Exercising with sciatica may seem like an impossible task if you have the condition, but experts believe it could ease your symptoms. The sciatic nerve is the longest in your body, starting with nerve roots located in your lumbar spine (lower back) that then run through your hips, butt, and legs, down to your feet.
According to spine health, sciatica pain affects 10-40% of the population and refers to diagnosable symptoms such as numbness, pain and tingling in the back and legs caused by a myriad of factors such as aging or a herniated disc . For most people, acute (mild) sciatica resolves in four to six weeks without medical intervention, but for others, it can become a lifelong chronic condition.
Severe nerve pain can be debilitating and unfortunately causes some exercises and training styles to be ruled out altogether. The good news? Learning how to exercise with sciatica (instead of avoiding it altogether) could help you live a healthier, pain-free life.
We talked to experts to delve into what sciatica is, why it occurs, and how sciatica exercise actually works to relieve sciatic nerve pain, as well as what to avoid altogether.
What is sciatica?
“Sciatica refers to pain that runs through the sciatic nerve, from the lower back to the foot,” Miss Vivian Elwell (opens in a new tab), a consultant neurosurgeon at London Bridge Hospital, tells WordsSideKick.com. “It is caused by compression, irritation, or damage to the sciatic nerve, which is usually caused by a herniated disc in the spine or a bone spur (bony projections that grow into the joints) in the vertebrae.”
The sciatic nerve is responsible for motor function (helps your arms and legs move) and sensory function (allowing you to feel sensation in your legs and feet), so any damage to this nerve can cause some problems serious.
Elwell explains that symptoms include shooting pains, numbness and weakness in the leg that are made worse by standing or walking. “Risk factors include age-related changes, obesity, prolonged sitting, and diabetes mellitus,” she says. “It can occur at any time in life, but men are three times more likely to have this condition, and it typically occurs between the ages of 40 and 50.”
Adam Foster, director of Fibro Guy Ltd (opens in a new tab) (a rehabilitation service for chronic pain and hypermobility syndromes), agrees that there are myriad ways that irritation presents, including nerve impingement and genetic abnormalities. “Fortunately, however, sciatica is rarely mechanical in nature, and problems like nerve impingement are rarer due to the abundance of space in our nerve roots.”
However, because some movements can aggravate the compressed nerve, many people believe that exercise should be avoided altogether, which is not the case at all. Gentle exercise can help relieve pain and speed recovery, but it’s crucial to differentiate between the types of exercise that can help and those that can hinder.
So what exercises can you still enjoy safely?
The best exercises for sciatica
“Bed rest has been a popular treatment for sciatica for most of the last few decades,” Foster tells us. “But the best we can do is stay relatively active.”
In terms of published evidence, most meta-analyses and reviews show that there are no significant benefits of bed rest over staying active when it comes to sciatica pain (and vice versa). However, as mentioned in a review published in Spine“Because there is not a significant difference between the advice to stay active and the advice to rest in bed, and there are potentially harmful effects of prolonged bed rest, it is reasonable to recommend people with acute low back pain and sciatica to stay active.”
Jodie Breach, director of physical therapy at health Nuffield, (opens in a new tab) agrees “Most people will find that gentle movement helps ease their pain,” she says. “You will probably still feel some pain while exercising, but this does not necessarily mean that it is causing damage. The key is finding the right level of exercise.”
Foster recommends combining a mix of extension (opens in a new tab) and mobility work. However, stretching has more of an effect on the nervous system than actual tissue, so he recommends moving slowly and carefully. “Smooth dynamic movement can be incredibly beneficial to your range of motion,” he advises.
Elwell advises working closely with a physical therapist who can indicate which exercises are beneficial for you. “Slow, gentle stretches are recommended,” she agrees. “Yoga (opens in a new tab)Pilates, swimming, walking and stationary indoor cycling are great options, and it’s important to stay as active as possible with your daily activities.”
A good guiding principle is that the pain should be tolerable and go away relatively quickly after exercise, so if that’s not the case, reduce the intensity.
Exercises to avoid if you have sciatica
“There are several helpful exercises for anyone with sciatica, but there are also several that can aggravate the pain,” Elwell explains. “Any high-impact exercise should be kept to a minimum, including contact sports, running, soccer and tennis. These sports put sudden and intense stress or rotational forces on the back and can potentially worsen underlying symptoms.”
Elwell recommends hitting the gym, but jumping, leaning forward, twisting, and lifting both legs together could aggravate pressure on the sciatic nerve. She recommends avoiding exercises like:
- Belching
- double leg raises
- toe touches
- weighted squats
- Bentover rows, and
- outdoor cycling
Instead, stretches that gently target the lower back and glutes, performed on some of the best yoga mats (opens in a new tab) for support: could help release muscle tension. Think knee-to-chest stretches (lying or standing), reclining pigeon pose, and yoga for back pain (opens in a new tab).
Other ways to control sciatica
Both Elwell and Foster recommend applying heat or ice packs to relieve pain, improve blood flow, and relax muscles, but if you’re having trouble with numbness, use them with caution. And seeking a spinal evaluation or visiting your doctor is also a recommendation if your pain worsens.
“Heat won’t do much for the nerve to the piriformis muscle (one of the deepest gluteal muscles) which can irritate sciatica,” Foster warns. “But it will provide some relief to calm your nervous system. Also, vibration therapy reduces muscle pain and can help treat muscle inflammation.”
Most importantly, though, remember that prevention is key, and make sure you take care of your back and overall health by staying active, managing your weight, and investing in a good quality mattress. Learning How to get a stronger core (opens in a new tab) Y how to improve your flexibility (opens in a new tab) It could also help protect your lower back during exercise.
