Exercises for sciatica pain

The human spine comprises 33 vertebral bones which are stacked one on top of the other. The spine is divided into five regions: cervical, thoracic, lumbar, sacral and coccyx. The lumbar, sacrum and coccyx combine to form the lower back.

The sciatic nerve is the largest nerve in the human body. It is formed by the combination of five nerve roots that originate from the lower part of the spine. The sciatic nerve passes deep inside the buttock and travels down through the back of the thigh all the way to the heel and sole of the foot.

Any irritation of the sciatic nerve leads to sharp pain, tingling sensation and weakness in the lower back and the back of the leg. This pain is medically known as sciatica.

The pain in sciatica can be described as an electric shock-like sharp shooting pain. People may also complain of burning pain in one of the legs.

One of the major causes of sciatic nerve injury is disc herniation or slipped disc. The vertebrae in our spine consist of two rings each - the central ring contains nuclear tissue and outer ring, called the annulus, is soft to reduce friction and provide cushioning. When a lot of pressure is put on the nuclear tissue (like when you lift a very heavy weight), it can cause the annulus to rupture. This is known as a ruptured or herniated disk. This can create pressure against one or more of the spinal nerves which can cause pain, weakness or numbness in the affected nerve.

There are other reasons like genetic factors, vitamin deficiency and inflammation which can cause sciatic nerve pain. There are certain exercises like press-up exercise, straight leg raise, bridging exercise and hamstring stretch exercise which can help relieve the sciatica pain.

Precautions while performing exercises for sciatica pain
Causes of sciatica pain
Exercises to relieve sciatica pain

Precautions while performing exercises for sciatica pain

You must consult your doctor or your therapist before practising any of these exercises. There are certain basic precautions which should be kept in mind while performing these exercises:

Always use an exercising or yoga mat for performing these exercises. All exercises should be performed on a flat surface.
Discontinue the exercise if your sciatica pain increases while performing any of these exercises.
Slowly build your stamina and do not overdo any exercise. If your body feels exhausted after two repetitions, stop there.
It is a good idea to exercise in the presence of a trained physiotherapist who can correct your form and advise you on how much you can push yourself.

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Causes of sciatica pain

There are certain factors that lead to pain in the sciatic nerve:

1. Genetic factors: Studies have confirmed that genes can affect the discs that form the path of the sciatic nerve. Due to some genetic fault, these discs can lack collagen proteins, which makes them weak and more prone to herniation. These weak discs can lead to compression or irritation of the sciatic nerve.

2. Compression of the nerve: Compression of the sciatic nerve can lead to constant pain in the lower half of the body. Conditions that can lead to a compressed nerve are:

Herniating disc: A disc in the lower back (spinal column) may bulge out abnormally (herniate) which can lead to irritation and compression of the sciatic nerve.
Stenosis of the foramen: The passage from where the sciatic nerve roots travel can become narrow (stenosis), leading to compression and irritation of the sciatic nerve.
Misalignment of vertebrae: Downward slipping of the vertebra (spondylolisthesis), defect in the vertebra (spondylolysis) or complete dislocation of vertebrae can compress the nerve roots of the sciatic nerve.

3. Inflammation: When a disc is herniated, it leaks substances like hyaluronic acid and fibronectin (protein) fragments. These substances are found to cause irritation and inflammation in the sciatic nerve. In some cases, nerve tissues grow abnormally in the inner and outer layers of the ruptured disc, which causes sciatica pain.

4. Obesity: Obese people might put a lot of pressure on their sciatic nerve while sitting, which can lead to sciatica pain.

5. Static posture: People who tend to work in the same position for a long period of time, like drivers, carpenters and desk job workers, are more prone to get sciatica pain.

6. Vitamin deficiency: Vitamin B12 helps in the formation of the myelin sheath (covering of the nerves) which is important for proper transfer of nerve signals. Due to vitamin B12 deficiency, there is the absence of myelin sheath, therefore the sciatic nerve becomes more prone to injuries and infections.

Exercises to relieve sciatica pain

There are certain exercises which can help relieve the sciatica pain. Certain stretching exercises, targeting the affected muscles can help relieve muscle tightness and improve their flexibility. Over tight hamstring muscles increase the stress on the lower back and worsen the symptoms of sciatica. Regular stretching of the hamstring can help in relieving the stiffness and pain.

Here are certain exercises that can help reduce sciatica pain.

Pelvic tilt exercise for sciatica pain

The pelvic tilt helps in improving the strength of the abdominal muscles and is the basic step for many sciatica pain relief exercises.

Steps:

Lie down on your back with your knees bent and feet flat on the ground
Pull your belly button in, towards the ground, tightening your lower stomach muscles, as this would automatically flatten your back and roll your pelvis (hip) upward. (Don't lift the hips in this exercise, the tilt should happen automatically as you try to pull your belly button towards the ground).
Hold this position for 10-15 seconds, then relax.
Repeat the exercise 10 times. Remember to breathe throughout.

Press-up: exercise for sciatica pain relief

Press-ups are also known as back extension exercises. Press-ups are based on a technique called centralization, which helps in moving pain up from the leg and limit it to the lower back (which was initially the origin of the pain). This helps in treating the pain. This technique is usually recommended for people with sciatica pain due to a lumbar disc herniation.

Steps:

Lie down on your stomach. Rest your forearms on the floor by bending your elbows and placing your palms in either side of your shoulders. Look towards the floor and keep your neck straight.
Now, arch your back up by straightening your arms as much as you can. Try to push the floor down with your palms. You should feel a gentle stretch in the stomach muscles.
Hold this position for 5 seconds initially, then slowly, gradually work your way up to holding the position for 30 seconds per repetition.
Repeat this exercise 10 times.

Sciatica exercise: straight leg raise

The straight leg raise exercise improves the strength of the abdominal muscles and reduces the chances of a recurrence of sciatica.

Steps:

The first step of the straight leg raise is to perform a pelvic tilt. So,
- Lie down on your back, bend your knees and place your feet firmly on the mat.
- Place your arms comfortably by your side.
- Breathe in and suck your belly button in. This will automatically straighten your back and curl the pelvis a little bit upwards. Make sure you don't actually raise your hips in this exercise - the tilt should happen naturally as you tighten the abdomen muscles.
Once this is done, straighten one of your legs out along the floor and gently raise it six to eight inches off the ground.
Hold the position for five to seven seconds and then rest.
Repeat this exercise 10 times and then start with the other leg.

Back flexion exercise for sciatica pain

Back flexion exercises help to treat sciatica caused due to spinal stenosis (constriction of the passage of the sciatic nerve by the vertebral bones of the spine).

This exercise helps in increasing the size of the passageway of the constricted sciatic nerve.

Steps:

Lie down on your back, with your legs resting flat on the ground.
Now, gently pull your knees towards your chest until you feel a mild stretch across your lower back.
Hold this position for 20-30 seconds before lowering your legs back to the starting position.
Repeat this exercise four to six times.

Standing hamstring stretch exercise for sciatica pain relief

A hamstring stretch helps in improving leg pain in sciatica as well as strengthen the lower back.

Steps:

For this exercise, you require a stable object like a block. The height of the block should at least be up to your knee.
Now raise one leg and place it on that object.
Keep your leg straight and toes pointing up. Make sure your lower back is not arching at any point.
Hold this position for 20-30 seconds and then rest.
Repeat the exercise on the other leg. Do two to three repetitions on each leg.

Hook-lying march sciatica exercise

The hook-lying march exercise helps in maintaining the lumbar region of the spine. Physiotherapists also recommend this exercise to prevent back pain and strengthen the muscles of the spine.

Steps:

Lie down on your back with your knees bent and feet flat on the ground
Pull your belly button towards the ground, tightening your lower stomach muscles, as this would automatically flatten your back and roll your pelvis (hip) upwards.
Now, slowly raise one of your feet an inch or two off the ground.
Put the foot down and repeat the same with the other foot.
Continue the marching for 30 seconds, then relax.
Straighten your legs on the ground for the next 30 seconds.
Repeat this exercise two to three times.

Bridging exercise for pain relief from sciatica

Bridging exercise helps in stabilizing the lumbar region of the spine and it also helps in improving the strength of the muscles that support the spine.

Steps:

Lie down on your back with your knees bent and feet flat on the ground.
Keep your arms straight beside you, palms facing down.
While keeping your arms straight, slowly raise your buttocks six or seven inches off the ground.
Hold this position for five to eight seconds before lowering your buttock back to the original position.
Repeat the exercise 10 times.

Prone leg exercise for sciatica

The prone leg exercise focuses on alleviating sciatica pain by maintaining the posture of the spine and pelvis.

Steps:

Lie down on your stomach with your arms straight at your side and legs straight.
Pull your belly button up towards your back to perform a reverse pelvic tilt - remember to breathe.
While performing the pelvic tilt, keep your legs straight and slowly raise one of your legs about an inch or two inches off the ground.
Hold this position for five seconds and then bring the leg back to the original position.
Repeat the exercise with the other leg.
Do five repetitions with each leg.

Abdominal curl-up exercise for sciatica

This is one of the most common exercises recommended to people with sciatica pain. This exercise helps in strengthening the lower abdominal muscles.

Steps:

Lie down on your back, fold your arms across your chest and perform a pelvic tilt.
Now lift your head and shoulders off the ground.
Hold this position for two to five seconds and then return to the starting position.
If you feel discomfort in the first position, you can also lock your hands behind your head to support your neck, but make sure that you don’t end up using your hands to lift your head up.
Repeat the exercise at least 10 times.