Physical Therapy and Exercise for Sciatica

Physical therapy exercises – incorporating strengthening, stretching and aerobic conditioning - are a central component of almost any sciatica treatment plan.

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

Sciatica exercises usually focus on three key areas:

• 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 (buttocks) and hip muscles. Taken together, these 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. See Hamstring Stretching.

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

The specific sciatica exercises will depend on the underlying medical condition causing the sciatica pain, as well as a number of other factors, such as the patient’s level of pain and overall conditioning.

For information and illustrations on exercises for different causes of sciatica, see:

• Exercise for Sciatica from a Herniated Disc
• Exercise for Sciatica from Spinal Stenosis
• Exercise for Sciatica from Degenerative Disc Disease
• Exercise for Sciatica from Isthmic Spondylolisthesis
• Exercise for Sciatic Pain from Piriformis Syndrome
• Sacroiliac (SI) Joint Exercises for Sciatic Pain.

When sciatica pain is at its most severe, patients may find the pain hard to bear and may need to rest for a day or two. However, resting for more than one or two days is usually not advisable, as prolonged rest or inactivity can make the sciatic pain worse and will lead to deconditioning. Regular movement is important to provide healing nutrients to the injured structures that are causing the pain.

Back Exercise
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There are a number of types of health professionals who specialize in providing appropriate physical therapy and exercise programs and instruction, including physical therapists, chiropractors, physiatrists (also called physical medicine and rehabilitation physicians), and qualified certified athletic trainers. See more in Sciatica Exercises for Sciatica Pain Relief.

• Article written by:
• Stephen H. Hochschuler, MD

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