Patient education: Exercises for sciatic pain (The Basics)

What is sciatica? — The sciatic nerve is a large nerve that starts in the lower back. It runs all the way down the back of the leg.

Something like a disc or bone spur can pinch or damage the sciatic nerve. Tight, inflamed muscles can also pinch or damage it. This can cause pain, weakness, numbness, or tingling that goes from the buttock down the leg toward the heel. When these symptoms happen, people often call it "sciatica." The medical name for this is "radiculopathy."

You can have sciatic pain on 1 side or both. Most of the time, it gets better without surgery.

Why do I need to do exercises if I have sciatica? — Stretching and strengthening exercises can help ease back pain. It might also help prevent future back pain. Long term, it is important to strengthen the muscles in your lower back, buttocks, and belly. These are your "core muscles." Stretching exercises are also important to keep your muscles flexible.

Below are some stretching and strengthening exercises that might help you. Other forms of movement can help ease or prevent back pain, too. For example, some people like to walk or do aerobic exercise, yoga, or tai chi. The most important thing is to move your body. Your doctor, nurse, or physical therapist can help you find different types of activity that work for you.

What stretching exercises should I do? — Warm up your muscles before stretching. This helps prevent injury. To warm up, you can walk, jog, or cycle. Below are some examples of stretching exercises.

Start by repeating each of these stretches 2 to 3 times. For your body to make changes, try to hold each stretch for 5 to 10 seconds. Try to do the stretches 2 to 3 times each day. Breathe slowly and deeply as you do the exercises. Never bounce when doing stretches.

●Single knee-to-chest stretches (figure 1) − While lying on your back, bend your knees with your feet flat on the floor. Pull 1 knee toward your chest until you feel a stretch in your lower back and buttock area. Lower, and repeat with the other knee. If you have knee problems, pull your knee up by grabbing the back of your thigh instead of the front of your knee. You can also do this exercise by grabbing both knees at the same time.

●Deep hip stretches lying down (figure 2) − Lie on your back, and bend 1 knee, keeping that foot flat on the floor. Cross the other leg over your knee. Grab the thigh of the leg that has the foot on the floor. Slowly, pull the bottom leg toward your chest until you feel a stretch in the other buttock. Repeat using the opposite leg as the bottom leg.

●Deep hip stretches sitting (figure 3) − Sit on the floor with both legs straight. Take 1 leg and cross it over the other leg so that the ankle or foot of your top leg is next to your other knee. Now, take the elbow on the opposite side of your bent knee and bring it to the outside of the bent knee. With your elbow, slowly push the bent knee further across your body to get a good stretch in the hip.

●Sit backs (figure 4) – Start on your hands and knees. Your hands should be directly under your shoulders. Your knees should be spread slightly and directly under your hips. Slowly stretch your back as you bring your hips toward your ankles. Your arms are extended forward in a relaxed position, as your upper body sinks toward the floor.

What strengthening exercises should I do? — Below are some examples of strengthening exercises.

Start by doing each exercise 2 to 3 times. Work up to doing each exercise 10 times. Hold each exercise for 3 to 5 seconds. Try to do the exercises 2 to 3 times each day. Do all exercises slowly.

●Pelvic tilts (figure 5) − Lie on your back with your knees bent and feet flat on the floor. Breathe slowly and deeply. Press your lower back down to the floor. Tighten your stomach muscles as you breathe deeply and slowly, then relax.

●Hip lifts (figure 6) − Lie on your back with your knees bent and feet flat on the floor. Breathe deeply and slowly. Tighten your stomach muscles, keep your back flat, and lift your buttocks off the floor. Relax. You should feel this in your buttocks, not in your lower back.

What else should I know?

●Exercise, including stretching, might be slightly uncomfortable, but you should not have sharp or severe pain. If you do get severe pain, stop what you are doing. If severe pain continues, call your doctor or nurse.

●Do not hold your breath when exercising. If you tend to hold your breath, try counting out loud when exercising.

●Always warm up your muscles before exercising. Stretching before warming up can lead to injury.

●Doing exercises before a meal can help you get into a routine.

More on this topic

Patient education: Radiculopathy of the neck and back (including sciatica) (The Basics)
Patient education: Back exercises (The Basics)
Patient education: Low back pain in adults (The Basics)

Patient education: Low back pain in adults (Beyond the Basics)