Sciatica: Symptoms, Treatment, Exercises

What is sciatica?

Sciatica refers to pain that originates in the sciatic nerve, the longest nerve in the body. The sciatic nerve runs from the lower back down the back of each leg, and it controls the muscles of the lower leg and provides sensation to the back of the thigh, calf, foot, and toes.

Sciatica occurs when the sciatic nerve becomes irritated or compressed. Typically, the condition improves within four to six weeks, but it may persist for longer in some cases.

What are the symptoms of sciatica?

The most common symptom of sciatica is a sharp, shooting, burning, or tingling (pins and needles) pain that radiates from the lower back through the buttock and down the back of the leg. It can be accompanied by numbness, weakness, or difficulty moving the leg or foot.

What are the causes of sciatica?

Sciatica can be caused by the following conditions:

Herniated disc.
Degenerative disc disease.
Spinal stenosis, pressure on the nerve due to the narrowing of the spinal canal.
Tumours that compress the sciatic nerve.
Piriformis syndrome, a rare disorder where a muscle in the buttocks presses against the sciatic nerve.

Besides the causes of sciatica mentioned above, the following can also trigger sciatic nerve pain:

Sitting or standing for long periods.
Being overweight.

What are the treatment options for sciatica?

Symptoms of sciatica may spontaneously improve in many cases, given sufficient time and rest. Continue with your regular activities as much as possible.

These are some common treatment options for sciatica:

Apply heat pack to affected areas.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to relieve pain.
Corticosteroid injection may be used to reduce inflammation and relieve pain.
Gentle stretches and exercises.

Is it better to rest or exercise with sciatica?

It is recommended to stay active and exercise if you have sciatica. However, choosing the right types of exercise and avoiding activities that aggravate your symptoms is important.

If the sciatica is severe or acute, rest may be necessary for a short period of time to allow the nerve to heal. Bed rest is generally not recommended for more than a day or two, as it can lead to stiffness and further weaken the muscles.

When you are sleeping, lie on the unaffected side if you prefer to sleep on your side. Place a pillow between your knees to align your hips, pelvis, and spine. If you would like to sleep on your back, place a pillow under your knees to support the natural curve of your lower back and reduce pressure on the sciatic nerve.

What are the exercises for sciatica?

1. Stretching exercises for sciatica

Single knee to chest stretch

For this gentle stretching exercise:
- Lie down on your back with hands behind your right knee.
- Pull your knee towards your chest.
- You will be able to feel a stretch in the lower back and buttock areas.
- Hold this position for about 10 seconds, and then slowly lower your leg.
- Repeat the exercise with the other leg.
- Do five reps of this exercise for each leg.
Sitting spinal stretch

This exercise reduces sciatica pain because it relieves pressure from the sciatic nerve by creating space in the spine. It is especially effective for sciatica pain caused by compression of vertebrae.
- Sit on the floor with your legs extended.
- Flex your feet upwards.
- Bend your left knee. Then place your left foot outside of your right knee.
- Next, place your right elbow outside your left knee.
- Turn your body gently towards the left.
- Hold this position for about 30 seconds, and then do the same for the opposite side.
- Repeat this exercise three times.
Standing piriformis stretch

You can do this exercise using a wall for support or, if you are able, without any support.
- While you are in a standing position, place your sciatica-affected leg over the knee of the other leg.
- Next, bend the leg you are standing on till your body makes the shape of the number 4. Your hips should be at a 45-degree angle from the ground.
- Bend forward while holding your back straight.
- Remain in this position for 30 seconds to a minute.
- Repeat the exercise with the other leg.
- If you are using the wall as a support, your feet should be about 2 feet from the wall.
Basic seated stretch

For this exercise, you will need to be seated on a chair.
- First, cross the sciatica-affected leg over the other knee.
- Then, bend forward - your spine should be as straight as possible.
- Try bending as much as you can, but make sure to stop if you experience any pain.
- Hold the position for about 30 seconds.
- Repeat by using the other leg to stretch.

2. Cardio exercises for sciatica

Cardio exercises are great for building stamina and strengthening muscles. However, it is recommended to start easy. Therefore, choose low-impact cardio exercises to begin with.

High-intensity activities such as running and jumping can aggravate sciatica.

Walking

Walking is generally considered good for sciatic pain relief. Walking gets your blood pumping and strengthens your leg muscles. It is a low-impact activity that can help reduce sciatic pain.

However, it may aggravate the condition for some patients and cause more pain. Thus, it is best to ask your doctor to ensure the chosen activities are safe and appropriate for your specific condition.
Stationary bicycle

A stationary bike allows you to work your legs and core muscles without the high impact of biking on rough terrain. It also helps you avoid having to swerve and reduces the chance of falling, which can add to the pain you are already experiencing.
Swimming

Swimming is the best exercise if you have an injury – it is low impact, plus the water supports your body. One can strengthen the core muscles by doing a few laps every day. If you are not able to swim laps, try walking or running in the water.

3. Yoga exercises for sciatica

Forward pigeon pose

Kneel on all fours.
Move your left leg forward and position it on the ground. Your leg should be in front of your body.
The lower part of your left leg should be horizontal to your body.
Your right knee should be behind your left foot.
Then, stretch your right leg all the way behind you.
Slowly move your body weight from your arms to your legs. As you do so, your legs should start to support your weight.
Then sit up straight. Your hands should be at the side of your legs.
Breathe deeply and exhale when you lean your body towards your front leg. Make sure to support your weight with your arms.
Repeat this exercise with the other leg.

4. Exercises for sciatica leg pain

Sciatic nerve glide exercise

This exercise relaxes your sciatic nerve and, thus, helps relieve pain.
- Sit on a chair and straighten your right knee. Your left foot should be flat on the floor.
- Slowly flex your ankle. Your toes should start to point towards you.
- Flex your ankle back and forth. Do this 15 to 20 times.
- Repeat the exercise with your other leg.
- For best results, do three rounds for each leg twice daily.
Standing hamstring stretch

This stretch relieves sciatic pain by easing hamstring muscle tightness.
- Position your right foot on a step, stool or chair. Your foot should be below hip level.
- Flex your foot so that your leg and toes are in a straight line.
- You can bend your knee a little if your knee hyperextends.
- Lean your body towards your foot.
- How much you stretch depends on how far you bend your body forward. However, stop if you feel pain.
- Hold the positions for about 30 seconds, then do the same with the other leg.
Scissor hamstring stretch

This exercise relieves sciatic nerve pressure by loosening the hamstring muscles.
- Position your left foot three feet behind your right foot.
- Then, push your shoulders back while moving your hips forward.
- Ensure that your left hip is not in front of your right hip.
- Place your hands on your hips.
- Bend your waist while keeping your back straight. Your torso should now be over your right leg.
- Your body weight should remain on your right leg.
- Hold the position for about 10 seconds and repeat the exercise with the other leg in front. Do this 3 to 5 times for each leg.

5. Exercises for sciatica in pregnancy

Seated piriformis stretch

The piriformis muscle is located in your buttocks. This stretch helps loosen muscle tightness and decreases sciatic pain caused by irritation to the piriformis muscle. You will need a chair for this exercise.
- Sit on the chair and plant your feet flat on the floor.
- If the sciatic pain is on your right side, place your right ankle on your right knee.
- Then, lean forward with your back straight until there is a stretch through your gluteal area.
- Hold the position for about 30 seconds.
- Repeat this exercise throughout the day and especially when you feel sciatica discomfort.
Table or chair stretch

This exercise is effective for sciatic pain as it stretches the back, buttocks, and leg muscles. You can use a table or chair for this stretch.
- With the chair or table in front of you, stand with your feet apart. Ensure that your feet are positioned wider than your hips.
- Place your hands on the chair’s backrest or the table. Lean forward while keeping your hands in position.
- Your arms and back should be straight.
- Then, slowly move your hips away from the chair or table. You will soon feel a stretch in the back of your legs and lower back.
- To increase the stretch, move your hips from side to side.
- Remain in this position for about 30 seconds to 1 minute. Do this two times daily.
Hip flexor stretch

Hip flexors are important muscles that help leg movements. For example, they move your legs forward when you walk.

Pregnancy can cause these muscles to tighten, affecting one’s pelvic alignment and causing sciatic pain. To stretch the hip flexors:
- Kneel on your hand and knees. Your palms should be on the floor.
- From the kneeling position, move one foot in front in a stepping motion. Your knee and hip should align at a 90-degree angle.
- Shift your weight forward by moving your hips forward. You will be able to feel a nice stretch on your leg and hip.
- Maintain the position for nearly 30 seconds, and then repeat the exercise with the other leg.

What exercises to avoid if I have sciatica?

The worst exercises for sciatica are those that add extra pressure on the lower back. Exercises that can worsen sciatica include:

High impact training
Squatting
Rotating or twisting the torso
Lifting both legs off the ground
Bending forward while legs are straight

Some examples of these exercises are:

Double leg lifts
Hurdler stretches
Supine leg circles
Burpees
Weighted squats

Book an appointment at Pantai Hospitals

Although most cases of sciatica resolve on their own, it is best to speak to your doctor to learn more about sciatica.

A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding sciatica. We assure you the best possible care tailored to your specific needs.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.