By Dana Santas, CNN
Often associated with low back pain, sciatica tends to be more of a pain in the butt — and sometimes also the leg. That’s because the pain travels along the sciatic nerves, the longest nerves in your body. Each sciatic nerve runs bilaterally from the base of your spine through the deep muscles of your buttocks and down the back of a leg.
In the preceding two articles in this series, I helped you understand more about the possible origins of your back pain and how to begin finding relief through exercise. Now we focus on assisting those who are suffering specifically with sciatica.
No magic bullet for sciatic pain
When injured, compressed or irritated, a sciatic nerve causes significant discomfort, including shooting pain in typically one side of your bottom, unabating painful tingling, or numbness and weakness down the back of one or both legs. As many as 40% of adults experience sciatica in the course of a lifetime, experts have estimated. Unfortunately, without proper treatment, the condition can become chronic.
If you’ve experienced sciatic pain, you’ve probably spent hours searching the internet for ways to make it stop, only to encounter conflicting advice. That’s because sciatica is a symptom of numerous conditions that respond to different treatments. The most common causes originate from either nerve compression coming from the lumbar spine, or nerve impingement due to muscle tension in the buttocks, trapping the sciatic nerve.
With sciatica’s varying causes, there isn’t a single magic bullet for relief. However, the right corrective exercises, done regularly, can be effective in not only relieving sciatica but also preventing it. Read on for techniques to try to help you determine the cause of your pain and the best ways to alleviate it.
Exercises for relief and prevention
You may feel your most significant sciatic nerve pain in the muscles of your butt or down your leg, but that pain doesn’t necessarily mean it originates there. Although muscle tension in your hips could be causing the pain, the pressure on the nerve could also be coming from your low back due to spinal compression and pelvis position. That’s why you should try different exercises that address those different areas to see how your pain responds.
Below, I describe the best approaches to take to determine the origins of your pain and share exercises you should do for relief and prevention. When practicing any exercises, stop immediately if your pain increases or feels “wrong.”
The exercises noted below are designed to address the most common causes of sciatica, but not all types of back pain respond to the same remedy, so not all exercises will work for everyone.
Important note: Talk with your doctor to understand the source of your pain and get approval before beginning any exercise program.
Origin: Lumbar spine
When your sciatica stems from your lumbar spine and pelvis position, it helps to activate and strengthen deep core muscles to stabilize your low back while also working to put your pelvis in neutral alignment.
The seated bent-knee block hold demonstrated in this video works to strengthen low, deep core muscles while activating your inner thighs to help realign your pelvis. If being seated on the floor is too much for you now, do the modified version of the exercise, seated on a chair (also demonstrated in the video) or go back to the breathing bridge exercise included in the second part of our series, which works muscles in a similar manner.
As you try this exercise or any of the variations noted above, be sure to tune into your mind-body connection, so you can better understand the sensations you experience and how you should respond. If your pain becomes more acute or increases at all, stop immediately. If your pain decreases, it indicates you’re on the right track in treating your sciatica. Practice two to three rounds of this exercise once or twice a day over the next several days to see how you feel.
You might also want to try this hip flexor exercise as it also works to realign your pelvis to take pressure off your lumbar spine.
Origin: Hips and buttocks
We’ve already covered how tight hips lead to low back compensation, resulting in back pain. Tight hips can also cause sciatica due to tense muscles in the middle of the buttocks — your piriformis muscles — putting pressure on the sciatic nerve. This condition is known as piriformis syndrome. If piriformis syndrome is the cause of your sciatic symptoms, releasing tension in your hips will take pressure off the nerve to relieve your symptoms.
The seated hip-opening twist in this video is designed to stretch your piriformis. Try this exercise slowly and carefully, paying attention to your form as you rotate. The twist needs to initiate from your midback. Do not force it, as compensating from your low back could exacerbate any lumbar disc issues. Stop if your pain worsens.
If you feel your sciatic symptoms abate while practicing this exercise, do two to three rounds once or twice a day for a few days to see how you progress. You should also try the hip-opening reclined and seated figure-four exercises included in the full video at the top of this article.
Manual soft tissue techniques, such as massage and foam rolling, can also provide some symptom relief, but the only way to prevent sciatica is by proactively using corrective exercise to strengthen, mobilize and realign the areas of your body that were causing the issue in the first place.
Look for the final installment of our series to help you create a proactive, long-term strategy for maintaining your back health for a pain-free, active lifestyle.
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