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Sciatica Exercises
ﺗﻤﺎرﻳﻦ ﻟﻌﺮق اﻟﻨّﺴﺎ
By: Ron S. Miller, PT
In This Article:
Page 1 of 17
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Sciatica Exercises
Many sciatica exercises focus on strengthening the abdominal and back muscles in order
to provide more support for the back. Stretching exercises for sciatica target muscles that
cause sciatic pain when they are tight and inflexible. When patients engage in a regular
program of gentle strengthening and stretching exercises, they can recover more quickly
from a flare up of sciatica and can help to prevent future episodes of sciatica pain.
Leg pain or sciatica (also known as radiculopathy) from a herniated disc is commonly
caused by disc material protruding backwards and irritating or compressing a nerve root,
which in turn causes pain to radiate along the sciatic nerve.
Specific lower back exercises for sciatica pain relief from a herniated disc are
prescribed according to which positions will cause the patient’s symptoms to move up the
lower extremity and into the low back.
If the patient is unable to lie flat, similar sciatica exercises can be done standing by
arching backward slowly with hands on hips (Figure 3). However, the prone position
described above is usually preferred.
These extension exercises are done regularly, about every two hours. More importantly,
the spine specialist may recommend that the patient with this condition should avoid
getting into a forward flexed (bent over) position. This tends to counteract the effects of
the extension exercises. The specialist may ask the patient to correct any forward flexed
positions immediately by doing an extension exercise.
Page 3 of 17
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Sciatica Exercises
Page 4 of 17
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Sciatica Exercises
Sciatic pain from nerve root irritation or impingement can be caused by spinal stenosis, a
condition that causes the nerve’s passageway to narrow or constrict. A typical symptom
of spinal stenosis is sciatic pain that radiates along the sciatic nerve down the leg while
walking, with sciatic pain relief only felt when sitting down. The study of this leg pain
(sciatica) is referred to as radiculopathy.
For more information on spinal stenosis, please see lumbar spinal stenosis and living
with spinal stenosis.
Back exercises targeted at alleviating the sciatica pain caused by stenosis typically
include a combination of specific stretching and strengthening exercises that focus on:
1. Stretching the muscles of the back that hold the spine in extension (backwards
bending)
2. Strengthening the muscles that bring the spine into flexion (forward bending).
Page 5 of 17
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Sciatica Exercises
Hook-lying march. For a more advanced sciatica exercise, this position may be held
while marching in place in the hook-lying position, slowly raising alternate legs 3 to 4
inches from the floor (Figure 11). Aim to ‘march’ for 30 seconds, two to three
repetitions, with 30-second breaks in between repetitions.
Curl-ups. Another strengthening exercise that may be recommended by spine
specialists to strengthen the lower abs is called a curl-up (Figure 6). These are done
by folding arms across chest, flattening the back by tightening lower abs, then raising
the head and shoulders from the floor. Hold for two to four seconds, then slowly
lower to starting position. As strength builds, aim to complete two sets of ten curls.
These sciatica exercises alone will not necessarily make the patient with sciatica from
spinal stenosis “better”, but they will allow the patient to more easily hold a posterior
pelvic tilt during activities, especially standing and walking. This posture will allow the
patient to perform more activities with less pain. The pelvic tilt is often very difficult for
patients to learn and can take a good deal of practice with the guidance of a physical
therapist before it is used effectively to treat sciatica resulting from spinal stenosis.
Page 6 of 17
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Sciatica Exercises
While degenerative disc disease most often causes low back pain( )ﺁﻻم أﺳﻔﻞ اﻟﻈﻬﺮ, if a
degenerated disc impinges on a nerve root in the low back it can also cause a form of
sciatica.
With that said, a series of sciatica exercises for degenerative disc disease exist and may
provide relief of sciatic symptoms.
Alleviating sciatic pain caused by degenerative disc disease includes finding the most
comfortable position for the lumbar spine and pelvis and training the body to maintain
this position during activities.
In doing this correctly, one can improve the proprioception (sense of movement) of the
lumbar spine and reduce the excess motion at the spinal segments. This will in turn
reduce the amount of irritation at these segments, resulting in sciatica pain relief and
protecting the area from further damage.
This type of exercise program is progressive, starting with the easier sciatica exercises
and advancing to the more difficult exercises once the lower level program is mastered.
The most important aspect of using these sciatica exercises is sensing and controlling
motion in the spine. Once learned, the body can eventually take over and do this without
the level of concentration it takes early on.
Page 7 of 17
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Sciatica Exercises
Hook-lying march combination. This is the same sciatica pain relief exercise as
described above, but includes raising and lowering the opposite arm over the head
(Figure 12).
Bridging. Start by lying on the back with the knees bent, then slowly raise the
buttocks from the floor (Figure 13). Hold bridge for eight to 10 seconds, then slowly
lower to starting position. As strength builds, aim to complete two sets of ten bridges.
These sciatica exercises should all be performed with a rigid trunk. The pelvic tilt,
tightening the lower stomach muscles and buttocks to flatten the back (Figure 10), can be
used to find the most comfortable position for the low back.
Similar stabilizing exercises can be done in the 4-point position (kneeling on hands and
knees), raising the arms and legs only as high as can be controlled, maintaining a stable
trunk and avoiding any twisting or sagging:
Raise one leg behind with the knee slightly bent and no arch in the back or neck
(Figure 15). Hold for four to six seconds, then slowly lower to starting position. As
strength builds, aim to complete two sets of ten leg raises.
For a slightly more advanced exercise, raise one leg with the knee slightly bent and
no arch in the back or neck and also raise the opposite arm (Figure 16). Hold for four
to six seconds, then slowly lower to starting position. As strength builds, aim to
complete two sets of ten leg raises.
Practical point: Exercise has both mental and physical components. By increasing their conscious
awareness of the position of their spine, patients can assume the most comfortable stance and better
control their pain symptoms.
Page 8 of 17
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Sciatica Exercises
Sciatica can be caused by isthmic spondylolisthesis if the condition results in nerve root
irritation or impingement. In most cases, if isthmic spondylolisthesis affects or pinches a
nerve root it will affect the L5 nerve root.
When treating sciatica resulting from isthmic spondylolisthesis with exercise, the spine
specialist will typically recommend a program of sciatica exercises that is a hybrid of:
Flexion based exercises (as when treating spinal stenosis), and
Stabilization program (as when treating degenerative disc disease).
The goal of this type of sciatica exercise program is to teach the lumbar spine to remain
stable in a flexed position. Therefore, the sciatica exercises for isthmic spondylolisthesis
are a combination of both programs.
Practical point: The pain from isthmic spondylolisthesis can be minimized by training the lumbar spine to
remain stable when flexed, such as it is when picking something up off the floor or tying one’s shoes.
Page 9 of 17
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Sciatica Exercises
Supine piriformis stretches. Lie on the back with the legs flat. Pull the affected leg up
toward the chest, holding the knee with the hand on the same side of the body and
grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee
towards the opposite ankle (Figure 17) until stretch is felt. Do not force ankle or knee
beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim
to complete a set of three stretches.
Lie on the floor with the affected leg crossed over the other leg at the knees and both
legs bent. Gently pull the lower knee up towards the shoulder on the same side of the
body (Figure 19) until stretch is felt. Hold stretch for 30 seconds, then slowly return
to starting position. Aim to complete a set of three stretches.
Page 10 of 17
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Sciatica Exercises
Practical point: Stretching the piriformis muscle a few times a day, especially when combined with
hamstring stretches, will prevent tightening of the lower back and relieve tension from hip to foot.
Page 11 of 17
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Sciatica Exercises
Practical point: The main objective of exercises for sciatic pain from sacroiliac joint dysfunction is to
restore the range of motion in this joint which can be limited if the joint is inflamed.
Page 12 of 17
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Sciatica Exercises
As a final note, regardless of the diagnosis, most types of sciatica will benefit from a
regular routine of hamstring exercise, especially hamstring stretching. The hamstrings
( وﺗﺮ اﻟﺮآﺒﺔ, ﻋﺮﻗﻮب, )أوﺗﺎر اﻟﻤﺄﺑﺾare muscles located in the back of the thigh. They help bend
the knee and extend the hip. Tightness in the hamstrings will place increased stress on the
low back and often aggravate or even cause some of the conditions that result in sciatica.
When doing hamstring stretches, patients should avoid bouncing, which can trigger a
muscle spasm.
Depending on the patient’s specific medical condition and level of pain, the lying down
position may be preferable and comfortable. In particular, patients with low back pain
( )ﺁﻻم أﺳﻔﻞ اﻟﻈﻬﺮshould choose whichever position is most tolerable for their back while
still giving a gentle stretch.
Page 13 of 17
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Sciatica Exercises
Page 14 of 17
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Sciatica Exercises
Page 15 of 17
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Sciatica Exercises
Page 16 of 17
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Sciatica Exercises
Page 17 of 17
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