Sciatica is a painful condition that can also lead to weakness and numbness in the low back, hips and legs. The first step in treatment is to diagnose the underlying problem that is causing the sciatica nerve to be irritated. Depending on the cause and severity, treatment may involve medication and in some cases surgery. Exercise can also help manage sciatica; however, medical advice should be sought first, as the wrong exercises can make symptoms worse instead of better.
The sciatica nerve is the longest nerve in the body. It starts in the low back and then splits into two nerves that run down the back of each leg. This nerve helps to transmit signals from the brain to the intestines, bladder, bowls, legs and feet. If this nerve becomes irritated, symptoms such as pain, numbness and tingling in the back, hips and affected leg can occur and there can be a loss of bladder and bowel control. Symptoms are different for each patient and they range from mild to disabling. The symptoms experienced are in part determined by where the nerve is affected. In the case of L4 and L5 sciatica, the nerve is injured between the fourth and fifth vertebra in the low back; this is the most common site for injury.
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The first step in treatment is to identify the underlying cause of sciatica, as that will help determine what exercises to do and which ones to avoid. There are many causes including a bulging, herniated or ruptured disc; arthritis or stenosis, both of which cause a narrowing of the space between the vertebra in the back; abnormalities in the blood vessels of the spine; tumors; infections; injuries; poor posture and body mechanics; or tight muscles. In some cases, the underlying cause must be treated first, before exercise can be started. If the symptoms are severe enough, surgery may be necessary.
According to the American Medical Association, approximately 80 to 90 percent of patients with sciatica get better over time without surgery. The right exercise program can help to relieve symptoms in many cases. Initially, some patients need to take medication to control symptoms enough so that exercise can be tolerated. It is also beneficial to start an exercise program under the supervision of a physical therapist who can design a program that is very individualized. The goal of an exercise program is to strengthen the low back and abdominal muscles to take pressure off of the nerve. This needs to be combined with gentle stretching to help relax tight muscles and improve flexibility. For some patients, exercise may even prevent sciatica symptoms, reports the Cleveland Clinic.
A program may include walking, which can help to shed unwanted pounds that are placing pressure on the nerves as well as get the whole body moving and limber. If walking on land is too painful, try walking in the water.
Lying on your back and hugging a knee to your chest will help to stretch the low back. While lying on your back, lowering both knees to the right and holding the stretch and then holding to the left can also help. From the back, try lifting one leg straight up and press the heel up to the ceiling. The above three stretches can all help to loosen the lower back, hip and leg muscles. Each stretch should be held for a 30-second count. The goal is to move slowly and with control and stay within a pain-free level.
It is important to listen to your body and base the exercise program around movements recommended by a medical professional and around personal symptoms. Exercise should never make symptoms worse, it should make them better. Certain movements such as back bends or twisting movements are often contraindicated for those with a herniated disc or stenosis. Certain forms of arthritis also have specific considerations. It may take time to find the right program and intensity level, however once a regular exercise program is established, the benefit is often relief from symptoms and a return to normal activities.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.