Exercises and movements to treat sciatica

Sciatica is a painful condition where the sciatic nerve is pinched, sending pain from the lower back down the leg and all the way into the foot.

Sciatic pain can be caused by damaged discs, inflamed tissues surrounding the nerve, and a chronically tight piriformis muscle that compresses the nerve. Long-term compression can lead to nerve damage, so it’s best to treat this early.

Once you have found the cause of your sciatica, you can choose the right exercises and movements to relieve the pain and prevent it from recurring.

Personal experience

I was diagnosed with sciatica at age 11, and have had pain pretty much constantly through my teens and tweens, and then on and off ever since. I have tried many physiotherapy techniques, and I’ve worked out the best preventative stretches and massage techniques to keep it at bay for the past decade.

Later in life, specialists discovered the cause of my sciatic pain was actually auto-immune spondyloarthritis. The physical therapies and exercises for that are essentially the same as what I had been doing for years.

Not all of the stretches and movements below will work for you - experiment carefully, with a physiotherapist’s help.

Note: I am not a doctor or physical therapist. Please see your doctor to identify the actual cause of your pain, and determine which of the following exercises are appropriate for you.

Alexander technique

The Alexander technique (for correct posture and movement), taught to back pain sufferers in a randomized trial, was shown to reduce and control their back pain symptoms.

This technique is used by singers and musicians to maintain correct and healthy posture and can reduce sciatic pain. The best way to learn the Alexander technique is to find a teacher who will train you in a series of classes, and will give you additional exercises to do at home.

McKenzie exercises

Designed by physiotherapist Robin McKenzie in the 1950s to treat a variety lower back problems, including herniated discs and sciatica, the McKenzie exercises are well studied and often recommended to relieve lower back and leg pain.

Your physiotherapist or specialist will help you perform the press-up exercises safely, showing your the correct form. Many back pain patients report fantastic results with leg-pain reduction, even in the first week, when exercises are done regularly.

Tip: When your pain is better under control, the gentle press-up can be strengthened into the yoga cobra pose.

Piriformis Stretch

If your pain is caused by pressure from a short or cramped piriformus muscle (the muscle that runs into your hip and across the buttock) you may have piriformis syndrome. This syndrome is diagnosed by ruling out all spinal disc and bone problems.

Piriformis syndrome may appear on a nerve conductance test. Electrical signals are slower when the nerve is strangled by the piriformis muscle.

Runners, cyclists and rowers—anyone who bends forward at their hips a lot and overuses these muscles—is at risk of developing back and leg pain.

• Lay on your back with one foot on a wall, knee bent at right angles. rest the other foot just above the bent knee on your thigh, and hold for 60 seconds and relax.
• Repeat on the other side. If you don’t feel enough of a stretch, move closer to the wall bringing your knee closer to your shoulders.

Physiotherapy exercises

Physiotherapy exercises should be done daily to relieve back pain, correct improper posture, and strengthen the back and core abdominal muscles.

• Use a yoga mat or folded blankets to make the surface softer, especially when lying on your back.
• Balance balls are great for strengthening core abdominal and back muscles, and can be used as a chair when traditional seats hurt.
• Choose a good quality anti-burst balance ball that is the right size for you.
• If you want to do strength training with your ball, look at the max weight. You’ll need a strong ball!

Exercises and stretches

• Single knee to chest: Lie on your back, legs straight, with a pillow under your knees. Pull one knee into your chest, feel the stretch through the hip, buttock and into the back. Hold for 30 seconds, and repeat on the other side. Repeat this many times.
• Back massaging circles: Lie on your back, both legs gently pulled towards chest. Circle your knees so that the lower back is gently massaged. This may hurt significantly in the beginning, so be gentle. You can do this with a balance ball under your lower calves.
• Core muscle contractions: Lie on your back, legs straight, with a pillow under your knees. Contract only the deep muscles that stabilize the spine, breathe as normally and as relaxed as possible. Hold for 30 seconds then release. Repeat many times. This is surprisingly difficult to do!
• Lying twist: Lie on your back, knees bent, feet flat on the floor. Stretch your arms at shoulder height, away from your body. Drop your knees to one side, and turn your head to the other. Be gentle! Hold for 30 seconds, and repeat on the other side.
• Balance ball bridge: Lie on your back with a balance ball under your calves. Keep your shoulders and neck on the ground and raise your pelvis so that your back and upper legs are in a straight line. Drop your pelvis slowly to the ground. Repeat 10-15 times. If you don’t have a balance ball, use a chair under your calves.
• Balance ball diagonal arm/leg raise: Lie with your stomach on the balance ball, legs and arms on the ground, shoulder width apart. Raise your right arm and left leg horizontal with the floor. Hold for 5 seconds, then release and repeat on the other side. Repeat these 10-15 times. Do this exercise on your hand and knees if you don’t have a balance ball.

Yoga Poses

Many gentle yoga poses can relieve sciatic pain. Plus there are many other stretching and back strengthening poses to prevent it from reoccurring. Important: Check with a doctor or physiotherapist, start gently and relax. Never strain to hold a pose in yoga - it is not a competition. Warm up and cool down with light aerobic movements and gentle stretches to avoid injury. If you find yoga too strenuous or painful, tai chi may be more appropriate.

• Cat-cow pose relieves pressure and increases mobility in the back (marjariasana).
• Standing forward bend loosens the hips, stretching the hamstrings and lower back (uttanasana).
• Head-to-knee pose stretches the lower back and hips (janu sirsasana).
• Big-toe pose stretches the hamstrings and relieves lower back pain (supta padangusthana).
• a butterfly leg pose opens and loosens the hips (baddha konnasana).
• Fire-log pose opens the hips (agnistambhasana).
• Lower back twist loosens the back muscles (bharadvajasana).
• Sage’s pose loosens the back muscles (marichyasana).

Back-strengthening yoga poses Be careful when attempting the strengthening poses. If at any time your nerve twinges, stop, stretch gently and relax.

• Extended side-angle pose stretches the outside of the leg and chest, and strengthens the back (utthita parsvakonasana).
• Warrior pose variations strengthen the legs and lower back (virabhadrasana).
• Cobra pose strengthens the back, but be careful not to over-stretch (bhujangasana).
• Downward-facing dog lengthens and strengthens the back and arms (adho mukha svanasana).