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Sciatica is a widely accepted catch-all term that people use to describe pain in the back and hip, radiating down the back of the leg.
It may surprise you to learn that sciatica itself is not a diagnosis, it’s a symptom (with several possible causes).
Most cases are a result of irritation to the sciatic nerve originating at the lower spine. However, people are quick to call pain in the back of the leg “sciatica,” whether it is or not, and the term is used somewhat inconsistently.
If you’re googling “best exercises for sciatica,” you’re asking the wrong question. The answers lie in what’s causing your sciatic pain.
Save yourself some time and frustration by learning what to avoid with sciatica and get on the right path to pain relief!
Disclaimer: This content is for educational purposes and is not medical advice. Read the full disclaimer.
SCIATIC NERVE ANATOMY
The sciatic nerve is one of the longest and thickest nerves in the body (up to 2cm) and originates from multiple nerve roots in the lumbar spine (lower back), forming a left and a right sciatic nerve.
Anatomy varies but generally starts around the piriformis muscle (at the back of the hip) and runs down the back of the thigh, splitting off into smaller nerves behind the knee. These branches then continue to the foot.
The sciatic nerve provides motor function (allows you to move your muscles) directly and indirectly to the lower body’s major muscle groups, including the hamstrings and adductors with branches to lower leg muscles and feet. (Davis D., 2020)
More distal branches provide sensation to the back of the leg and parts of the foot.
SYMPTOMS OF SCIATICA
Sciatica symptoms vary in intensity and severity.
Some common symptoms of sciatica are:
- Moderate to severe pain in the lower back, back of the hip/buttock, and down the back of the leg
- Sensation changes such as numbness, tingling, pins and needles, or prickly sensations
- Muscle weakness
- Pain and symptoms can be anywhere along the distribution of the sciatic nerve
If any of these symptoms are accompanied by loss of bowel or bladder function or numbness in the area where you would sit on a saddle, get to the doctor ASAP because that’s a medical emergency.
IS IT SCIATICA OR SOMETHING ELSE?
Many sciatica cases originate from the spine, such as with a disc bulge, causing inflammation of the lower spinal nerves. This is sometimes referred to as a pinched nerve. But the spine is not the only place this nerve can become irritated.
Dumping all of these leg pain causes into a big garbage can labeled “sciatica” gets confusing in a hurry.
Several issues can cause sciatica-like pain by either irritating the sciatic nerve along its path (like in piriformis syndrome) or causing referred pain down the leg in a similar pattern (such as from a muscle spasm from the glute minimus.)
Pseudo-sciatica (also not a diagnosis) doesn’t mean your symptoms are fake. It just means that you could be experiencing sciatic-like symptoms and not true sciatica.
But the pain is real, and the right cause needs to be determined to get healthy again.
POTENTIAL CAUSES OF SCIATIC PAIN
Sciatic nerve pain can result from any irritation to the sciatic nerve. Here are some potential ways this tissue can become angry.
- Lumbar disc bulge or herniation (slipped disc)
- Impingement at the lumbar nerve root
- Muscular spasm
- SI joint issues
- Piriformis syndrome
- Spinal stenosis
- Degenerative disc disease
- Limited hip mobility
- Malignancies or infections
Conditions such as vascular disease or peripheral neuropathy can mimic sciatic symptoms but are very different conditions.
Hamstring strains can also be mistaken for sciatic nerve pain but a proper evaluation will tell them apart.
AVOID GOOGLING “EXERCISES FOR SCIATICA”
I get it. When you have sciatic pain, you’ll do almost anything to feel better.
The internet is an easy way to research and learn about health conditions (from quality sources, of course), but if you’re asking the wrong questions, you’re going to get the wrong answers.
Plenty of people out there are willing to offer you bad advice, especially in places like Facebook groups and message forums. Following the wrong advice can lead to feeling worse!
Taking an active role in your health doesn’t mean going rogue and self-diagnosing, and self-treating.
If sciatica is a symptom with several possible causes, there isn’t one magical sciatica exercise that magically fixes everyone.
- If a lumbar herniated disc causes nerve compression, extension exercises might benefit the program.
- If the sciatica pain is due to lumbar stenosis, flexion exercises might be the way to go.
- If the discomfort results from an SI joint dysfunction, either of those movements might aggravate the pain.
- If it’s piriformis syndrome, spinal range of motion exercises likely won’t help.
- There can be multiple conflicting issues occurring at once that change the appropriate treatments.
This is why you need more specifics.
There are plenty of great exercises for sciatica. However, whether or not they’re great for your sciatica is another story.
DETAILS THAT CAN HELP IDENTIFY YOUR SCIATIC PAIN
When you visit your physical therapist or chiropractor, they will ask you some questions to help tease out the cause of your pain.
Here are some questions to ponder that can help you (and your healthcare providers) determine what’s causing your symptoms and get you on the right track to feeling better.
The more detail you can provide, the better they can help you get some pain relief.
THE LOCATION OF THE PAIN
The sciatic nerve travels along a specific path. The location of your symptoms can help determine if it’s sciatica or something else.
Hamstring strains are sometimes confused with sciatica pain, but a proper evaluation can tell them apart.
QUALITY AND SEVERITY OF YOUR SYMPTOMS
The quality of the pain (sharp, dull, achy, numbness/tingling) can be a clue.
Do you perceive any muscle weakness?
EFFECT ON ACTIVITY
Try to identify activities/movements that make the pain better and which make it worse. This can help establish a pattern and get you closer to a diagnosis.
HOW DID THE PAIN START
Was this a sudden onset after a specific movement, or did the pain gradually increase?
See also, How To Prepare For Your First Physical Therapy Appointment (+Free Checklist) for a head’s up on what to know before you go.
WHAT TO AVOID WHEN YOU HAVE SCIATICA
You’ll need to know what’s causing your sciatica to get the right exercises.
However, an essential part of getting better is understanding what makes the pain worse to avoid exacerbations.
Here are some examples of activities to avoid if you suspect you have sciatica.
AGGRESSIVE HAMSTRING STRETCHING & FORWARD BENDING
If the sciatic nerve is irritated, putting tension on the nerve by stretching will most certainly aggravate the pain, like pulling a rope at both ends.
Examples would be bending over to touch your toes with straight legs or sitting with your legs out and leaning forward to touch your toes. This also includes downward facing dog.
Daily activities such as bending forward to pick something up or gardening activities can also tension the sciatic nerve and make you feel worse.
If you find that these motions aggravate your pain, make a note, and modify your movements to pain-free motions.
Use props like a stretch out strap to keep yourself safe and avoid overstretching.
Bend the knees and use good body mechanics during everyday activities.
PUSHING THROUGH THE PAIN
The no pain, no gain mentality will come back to bite you. Subscribing to this outdated, old-school phrase does more harm than good.
Instead, get in tune with pain/symptoms vs. sensation of muscles working.
Differentiating between these can help you avoid taking one step forward and two steps back in your rehab process. This goes for everyday activities too.
Less pain = more gain.
Heavy lifting, especially squats, deadlifts, and bent over rows, can further irritate an angry sciatic nerve.
Take a step back and let yourself heal so you can return stronger and better than before.
HIGH IMPACT EXERCISES
High impact exercises take a toll on the muscles and joints of the body. There are plenty of low impact workouts to keep you moving.
If something is already irritated, high impact exercises will likely worsen the problem.
AGGRESSIVE ABDOMINAL EXERCISES
Some abdominal exercises (like double leg lifts and sit-ups) can place a lot of pressure on the lower back.
If your symptoms are a result of a lumbar disc herniation, aggressive abdominal exercises will likely aggravateve the situation.
To be honest, sit-ups aren’t even a great exercise to work the core muscles anyway.
EXTREME SPINAL MOVEMENTS
Extreme spinal movements in any direction can further compress irritated tissues.
EXCESSIVE SITTING OR STANDING
Excessive time in any one position can aggravate sciatic pain. Consider using a lumbar support pillow to maintain your natural alignment while sitting.
ANYTHING THAT AGGRAVATES YOUR SYMPTOMS
Not everyone follows textbook patterns when injured.
Nerve tissue is incredibly sensitive, and it’s possible to pay for this for hours or even days after exacerbating your symptoms. Make sure you’re listening to your body.
WHAT TO DO FOR SCIATICA
We’ve spent a lot of time on what not to do. Here are some things you can do to take an active role in fixing your sciatic pain.
- DO get evaluated to determine the cause of your pain and set you up with the proper exercise program for you.
- DO pay attention to your symptoms so you can articulate them to your health care providers to receive a more specific treatment.
- DO learn about your condition so you can better understand safe ways to move and avoid exacerbations.
- DO be consistent with your prescribed home program.
- DO speak up and problem solve with your healthcare providers when something isn’t working.
- DO manage your expectations for healing and celebrate small wins toward getting back to normal.
Sciatica is a symptom, not a diagnosis, and there’s no one-size-fits-all cure.
Resist the urge to self diagnose and follow some generic lousy advice. It’s essential to find out what’s causing your symptoms to get sciatica pain relief.
Learning what to avoid when you have sciatica is just as important to avoid making the problem worse.
For persistent symptoms, it’s always good to get an evaluation and individualized treatment to avoid chronic pain and nerve damage.
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Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
Visser LH, Nijssen PG, Tijssen CC, van Middendorp JJ, Schieving J. Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis. Eur Spine J. 2013;22(7):1657-1664. doi:10.1007/s00586-013-2660-5
Thiyagarajan, Senthilkumar. (2017). Pseudo Sciatica-It’s the Condition we really Treat Better than Medicine. Journal of Novel Physiotherapies. Volume 7. 10.4172/2165-7025.1000327.