Sciatica: The 4 Best Exercises For People With Sciatica
Are you frustrated with your sciatica?
Would you like to know the best ways to treat sciatica?
Keep reading to discover what your options are and how to do the exercises to help your chiropractor or physiotherapist through your treatment program.
What is Sciatica?
Simply put, pinching of a nerve which causes pain into your buttock, down your thigh into the leg and sometimes into the foot.
The nerve can be pinched in 6 different spots. So if your medical doctor or chiropractor is telling you that you have sciatica, ask them to be more specific.
Saying you have sciatica is the equivalent of saying you have pain in the neck that radiates down the arm. You already knew you had pain going down the leg. It’s not a diagnosis. A non diagnosis or a wrong diagnosis will change the whole course of treatments and getting the wrong treatment will not get you better.
For example if your sciatica is from disc herniation your treatment will be very different from a person with degenerative disc disease.
L4 and L5
So how do I know where my pinched nerve is? There are two nerves that come out between the last two vertebrae in your body. Your nerve is very commonly pinched here.
Your lower back vertebrae are called lumbar vertebrae. There are 5 vertebrae in the lower back. Taking the “L” for lumbar spine, they are named L1, L2, L3, L4, L5. The last two vertebrae in your lower back are L4 and L5.
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Just below L5 is one of your pelvic bones. It’s called the sacrum. The sacrum has holes with the yellow colored nerves coming out.
S1, S2, S3
The nerves are called S1, S2 and S3. “S” is for sacrum. These nerves are rarely pinched.
Your sciatic nerve is formed when the nerves from L4 L5 and L5 S1 join together with the S1,S2 and S3 nerves in your buttock.
So, most of you will have your nerve pinched in one of three spots.
- In the buttock where the Sciatic Nerve starts, in other words where the S1,S2,S3 nerves join the two other nerves that come out between L4 ,L5 and L5 S1.
- Between L4 and L5 vertebrae
- Between L5 and S1 vertebrae
Now you know where the nerve can be pinched but it doesn’t answer why one of the nerves is pinched causing your sciatica
The Usual Suspects (Causes) of Sciatica
Most people’s sciatica is from:
- Herniated Disc at L45 or Herniated Disc at L5S1 (some osteoarthritis = “wear and tear” is involved)
- Degenerative Disc Disease (Osteoarthritis of the Disc=”Wear and Tear” of the Disc)
- Stenosis (Basically advanced osteoarthritis)
- Spondylisthesis (A fracture of the vertebra or Osteoarthritis with the vertebebra moving forward)
- Piriformis Syndrome
These are the diagnosis that your doctor or chiropractor should be telling you about not sciatica.
Remember sciatica only says that you have a pinched sciatic nerve causing pain into your buttock and leg, sciatica doesn’t tell you the cause of your pain. Without determining the cause you will get hit or miss treatments from your chiropractor or physiotherapist as they can’t give you specific treatment.
The key exam that you need to determine what the heck is causing your pain is a neurological examination. You have probably seen it on TV before.
- Reflex tests with a reflex hammer on your knee and back of ankle
- Muscle Strength Testing: Resisted muscle testing of your foot. You try and push up/down while the chiropractor holds your foot. An alternative is heel walking and walking on your toes.
- Light Touch and Sharp Dull Testing: A light touch directly on the unclothed legs and feet to determine if you are unequal in your sensitivity to light touch and sharp/dull testing. Light touch is often enough as a screening.
Also remember that the diagnosis should pretty much be determined in the office and X-rays, MRI, CT scans done only if the their are signs of something else or the diagnosis is kind of fuzzy.
You herniate a disc from the everyday habits that you have. The everyday habits of slouching and bending with a rounded low back, build up to weaken and damage the disc to the point it is ready to break open and herniate.
The problem is there is no pain. You don’t feel sciatica, until the disc has herniated as there are no nerves inside the disc. So you continue your habits and think you don’t have a bad back until one day you lift your daughter off the floor.
The only problem is you had a bad back with no symptoms for a very long time. This is just like car with a little bit of rust showing but if you take the car apart you see a lot more rust.
Degenerative Disc Disease – Osteoarthritis of the Disc
Degenerative Disc Disease really is a continuation of the break down of the disc that was started by the bad lifting and slouching habits.
The disc becomes smaller, brittle like an old elastic band that is decaying, leading to the disc becoming smaller in height. The smaller disc makes the space between the vertebrae smaller. Thus, your nerve doesn’t have much room, so your nerve gets pinched between L4 and L5 or L5 and S1.
Stenosis- Most commonly from continuation of Osteoarthritis
Stenosis is a “narrowing”. There are two types of stenosis
- Lateral Stensosis
- Spinal Stenosis
- Lateral Stenosis is the narrowing of the hole which the nerves from the spinal cord come from. Does this sound familiar. It’s really degenerative disc disease + the bone degenerating forming spurs that narrow the hole for the nerve. A smaller hole for your nerve eventually means a pinched nerve.
- Spinal Stenosis is narrowing of the canal where the spinal cord sits. This is not as common so we shouldn’t get into it here.
Spondylolisthesis (Vertebebra moving forward)
Spondlylolisthesis is usually the moving forward of the vertebra (sometimes backwards). When the vertebra moves forward the spinal cord and nerves are pulled putting tension in your nerve. Nerves under tension get irritated and so turn into sciatica. This can happen from a fracture to the vetebrae or osteoarthritis.
Most people’s sciatic nerve usually goes over or under the piriformis muscle. In some cases, possibly yours, the sciatic nerve goes right through the piriformis muscle. When the muscle tightens up it literally squeezes on the sciatic nerve causing sciatica.
Walking like a “man” is an another reason for sciatica. That’s right, when you walk bow-legged with your feet turned out might mean “you the man” but it also can give you trouble later.
Chances are, if you are reading this you already have a problem with sciatica. When you turn your feet out this makes the piriformis muscles work harder.
The harder your piriformis works the more likely the nerve will be pinched causing sciatica.
The 4 Best Exercises For Sciatica
While treatments are different for sciatica depending on the cause you can still help your chiropractor or physiotherapist by doing your home exercises.
Flossing: first introduced by Michael Shacklock
Flossing is good for your teeth but a different kind of flossing is good your spine and spinal hygiene.
First determine if you can floss safely:
- Lie face-up on a bed or relatively hard surface. Please don’t lie on the couch, it is too soft and will aggravate your lower back.
- Raise your painful leg to the point of pain and keep it there.
- Bend your neck forward till your pain is aggravated from above
- Lower the leg till the pain decreases.
If the pain decreased you are safe to do flossing.
Warning: This exercise can cause acute sciatica but chances are minimized by doing the screening exercise. Don’t floss until you have been out of bed for at least 2 hours. Now The Flossing:
- Sit down in a chair with your legs swinging freely
- Bend your neck forward for 5 seconds (if this doesn’t cause sciatica you can do the next step)
- Bend your neck backwards as far as posssible and straighten the knee (5 seconds)
- Repeat 3 sets of 10X on each leg. You can do this up to 5/day.
Piriformis Stretch A) Sitting and B) Lying Face-Up
- Sit in a chair and cross the bad leg over the good
- Keep the arch in your back and move your chest forward
- Repeat 3 sets 30 secs. This can be done several times a day
Lying Face-up: This exercise might be easier for some of you.
- Lying Face-up both knees bent. Put the bad leg over the good.
- Bring the good leg up to support the bad leg.
- Push the bad leg outward.
Ball Exercises: Piriformis, Gluteus Maximus, Gluteus Medius
- Cross your bad side leg over the other knee
- Get a tennis ball, basketball or a medicine ball and sit on it with your buttock.
- To treat the pififormis go lean at about a 45-degree angle.
- Stop at each tender point and hold until each one is ironed out or feel less tender.
- Same as the piriformis except that you don’t need to cross the bad over the good.
- Same as Gluteus Maximus except that you now lean at almost a 90 degree angle -You are almost on your side with a focus on the side area just below the belt or hip bone
- Lie down face down with your hands underneath your shoulders.
- Push up from as high as you can until your lower back stops you or your elbows are straight.
- The pelvis should still be on the floor and the lower back muscles relaxed.
- Do these exercises holding each time for 1-2 seconds 6-8 times per set. This exercise can be repeated every two hours throughout the day.
If your pain is from a disc herniation you can combine the disc herniations part 2 exercises with these exercises. If your sciatica is from a different cause I will write about all the conditions that cause sciatica over time.
Write in the comments to tell us how you are doing with your sciatica. Connect with me on LinkedIn.
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