Top 5 Exercises for Early-Stage Sciatica
Sciatica is a condition that causes lower back and leg pain, numbness, and tingling. It is caused by pressure on the longest and widest nerve in the body, the sciatic nerve. From the lower back, the sciatic nerve travels through the buttocks and down the back of each leg. Sciatica is a very common problem, and can be very debilitating. We see it every day numerous times at our clinic at Surrey Physio. Myself personally, as author of this article, I’ve both suffered with it (for many years) and treated hundreds if not thousands of cases of sciatica over 20 years of working.
Let’s talk about the cause of sciatica. Numerous conditions, such as a herniated disc, spinal stenosis, or spinal injury, can cause sciatica. In addition, a tumour or cyst that presses on a nerve can also cause this condition. By far the most common cause is a disc problem. Discs are the pads between the vertebrae that help with movement and act as a shock absorber for the spine. Discs can degenerate, and the outer layers of the disc can split causing the centre of the disc to bulge outwards. When the disc bulges or herniates, it can come into contact with the nerve root that forms the sciatic nerve.
There are numerous opinions and theories why disc problems may happen, and the majority of clinicians believe that disc problems (and back problems in general) are caused by three things: 1) weak muscles in the core and back, 2) repetitive forward bending 3) stiffness in the lower back, usually from sedentary lifestyles. Forward bending is currently (at date of writing) a contentious topic, as some research does not support that repeated forward bending can cause disc problems, while other research does support it.
Most people either end up hoping it will disappear, or if the pain is particularly bad, they’ll seek a doctor, physio, or osteopath. We see thousands of patients every year with sciatica, it is extremely common.
The first line approach is to mobilise, and gently get moving. In addition, many clinicians advise to avoid forward bending (and this certainly helped my sciatica improve significantly). Second line treatments involve medication, manual therapy, and exercise therapy. Obviously, we prefer the use of natural treatments for back pain and sciatica, with anti-inflammatory medication being very problematic to the stomach lining. Sciatica treatment depends on the underlying cause though and this needs to be established.
If early-stage symptoms don’t improve, then we’d look to send you for an MRI scan. Just remember, that going to your GP to request an MRI scan is unlikely to result in them being able to refer for one. So most people need to go privately.
Top 5 Exercises for Early-Stage (Acute) Sciatica
1. Lumbar Rotation: Lie on a bed or floor. Bend your knees and keeping your feet flat on the bed or floor, rotate your hips to one side creating a rotation through your lower back. Only go as far as feels comfortable, you do not need to get your knees to the floor. Return to the opposite side. This is an excellent lower back mobility exercise, especially if you have acute lower back pain or disc problems.
2. Cat Camel Stretch: Start in a neutral four point position on your hands and knees. Round your back from an arched position as you pull in your abdominal muscles. It should feel like a gentle stretch to your lower back. Don't over-arch your back; keep it comfortable, unless your therapist guides you otherwise. After you have rounded your back, form an arch with your lower back. Repeat the movement to the required number of repetitions. This is a good exercise to stretch your back and reduce back pain.
-3. Side Flexion: Stand up straight, and bend to the side by running your hand down the outside of your leg. Keep the movement slow and fluid. Repeat to the opposite site. This is a good mobility exercise for the lower and upper back.
4. Chair Rotation: Place an ankle weight around each ankle. Stand upright with good posture. Hold on to a wall or table for support. Put your weight through one leg and take the other leg out to the side, and back to neutral. Repeat as required. You can also hold the leg out to the side and maintain this position. This exercise predominantly strengthens your outer hip and gluteal (buttock) muscles, but also mobilises a stiff hip joint.
5. Glute Stretch: Lie on your back, and bring your knee towards your opposite shoulder to feel a stretch in your bottom. Tip: changing the angle you take the leg will change the position of the stretch and you can play around with the position to find the stretch that feels most effective for you.
Remember that sciatica can be a very painful and debilitating condition. If you are experiencing any of the symptoms of sciatica, it is essential that you see a doctor or seek advice from a physiotherapist or osteopath for a proper diagnosis and treatment. You can find relief from your symptoms and resume living your life with the correct treatment plan, and in most cases, sciatica does tend to get better.
If you are a therapist and like the exercises and information in this document, please go to www.rehabmypatient.com and sign up to this amazing exercise prescription software. If you are a patient and need some advice, treatment or a consultation, please go to www.surreyphysio.co.uk/bookonline. We provide virtual and face-to-face appointments with our expert team.
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