Exercising with sciatica may seem like an impossible task if you have it, but it could ease your symptoms, experts say. The sciatic nerve is the longest in your body, starting with the nerve roots in your lumbar spine (lower back) which then run through your hips, buttocks and legs, to your feet.
According to Spine Health, sciatic pain affects 10-40% of the population and refers to symptoms that can be diagnosed as numbness, pain and tingling in the back and legs caused by a myriad of factors such as aging or herniated disc. For the majority of people, acute (mild) sciatica gets better in four to six weeks without medical intervention, but for others it can progress to a lifelong chronic condition.
Severe nerve pain can be debilitating, and unfortunately some exercises and workout styles are cut out altogether. The good news? Learning to exercise with sciatica (rather than avoiding it altogether) could help you live a healthier, pain-free life.
We spoke with experts to dig deeper into what sciatica is, why it happens, and how exercising with sciatica for sciatic nerve pain relief really works, plus what to avoid completely.
What is sciatica?
“Sciatica refers to pain that travels through the sciatic nerve, from the lower back to the foot,” said Ms Vivian Elwell. (opens in a new tab), a consultant neurosurgeon at London Bridge Hospital, tells Live Science. “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 develop in the joints) on the vertebrae.”
The sciatic nerve is responsible for motor function (helping your arms and legs move) and sensory function (allowing you to feel sensations in your legs and feet), so any damage to this nerve can lead to serious problems.
Elwell explains that the symptoms include shooting pains, numbness and weakness in the leg that gets worse when standing or walking. “Risk factors include age-related changes, obesity, prolonged sitting, and diabetes mellitus,” she says. “It can happen at any time in life, but men are three times more likely to get the disease, and it normally occurs between the ages of 40 and 50.”
Adam Foster, Director of The Fibro Guy Ltd (opens in a new tab) (a rehabilitation service for chronic pain and hypermobility syndromes), agrees that there are myriad ways for irritation to set in, including pinched nerves and genetic abnormalities. “Fortunately, sciatica is rarely mechanical in nature, and problems such as nerve impingement are rarer due to the abundance of space in our nerve roots.”
However, since certain 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 up 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 do safely?
The best exercises for sciatica
“Bed rest has been a popular treatment for sciatica for most of the past few decades,” Foster tells us. “But the best thing 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 staying in bed over staying active when it comes to sciatic pain (and vice versa). However, as mentioned in a review published in Spine, “because there is no substantial difference between advice to stay active and bed rest advice, and there are potentially harmful effects of bed rest prolonged, it is reasonable to advise people with acute low back pain and sciatica to stay active.
Jodie Breach, Head of Physiotherapy for Nuffield Health, (opens in a new tab) accepted. “Most people will find that gentle movements help ease their pain,” she says. “It’s likely that you’ll still feel pain while exercising, but that doesn’t necessarily mean it’s causing harm. The key is finding the right level of exercise.
Foster recommends combining a mix of stretches (opens in a new tab) and mobility work. However, stretching has more of an effect on your nervous system than on the tissues themselves, so he advises you to move slowly and carefully. “Gentle dynamic movement can be incredibly beneficial to your range of motion,” he advises.
Elwell advises working closely with a physical therapist who can determine which exercises benefit you. “Slow, gentle stretches are advised,” she agrees. “Yoga (opens in a new tab)Pilates, swimming, walking and stationary indoor cycling are all great options, and it’s important to stay as active as possible in your daily activities.
A good guiding principle is that pain should be tolerable and settle relatively quickly after exercise, so if not, the intensity should be reduced.
Exercises to avoid if you have sciatica
“There are several exercises that are helpful for anyone struggling with sciatica, but there are also several that can make the pain worse,” says Elwell. “Any high-impact exercise should be kept to a minimum, including contact sports, running, soccer, and tennis. These sports put sudden and intense tension or rotational forces on your back and can potentially worsen your symptoms. underlyings.
Elwell recommends hitting the gym, but jumping, bending, twisting, and lifting both legs together could worsen pressure on the sciatic nerve. She recommends avoiding exercises like:
- Double leg raises
- Touching toes
- Weighted squats
- folded rows, and
- outdoor cycling
Instead, stretches that gently target your lower back and glutes – performed on some of the best yoga mats (opens in a new tab) for support – may help release muscle tension. Consider knee-to-chest stretches (lying or standing), reclined pigeon pose, and yoga for back pain. (opens in a new tab).
Other Ways to Manage Sciatica
Elwell and Foster both recommend applying heat or ice pads to relieve pain, improve blood circulation and relax muscles, but if you suffer from numbness this should be used with caution. And asking for a spine evaluation or seeing your doctor is also advisable if your pain worsens.
“Heat won’t do much for the nerve to the piriformis muscle (one of your deepest gluteal muscles) which can irritate sciatica,” Foster warns. “But it will provide some relief to calm your nervous system. Likewise, vibration therapy reduces muscle pain and can help treat muscle inflammation.
But above all, remember that prevention is key, and be sure to take care of your back and overall health by staying active, managing your weight, and investing in a good quality mattress. Learn how to get a stronger core (opens in a new tab) and how to improve your flexibility (opens in a new tab) could also help you protect your lower back during exercise.