The sciatic nerve is a large nerve that originates in the lumbar spine, travels through the pelvis and the buttock, between the ischium and coccyx, and extends down each leg. It is the largest nerve in the body. Sciatica -- pain in the sciatic nerve and surrounding tissues -- can originate in the low back or buttocks and radiates down one or both legs.
Possible Causes
Sciatica can be due to nerve compression, either when the nerve is being compressed by a ruptured or bulging vertebral disk or when it is compressed by a muscle, such as the piriformis, deep in the buttock. The sciatic nerve also can become inflamed because the nerve is stretched or it is compressed by an outside source such as a wallet in a back pocket or a lump in a car seat. Muscle spasms in the low back and buttocks can impinge on the sciatic nerve, as can spinal arthritis.
Treatment
Exercise does not help back or hip pain in the acute stage. In fact, it may make the pain worse. Rest, ice and oral anti-inflammatory medications may help. After the acute phase subsides and the pain is less severe, you can begin gentle aerobic exercise, such as walking or swimming. Avoid exercises that aggravate the problem, including straight leg sit-ups, prone leg lifts and leg exercises using exercise equipment.
Stretches
Hamstring stretch: Lying on your back with your knees bent, raise one leg and support it with your hands while you try to straighten the knee and bring it toward your chest. Hold the stretch for 20 seconds and then repeat with your other leg.
Knee to chest: lying on your back, pull both knees to your chest until you feel a stretch in your low back. Hold the stretch for five seconds and repeat five times.
Backward arch: While standing, arch your back as far as you can comfortably and hold the stretch for five seconds. Repeat five times.
Quadriceps stretch: While standing, bring one foot up behind your buttocks, pulling it with your hand. If you can't reach your foot to pull it up in back, wrap a scarf around your foot and pull on the scarf to move your foot as close to your buttocks as possible. Repeat with the other leg.
Piriformis stretch: Lying on your back, bring one knee to your chest and then use the opposite hand to pull the knee over to the opposite side. Hold the position until you can feel the stretch deep in your buttock. Return to the starting position and repeat with the other leg.
Strengthening Exercises
Abdominal curls or crunches: Lie down on your back with your arms beside you and your knees bent. Flatten your low back against the floor while you roll your head and shoulders off the floor; hold the position for 10 seconds and return to the starting position. Repeat 10 times.
Oblique crunches: From the same starting position as the abdominal curls, raise one leg and pull it toward your chest with your hands. Raise your head and shoulders toward the opposite hip. Hold for five seconds. Repeat 10 times and then repeat with the other leg raised.
Prone upper body lifts: Lying prone with your arms at your sides, arch your head and upper body off the floor, without using your arms or hands. Hold for five seconds and return to the starting position. Keep your hips and legs pressed to the floor while you arch upward. Repeat 10 times.
