First of all, what is Sciatica?

Sciatica is a term that describes symptoms of pain, numbness, and/or weakness that radiate along the sciatic nerve from the lower back to the buttocks and leg.

Our longest nerve in the body, the sciatic nerve travels from the lower back and buttocks into the legs. So how do we go about treating sciatica?

The medical term for sciatica is ‘lumbar radiculopathy’.

The vast majority of sciatica symptoms result from lower back disorders that put pressure on or cause irritation to a lumbar nerve (bottom of spine) root. Most commonly, sciatica is caused by a disc problem such as a herniated disc that is pressing against a nerve root.

Sciatica treatment may include both nonsurgical and surgical methods, but in this article we will look at the non-surgical treatment options and combinations:

Nonsurgical Treatment for Sciatica

First line treatments of sciatica typically include some combination of physiotherapy, medications, therapeutic injections, and alternative therapies.

Acute sciatica usually gets better with 4 to 6 weeks of nonsurgical treatment. For chronic sciatica, with pain lasting over 8 weeks, treatment time may take longer and may depend on the underlying cause.

Physio for Sciatica

Physiotherapy incorporates a combination of strengthening, stretching, and aerobic conditioning, and is a central component of almost any sciatica treatment plan.

The goals of the exercises for sciatica include:

• Strengthen the spine and muscles of the lower back, abdomen, buttocks, and hip.
• Increase core strength
• Stretch tight and inflexible muscles, such as hamstrings
• Encourage the exchange of fluids and nutrients in the body by light aerobic exercises such as walking, swimming, or pool therapy

It is important to maintain as much activity as possible and avoid prolonged periods of physical inactiveness or bedrest. 

Exercises for Pain Relief

Specific sciatica exercises depend on the cause of the pain.  It is important to first get an accurate diagnosis for the cause of sciatic pain.

The specific exercises recommended will be targeted for the underlying cause of the sciatica. For example, if leg pain is caused by instability from a degenerated spinal disc, exercises will generally focus on strengthening the spinal muscles to better support itself and reduce excessive micromotions.

Sciatica exercises serve two main purposes:

• Reduce the sciatic pain in the short term.
• Provide conditioning to help prevent future recurrences of the pain.

Without exercise and movement, the back muscles and spinal structures become deconditioned and less able to support the back.

Active exercise is important for the health of the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy and prevent pressure on the sciatic nerve.

Typical features of any sciatica exercise program include:

Core muscle strength. Many sciatica exercises serve to strengthen the abdominal and back muscles in order to provide more support for the back. Another important set of muscles to focus on are the glutes (both max, min and piriformis), as these muscles are often ‘switched off’ due to dominate hamstrings and quadriceps. 

Stretching exercises for sciatica target muscles that cause pain when they are tight and inflexible.

Hamstring stretching. Regardless of the diagnosis, most types of sciatica will benefit from a regular routine of hamstring stretching. The hamstrings are muscles located in the back of the thigh. Overly tight hamstrings increase the stress on the low back and often aggravate or even cause some of the conditions that result in sciatica.

Aerobic exercises. In addition to specific sciatica exercises, aerobic conditioning may also be encouraged for general fitness. Walking is an excellent form of exercise for the low back because it is relatively low impact but can provide all the benefits of an aerobic workout. If possible, it is best to gradually progress to doing up to 3 miles of exercise walking at a brisk pace each day.

The next time you feel pain down your leg firstly remember sciatic pain is a general term and it is always good to get a professional opinion before self -diagnosing. Remember to focus on a mindset that this will be a temporary problem at doing movement is generally advisable over the tendency to stop everything.

Success in wellness,
Phil Jones.