The sciatic nerve extends from the end of the spinal cord down the back of the thigh to the top of the knee joint. It is the largest and longest nerve in the body. When it becomes irritated due to physical trauma, a muscle disorder, or a compression of the nerve itself, it can cause pain from the lower back to the knees. The symptom is generally referred to as "sciatica". While it is true that rest plays an important role in healing from this condition, it is very useful to do exercises to make the muscles surrounding the sciatic nerve stronger and more flexible. A sedentary lifestyle can cause deterioration of both the nerve itself and surrounding muscle groups. Read on for detailed instructions on how to do the exercises to relieve sciatica.
Steps
Part 1 of 4: Strengthen the Core
Step 1. Understand why it is important to strengthen the core
It is essential to both cure and prevent herniated disc and the sciatic nerve pain that goes with it. A strong, massive core helps prevent spinal injury and spinal misalignment as the muscles keep the sciatic nerve in place.
- The core also protects the spine from possible potentially harmful movements performed during physical activity or carrying out normal daily tasks. As the core muscles become stronger, the intermittent twinges in the leg (one of the most common symptoms of sciatica) should ease and disappear.
- Core muscles include the upper, lower, oblique abdominals, transverse and sacrospinal muscles. They are located on the front, sides and back of the abdomen and enclose the spine. Read on to learn how to do specific exercises that will help strengthen your core muscles.
Step 2. Exercise "plank"
This is one of the best exercises for relieving sciatic nerve pain caused by a herniated disc, as it keeps the spine in proper alignment and prevents worsening of the disc dislocation. To do the exercise right:
- Assume the position in which traditional push-ups are done. Your hands and feet should be resting on a soft surface, such as an exercise mat. The head, shoulder blades and buttocks must form a single horizontal straight line. The hands must be placed exactly under the shoulders and the feet must be kept together.
- Contract your abdominal muscles as if you were preparing to receive a punch in the abdomen. Hold the position for 15 seconds, constantly checking that the hips do not collapse downwards. Take deep breaths while doing the exercise to prevent your blood pressure from soaring.
- You shouldn't feel pain, tingling, or numbness in your back or legs while doing the exercise. If you have any of these symptoms, rest for 15 minutes, then try a modified version of the "plank" by supporting your body weight with your forearms and knees, rather than your hands and feet.
- Do three reps of 15 seconds each, resting for 30 seconds between each. Gradually increase the amount of time you hold the position, up to one minute.
Step 3. Exercise "side plank"
After having strengthened the core by performing the normal "plank" in a regular way, to the point of being able to maintain the position for 30 consecutive seconds, you can switch to the lateral one. This exercise is great for strengthening the oblique abdominal muscles and helps prevent leg pain caused by sciatica, especially during spinal twists.
- Lie down on the mat on the left side of your body. The latter must form a single straight line. Raise your torso and place your left arm on the ground, from the elbow to the hand. The weight of the body must be supported by the forearm and the outer side of the left foot. At this point the body should form a straight, slightly oblique line running from head to toe.
- Once in the position, keep the pelvis raised with the help of the oblique muscles of the left side. Remember to keep your abs tight, as if you are preparing to get punched in the stomach. Stay in this position for 15 seconds.
- You shouldn't feel pain, tingling, or numbness in your back or legs while doing the exercise. If you have any of these symptoms, rest for 15 minutes, then try a modified version of the "side plank".
- To perform the modified version of the "side plank", bend your knees instead of keeping your legs straight, this way your body weight will be supported by your left forearm and knee.
- Repeat the exercise 3 times, holding the position for 15 seconds and resting for 30 seconds between each execution. When finished, repeat on the other side of the body. Gradually increase the time you stay in position, up to 30 seconds.
Step 4. Hip thrust exercise
It is an excellent workout for the muscles of the lower back, hips and buttocks. They are part of the posterior muscle chain, a group of muscles that support your body weight and help you maintain correct posture. When the body is in the right position and the weight is evenly distributed, the pressure on the lower back bones decreases and the pain in the sciatic nerve is reduced. To perform the "hip thrust" exercise:
- Sit on the floor, taking care to place a bench or chair behind you. Rest your arms and upper back against the support you have chosen. Keep your knees bent and feet open to hip-width (this position engages the muscles in your hips and glutes as you perform the exercise).
- Push your hips up until your torso and thighs are parallel to the ground. The knees are bent and the soles of the feet must remain in full contact with the floor. Do not go apnea while doing the movement; remember to inhale and exhale regularly.
- Slowly lower your pelvis back towards the floor. The complete movement counts as one repetition. You should do 3 sets of 15 reps each day, resting for one minute between sets.
- You shouldn't feel pain, tingling, or numbness in your back or legs while doing the exercise. If you have any of these symptoms, stop exercising immediately and consult your doctor.
Step 5. Exercise of the "cat"
This is an excellent core workout that improves both strength and muscle flexibility. Since this is an advanced exercise you should include it in your daily routine only after you have strengthened your core by doing the three exercises explained in the previous points.
- Kneel on the floor and place your hands on the ground as well. Again it is best to use an exercise mat as a base. The hands must be positioned exactly under the shoulders, while the knees must be perfectly aligned with the hips.
- First "hump" like a cat intent on stretching: contract your abs and push the central part of the back as far as possible towards the ceiling, turning your gaze to the navel. The shape of the back should resemble an inverted "U". This exercise allows you to stretch every fiber of the front and side muscles of the core, as well as the middle and upper back. Stay in this position for 5 seconds, then return to the starting position.
- Now curve your back in the opposite direction: arch it by pushing the abdomen towards the floor and the buttocks towards the ceiling, while directing your gaze upwards. This part of the exercise allows you to strengthen the muscles of the lower back. Hold the position for 5 seconds.
- Alternate by arching your back first up and then down. Repeat 5 times on each side. In total you should do 3 sets of 5 reps each, resting for 2 minutes between each.
- If you experience symptoms attributable to a herniated disc, you should avoid this exercise and consult a doctor for appropriate guidance.
Part 2 of 4: Stretching for the Legs and Back
Step 1. Understand the importance of stretching
People with sciatica should do exercises to stretch their muscles daily. Stretching also helps to relax those that compress the sciatic nerve, thereby relieving pain. Repeating the exercises several times a day not only reduces existing symptoms, it also helps prevent the condition from worsening.
Step 2. Bring your knees to your chest alternately
This is a simple exercise that improves the flexibility of the lower back by relieving pressure on the sciatic nerve. To do it correctly:
- Lie on your back on the floor or on an exercise mat. Rest your head on a thin pillow.
- Bend your knees and place the soles of your feet on the ground. Grab your right knee with both hands and slowly pull it towards your chest. You should feel your lower back muscles stretch.
- Hold the position for 20-30 seconds, then bring your right foot back to the ground. Repeat the exercise with the left leg. In total, you should do 3-5 reps for each leg.
Step 3. Mobilizes and stretches the sciatic nerve
This exercise in particular serves to move the sciatic nerve and the posterior hamstring, helping them to adopt a more comfortable position.
- Lie on your back on an exercise mat and place a thin pillow under your head. Keep your knees bent and your chin tilted slightly towards your chest.
- Grab one knee with both hands and gently bring it closer to your chest. Now put both hands behind the knee, then try to straighten the leg. Keep pulling the knee towards your chest as you try to straighten it.
- Hold the position for 20-30 seconds while taking deep breaths, then bend the knee and return to the starting position. Repeat with the other leg; in total you should do 3-5 repetitions of each.
Step 4. Stretch your back muscles
This exercise mobilizes and stretches the spine backwards. It can be particularly beneficial in cases where sciatica is the consequence of a herniated disc.
- Lie on your stomach, then use your elbows to support the weight of your head and torso. Keep your neck and back straight.
- Keeping your neck straight and hips close to the floor, arch your back as much as possible, but only as long as there is no pain. You should feel the muscles in your lower back and abdomen stretch.
- Hold the position for 10 seconds while taking long, deep breaths. Return to the starting position, then repeat the exercise 10-15 times.
Step 5. Stretch the hamstrings of the knees with a standing exercise
This workout helps them become stronger and more flexible.
- Stand in front of an object that reaches approximately knee height, such as a footrest or stool.
- Lift one leg and rest your heel on the object in front of you. Keep your leg and knee as straight as possible, with your toes pointing towards the ceiling.
- Tilt your torso forward, placing your hands on your knee to support the weight. Try to keep your back straight as you bend over. Stay in this position for 20-30 seconds, while taking long, deep breaths.
- Repeat the exercise with the other leg. Continue until you've done 3-5 reps of each.
Step 6. Stretching for the buttocks
This exercise helps keep your gluteal muscles flexible, giving you the ability to perform a wider range of motion.
- Start by lying on your back, with your knees bent and the soles of your feet flat on the ground. Place a thin pillow under your head for support.
- Lift your left foot and rest your ankle on your right thigh. Interlace your fingers behind the back of the thigh and gently pull the leg towards your chest.
- The tailbone and hips must remain close to the floor throughout the entire exercise. You should feel the right glute muscles relax.
- Keep your thigh close to your chest for 20-30 seconds while taking long, deep breaths. Return your foot to the ground and repeat the exercise with the other leg. Do 3-5 repetitions of each.
Step 7. Stretching for the iliotibial band
The latter is a type of connective tissue that embraces the muscles of the hip, buttock and the outer part of the leg. If it becomes less flexible, it limits the range of motion and causes the muscles to compress the sciatic nerve, aggravating the symptoms of the disease. To restore flexibility to the iliotibial band, follow these guidelines:
- While standing, bring your right foot past your left foot by crossing your legs. Without bending your knees, lean your torso forward while pushing your butt backwards, as if you want to use it to close a door.
- Try to keep the natural curvature of your back unchanged throughout the exercise. Be careful not to bend it forward or backward, otherwise the vertebrae will be misaligned.
- The soles of the feet must remain firmly adherent to the floor. If the fingers are off the ground, the weight of the body is shifted backwards, which can cause compression of the back muscles and worsening of sciatica.
- Push your hips to the side as far as possible, but only until doing so is painful. Don't worry if you can't move them more than 4-5cm; it is common to have poor iliotibial band flexibility. Hold the position for 30-60 seconds.
Step 8. Flossing of the sciatic nerve
This stretching exercise helps to release the nerve from surrounding tissues and restore normal movement, thereby relieving pain and improving mobility. Start in a sitting position with your head facing down. Then, look upward as you lift your right leg, extending the knee. Return to the starting position to complete the exercise.
Do 20-30 repetitions, then switch to the left leg
Part 3 of 4: Doing Aerobic Activity
Step 1. Go swimming to increase your heart rate without stressing your back and legs
Swimming is the best cardiovascular exercise for those with sciatica. While swimming, the pressure on your back and legs is minimal; nevertheless, your heart beats faster and you burn more calories. In practice, you will derive all the benefits guaranteed by aerobic activity without risking pain or aggravating the disease.
For best possible results, you should swim for 30 minutes a day 5 times a week
Step 2. Try pilates to stretch and strengthen your muscles
It is a very effective low-impact discipline, which allows you to improve muscle strength without causing too much pain in the sciatic nerve. Most of the positions are aimed at stretching the muscles by performing slow and harmonious movements. For more information on pilates, read this article.
Step 3. Do yoga to relieve pain and learn to breathe properly
Yoga is another extremely effective low-impact discipline that helps reduce back pain and prevents it from returning. Specifically, the positions are a combination of stretching and breathing techniques, so they are the perfect type of exercise to relieve sciatica. For more information on how to do yoga, read this article.
Step 4. Don't rush to avoid over-straining your back
Running has many beneficial effects on the health of the whole body, but it is not a recommended aerobic activity for those suffering from sciatica. Running is tiring and upsets your lower back and legs, so you run the risk of increasing sciatic nerve pain.
On the other hand, going for a walk is highly recommended for people with this condition, as long as you stretch before and after the walk and maintain a correct posture all the time
Part 4 of 4: Understanding what Sciatica is
Step 1. Find out about the causes
The pathology can derive from various problems, but in any case it involves irritation of the sciatic nerve resulting from physical trauma, a muscle disorder or compression of the nerve itself. The most common causes include:
- Lumbar disc herniation: occurs when a disc in the spine comes out of its natural location. The expelled tissue comes into contact with the sciatic nerve and compresses it causes pain and irritation.
- Degenerative disc disease: occurs mainly with advancing age. As we age, the intervertebral discs become weaker and can partially collapse causing compression of the sciatic nerve.
- Piriformis syndrome: occurs when the piriformis muscle (located in the gluteus region) compresses the sciatic nerve.
- Lumbar spinal stenosis: develops when the spinal canal narrows, pushing its contents outward and causing pain in the sciatic nerve.
- Spine Abnormalities: Any abnormality in the structure of the lumbar spine will cause sciatica. These can include: infections, injuries, tumors, internal bleeding, bone fractures or muscle weakness.
Step 2. Learn about the symptoms of sciatica
The primary symptom of the disease is pain, which generally extends along the sciatic nerve, starting from the lower back, passing through the buttocks, hips and legs. Due to the pain, the patient may have difficulty moving, bending and walking.
Step 3. Understand how the condition is diagnosed
Getting an accurate diagnosis is important because only then can the doctor determine what is the best cure. The sciatica diagnosis process generally involves these tests:
- Physical examination: the visit includes the Lasègue test. Your doctor will ask you to lie down and lift your leg slowly, then note the position you feel pain in to determine which part of the sciatic nerve is suffering.
- X-ray: You will likely be prescribed by your doctor to rule out the possibility that sciatica is caused by a spinal fracture.
- Magnetic resonance imaging (MRI) and computed tomography (CT scan): These two tests are the most useful for diagnosing sciatica. Thanks to the detailed images of the lower back, the doctor will be able to better examine the problem.
- Additional Tests: There are other sciatic nerve tests that can help confirm the diagnosis. For example, the study of motor and sensory conduction velocity, electromyography, myelogram and the evoked potential test.
