• Keep a towel or pillow under your head

• Keep both of your knees bent

• Engage the abdominal muscles by inhaling air through the abdomen as in pulling your belly button inward

• Keep one leg bent

• Raise your other leg as far as you can towards the ceiling

• Grab your thigh and assist in straightening your leg

• Hold for 3 seconds

• Then relax and repeat

Piriformis stretch (reclining pigeon pose)

• Lay down in supine position

• Bend both your legs

• Bring the affected over the unaffected leg

• The ankle should be supported on the knee cap of the uninvolved leg

• Grab the uninvolved leg on which the ankle is placed

• Stretch it towards yourself

• Hold for 3 seconds

• Repeat 5 times

Alteration Piriformis superpose

• Lay down in prone position

• Bend your affected leg and place it on the unaffected leg

• Stretch your hands outwards

• Stretch as far as you can

• Hold for 3 seconds

• Repeat 5 times

Figure 4 stretch seated

• Adapt a sitting position on a chair

• Bring your affected leg over the unaffected leg

• The ankle of the affected leg should be touching the knee cap of the unaffected leg

• Stabilize your leg with both hands

• One hand should be keeping the bent leg in position by pushing it downward

• With the support of the other hand, lean a bit forward on your trunk

• Bend as much as you can comfortably handle

• Relax and repeat

• Hold this stretch for 5 seconds

• Repeat it 10 times

Outer hip stretch (lying)

• Lay down flat on the back in the supine position

• Your shoulders should be touching on the ground

• Move your affected leg over the unaffected leg in a bent position

• Gradually apply downward pressure

• You will feel stretch on your hips

• Hold for 5 seconds

• Repeat 5 times

Groin stretch (butterfly stretch)

• Lay down flat in the supine position

• Slightly bend your knees

• Keep your feet together

• Allow your knees to fall on the outer side, opposite to each other

• You will feel a stretch on the inner side of the thigh and groin region

• Hold for 20 seconds

• Repeat 3 times

Knee to chest

• Lie supine on your back

• Bend legs so that your knees point upwards

• Feet should be flat on the floor

• Bring one knee bent towards the chest

• Keeping the other leg straight

• Hold for 5 seconds

• Repeat 10 times on both legs

Summing up

Sciatica flares up when you adopt the same posture for an extended period and spend most hours in that position. Sitting for an extended period in driving a car or doing office work causes sciatic nerve impingement. It can be due to various musculoskeletal disorders, e.g. disc herniation, discitis, piriformis syndrome or inflammation in surrounding muscles.

The optimal goal of physical therapy exercises is to target the root cause of the pain. Afro mentioned exercises provide beneficial results and take a few minutes to perform. However, consult a physical therapist before performing exercises on your own.