Back Pain & Sciatica: Exercise as Treatment

*Disclaimer: Consult with a healthcare professional before starting an exercise program. Performing the exercises discussed in this article without a diagnosis and clearance may result in exacerbation of symptoms and a potentially worsening condition.*

Right. By this point in this series we have covered what sciatica is and threedifferent common causes for the condition. This post will focus on some basic treatment exercises that can be used to relieve symptoms and avoid making the condition worse. Although the three causes of back pain & sciatica that we covered are quite different, the principles and goals of their treatment exercises are very similar. Main goal: take pressure off of the sciatic nerve.

physical therapy sciatica exercise

Secondary goal: find pants to cover translucent skin.

This pressure relief is achieved by giving the joints and muscles of the low back and pelvis a balance of stability and flexibility. Too much instability and the bones in the spine can shift around and bump into the nerve roots, leading to shooting pains. Too much stiffness in one section of the spine can lead to poor mechanics and ultimately put more strain on the site of problem. So the exercises discussed today focus on strengthening the core & hips and increasing flexibility of the core & hips. Let’s start with the flexibility side of things.

 From the looks of things, she started with that a long time ago.

Hip Flexor Stretch – Hold 30 seconds, 3-5 times

The hip flexor (aka iliopsoas) makes an attachment from the low back to the front of the thigh. Tightness here can often lead to increased back pain and increased compression on nerve roots exiting the spine.

physical therapy chair lunge

The key here is to keep the back straight and avoid trying to arch backwards to increase the stretch.

Prayer Stretch – Hold 30 seconds, 3-5 times

This is a good stretch for the muscles in the low and mid back that can also help widen the gaps between the vertebrae in the spine, ultimately relieving pressure.

physical therapy back stretch

The key here is to really reach and walk your hands our in front once down in the bent position.

Knees to Chest – Hold 10 seconds, 5-10 times

This is focused primarily on creating some increased space between the vertebrae to decrease the pressure on the nerves and joints. It can also stretch out the muscles in the low back.

physical therapy knee ups

If 2 legs is too difficult, this can be performed 1 leg at a time, with opposite leg straight.

Piriformis Stretch – Hold 30 seconds, 3-5 times

This stretches the muscle that the sciatic nerve passes right next to or even through.

physical therapy leg stretch

The key here is to grab the leg as shown and gently pull the knee towards the opposite shoulder to feel the stretch in the right place.

The strengthening portion of our discussion focuses on not only the core & trunk, but also the hips! Weak hips with a stable spine is the equivalent of building a tower on a sand dune; it’s strong enough until the sands at the base shift and bring the whole thing down.

 This guy gets it.

Supine Marching 20-30 repetitions, 2-3 sets

This is a good exercise for the transverse abdominis, one of the muscles that make up your core and help with trunk stability.

physical therapy sinlge leg up

The key here is to keep you stomach muscles engaged throughout the movement to make sure the back stays flat on against your hands (or the ground). Slowly lift one foot a few inches off the ground, lower, then repeat with the other leg.

Bridging – 10-15 repetitions, 5-10 sec holds, 2-3 sets

This is a good exercise for the multifidus muscle in the low back as well as the glutes.

physical therapy hip thrust

The key here is to squeeze the buttocks and tighten the abdominals beforelifting off the ground. This keeps the back from hyperextending and focuses the exercise on the desired muscles.

Quadruped Multifidus Knee Lifts – 5-10 repetitons, 5 sec holds, 1-2 sets

Another good exercise for the multifidus, this also works on finding and maintaining a neutral spine position.

physical therapy back ups

This exercise is performed with a pillow or small towel roll under one knee to place you off balance. The key here is keep the  core tight and gently rotate the spine to lift the lower knee up to the same level as the other (~1-2 inches).

Clams – 10-12 repetitions, 5-10 sec holds, 1-2 sets

This exercises targets the gluteus medius which plays a big role in stabilizing the hips and pelvis. This is one of the trickier exercises to get right since small changes in form can have a big influence on which muscles are working.

physical therapy leg spreads

Squeeze the buttocks and the tighten the abdominals before  lifting the knee. You want to avoid rolling your body backwards at all during the lift, so don’t focus on how high the knee is getting; focus on doing the exercise right. You’ll know that your’re doing it right if you feel the muscle on the side of your butt (behind the hip bone) getting tired. If you feel it in a muscle on the side of your hip (in front of  the hip bone) then you need t readjust your form.

Ok, that just about covers the intro exercises for addressing back pain & sciatica. There are many more that can potentially be helpful, but these are likely to get the most bang for the buck without aggravating things as well. The last thing to cover is matching up the right exercises with the cause of the sciatica symptoms.

Herniated Disc – Stretches: Prayer stretch, hip flexor stretch. Strengthening: Bridging, clams

Spinal Stenosis – Stretches: Knees to chest, hip flexor stretch. Strengthening: Supine marching, clams

SIJ Dysfunction – Stretches: Piriformis stretch, hip flexor stretch. Strengthening: Clams, quadruped multifidus knee lifts

So this concludes our Back Pain & Sciatica series here on our blog. Remember to consult with a healthcare professional before attempting any self-treatment  or starting an exercise program to make sure that your condition 1) is treatable with exercise and 2) doesn’t get worse from doing the wrong things.


You can find Part 1Part 2Part 3, and Part 4 of our Back Pain & Sciatica series here!

And don’t miss our upcoming FREE Back Pain & Sciatica Workshop if you know of anybody that can benefit from finding relief from this common disorder!

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