Physical therapy exercises incorporating a combination of strengthening, stretching, and aerobic conditioning are a central component of almost any sciatica treatment plan.
When patients engage in a regular program of gentle exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of pain.
General Exercises for Sciatica
Sciatica exercises usually focus on three key areas: strengthening, stretching, and aerobic conditioning.
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 (buttock) and hip muscles.
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.
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.
Hamstring stretching is almost always an important part of a sciatica exercise program. Most people do not stretch these muscles, which extend from the pelvis to the knee in the back of the thigh, in their daily activities.
Another stretch that is often helpful in easing sciatica is the Bird Dog move: After getting on their hands and knees, individuals extend one arm and the opposite leg. The arm and leg extensions are then alternated. A more advanced version of this exercise is the Plank Bird Dog move, in which the extensions are done once the person is in the plank position on their hands and toes.
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 also has the unique benefit of releasing endorphins, the body's natural pain killers, which helps reduce sciatic pain.
For anyone in chronic pain or with a relatively high level of sciatica pain, one option for gentle exercise is water therapy, which is a controlled, progressive exercise program done in a warm pool.
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Exercises for Specific Sciatica Conditions
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
- Stretches and 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 generally not advised, as prolonged rest or inactivity can increase pain and will lead to deconditioning. Regular movement is important to provide healing nutrients to the injured structures that are causing the pain.
There are several 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.