Leg pain or sciatica from a herniated disc is caused by disc material protruding backward and inflaming or compressing a nerve root, which in turn causes pain to radiate along the sciatic nerve.

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When a lumbar disc herniates, it leaks some of its jelly-like nucleus into the spinal canal
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Sciatica Exercises for a Herniated Disc

Specific exercises for leg pain and other symptoms from a lumbar herniated disc are sometimes prescribed according to which positions will cause the symptoms to move from the leg (or foot) and into the low back. This process is called centralization and is commonly encouraged as part of the McKenzie Method exercise program.

For many patients, centralizing low back pain is accomplished by getting into a backwards bending position, called extension exercises or press-ups:

  • The low back is gently placed into extension by lying on the stomach (prone position) and propping the upper body up on the elbows, keeping hips on the floor. This should be started slowly and carefully, since this position may be painful at first.
  • Hold the press-up position initially for 5 seconds, and gradually work up to 30 seconds per repetition. Aim to complete 10 repetitions.

After practicing this exercise, the spine specialist or physical therapist may recommend a more advanced extension:

  • From the prone position, press up on the hands while the pelvis remains in contact with the floor. Keep the lower back and buttocks relaxed for a gentle stretch.
  • This position is typically held for 1 second, repeated 10 times.

If lying flat causes too much pain, a similar exercise can be done standing:

  • Place both hands on the hips for support and lean back as far as is comfortable while still feeling the lower back stretch backward. Be sure not to stretch so far that falling is a risk.
  • Hold this position for 5 seconds, gradually working up to holding for 30. Repeat 10 times.

The prone position is usually preferred above a standing position, but it may be advised to begin standing then move to lying down.

These extension exercises are done regularly, about every 2 hours. More importantly, the spine specialist may recommend avoiding bending forward. This position tends to counteract the effects of the extension exercises. The specialist may ask the patient to correct any forward flexed positions immediately by doing an extension exercise.


Advanced Sciatica Exercises for Abdominal Muscles and Back Muscles

As the pain works out of the leg and centralizes in the low back, the exercises typically are advanced to strengthen the low back and abdominal muscles to prevent recurrences of sciatic pain caused by the herniated disc.

Low back muscle strengthening exercises:

  • Upper back extension. In the prone position with hands clasped behind the lower back, raise the head and chest slightly while looking at the floor (stay low). Begin by holding position for 5 seconds, and gradually work up to 20 seconds. Aim to complete 8 to 10 repetitions.
  • Prone arm and leg lifts. In the prone position with the head and chest lowered to the floor, lightly raise an arm and opposite leg slowly, with the knee locked, 2 to 3 inches from the floor. Begin by holding position for 5 seconds, and complete 8 to 10 repetitions. As strength builds, aim to hold position for 20 seconds.

See Back Strengthening Exercises

Abdominal muscle strengthening exercises:

  • Curl-ups. For the upper abdominals, lie on the back with knees bent, arms folded across the chest, and the pelvis tilted to flatten the back against the floor. Then lift the head and shoulders from the floor, hold for 2 to 4 seconds, then slowly lower to starting position. As strength builds, aim to complete 2 sets of 10 curls. Do not attempt to lift the head up too high. For neck pain, place the hands behind the head to support the neck.
  • Single leg raise. For the lower abdominals, tighten the lower stomach muscles and slowly raise the straight leg 8 to 12 inches from the floor, keeping the low back held flat against the floor. Hold leg raise for 8 to 10 seconds, then slowly lower to starting position. As strength builds, aim to complete 2 sets of 10 lifts.
  • Water resistance exercise. Water exercises can strengthen the lower abdominal muscles—even just walking in waist-deep water can be helpful for sciatica relief.

It is always recommended to talk with a doctor prior to adding new exercises to a regular routine. A doctor can ensure exercises are effective and safe for a herniated disc, and can provide guidance and modifications if needed.

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