Sciatica First Aid: Exercise for Long-term Pain Relief

Once pain control for sciatica has been achieved, gentle stretching of the affected area, and low-impact exercise, (such as walking two to three miles) will help bring healing nutrients to the affected area and help to restore function.

As with any back treatment, care should be taken to not further aggravate the situation. It is always advisable to consult with a doctor with any questions or concerns that may arise during the course of care.

For long-term relief of sciatica pain, most experts agree that a regular routine of stretching and sciatica exercises is crucial.

• Stretching. Patients may find it takes several weeks or months to develop flexibility in the spine and soft tissues, but may also find that the stretching helps bring sustained pain relief. The spinal column and its contiguous muscles, ligaments and tendons are all designed to move, and limitations in this motion can accentuate pain and make one more susceptible to re-injury.
  
  Stretching exercise should focus on increasing flexibility in the disc, muscles, ligaments, and tendons. Additionally, it is important to stretch muscles not directly involved with the injured area, such as the arms and legs. For example, the hamstring muscles play a major role in lower back pain, as it is clear that hamstring tightness limits motion in the hip, which increases stress across the low back, especially during forward bending.
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• Strengthening. Building strength is also important to help prevent and/or lessen future recurrences of sciatic pain. Specific exercises designed to strengthen the “core” or trunk muscles are most important in the management of low back pain.
  
  Depending on the underlying cause of sciatica (such as a herniated disc vs. a degenerated disc), different exercises may be prescribed. Two common forms of strengthening exercises to treat sciatica are McKenzie exercises and Dynamic Lumbar Stabilization exercises. Learning which exercises to do, as well as how to do them correctly, is typically best learned with the help of a qualified spine specialist.

Manipulation and physical therapy

Another treatment option that can be helpful for many causes of for sciatica is manipulation by a qualified health care provider (most commonly a chiropractor or an osteopath). The type of manipulation, amount of force, the direction of the manipulation and the frequency of application are taken into consideration when managing patients complaining of sciatica. Combining this with various forms of physical therapy such as exercise therapies can be very effective.

Other considerations with sciatic pain

Though uncommon, when the sciatic condition worsens, it is most important to obtain a prompt evaluation. This is especially true if progressive muscle weakness, foot drop, or loss of bowel or bladder control occur, as these symptoms require immediate emergency attention and permanent problems can result if not managed promptly. In general, whenever questions arise about the course of care and associated signs and symptoms, health care provision should be obtained and the questions answered.

The good news is that most cases of sciatica will resolve naturally within a few weeks. The treatments described here can help alleviate pain until things return to normal, and help speed recovery, as well as avoid recurrence. Every patient is different of course, and not all sciatica treatment options will work for all cases of sciatica.

Sciatic pain can be mild and intermittent, but this type of pain along the large sciatic nerve can also be searing and unbearable. For severe cases of sciatic pain, it makes sense to get a firm or definitive diagnosis regarding the underlying cause of the sciatica (e.g. a herniated disc, degenerative disc disease, spondylolisthesis) and discuss additional treatment options with a spine specialist. In addition to the remedies discussed above, there are a wide variety of additional treatment options, including injections, surgery, and more.

• Article written By:
• Randall Schultz, MD

May 24, 2004

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