Sciatica Exercises: The 4 Best Exercises

Lower Back Pain and Sciatica

Discover the Best Sciatica Exercises for Pain Relief and Recovery

Persistent sciatica pain can transform daily activities into daunting tasks, leaving you searching for relief. If you’re on the hunt for effective strategies to alleviate sciatica and bolster your rehabilitation, welcome to your comprehensive guide. Here, we delve into not only the treatment options but also spotlight sciatica exercises that are crucial for pain relief and recovery. These exercises, when integrated with the professional care from your chiropractor or physiotherapist, are designed to reduce sciatica symptoms significantly.

Why Focus on Sciatica Exercises?

Exercises specifically tailored for sciatica play a pivotal role in managing and reducing pain. They are essential for strengthening the muscles supporting your spine, improving flexibility, and promoting healthy circulation to the affected nerve regions. This guide is your go-to resource for understanding how targeted exercises can complement medical treatments and accelerate your journey to relief and rehabilitation.

Understanding Sciatica: Sciatica Exercises

Sciatica is often described as a painful sensation that originates in the lower back or buttock, extending down through the thigh and leg, and occasionally reaching the foot. This discomfort results from the compression or irritation of the sciatic nerve. However, the root cause of this pinching can vary, necessitating precise diagnosis and tailored treatment plans.

The Complexity of Sciatica Causes: Sciatica Exercises

Identifying the exact source of sciatica is crucial, as nerve compression can occur at multiple points along its path. Misdiagnosis or oversimplification of your condition as merely “sciatica” without further investigation can lead to ineffective treatment strategies. It’s essential to understand whether the pain stems from issues like disc herniation, degenerative disc disease, or another underlying cause to ensure the appropriate therapeutic approach is employed.

See Also:  Best Toronto Chiropractor: How To Find The Best Chiropractor In Your City

Sciatica Spinal Nerve with Lumbar Vertebrae: Best Toronto Chiropractor
Sciatica: Spinal Nerve with Lumbar Vertebrae

L4 and L5: Sciatica Exercises

So how do I know where my pinched nerve is? Two nerves 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 the lumbar spine, they are named L1, L2, L3, L4, and L5. The last two vertebrae in your lower back are L4 and L5.

Sacrum and sacral nerves that form sciatic nerve
The sacrum bone pictured above with sacral nerves that form the sciatic nerve. The lumbar nerves that help form the sciatic nerve are not seen in this picture.

Ion medical designs http://www.ionmedicaldesigns.com/ion_site/two_dimensional_artwork.html

Just below L5 is one of your pelvic bones. It’s called the sacrum. The sacrum has holes with yellow-coloured nerves coming out.

S1, S2, S3: Sciatica Exercises

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 the Sciatic Nerve starts, in other words where the S1, S2, and 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
Sciatica- Piriformis Muscle and sciatic nerve
Sciatica- Piriformis Muscle and sciatic nerve –Picture from sciaticafastrelief.com

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)
  • Spondylolisthesis (A fracture of the vertebra or Osteoarthritis with the vertebra moving forward)
  • Piriformis Syndrome

These are the diagnoses 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 in 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.

See Also: MRI CT scans X-rays, What’s Best For My Pain

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 the back of your 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.  A 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, and CT scans done only if there are signs of something else or the diagnosis is kind of fuzzy.

See Also: Herniated Disc Part 2: The Best Exercises For Your Herniated Disc

Herniated Disc: Sciatica Exercises

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 a 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 is a continuation of the breakdown of the disc that was started by bad lifting and slouching habits.

The disc becomes smaller, and 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

  1. Lateral Stenosis
  2. Spinal Stenosis

1. Lateral Stenosis is the narrowing of the hole which the nerves from the spinal cord come from. Does this sound familiar? It’s 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.

2. Spinal Stenosis is the narrowing of the canal where the spinal cord sits. This is essentially pinching of the spinal cord usually in the lower back.

Spondylolisthesis (Vertebebra moving forward)

Spondylolisthesis is usually the moving forward of the vertebra (sometimes backwards). When the vertebra moves forward the spinal cord and nerves are pulled putting tension on your nerve. Nerves under tension get irritated and so turn into sciatica. This can happen from a fracture to the vertebrae or osteoarthritis.

Piriformis Syndrome

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 squeezes on the sciatic nerve causing sciatica.

Walking like a “man” is another reason for sciatica. That’s right, when you walk bow-legged with your feet turned 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.

1. Flossing: first introduced by Michael Shacklock

Flossing is good for your teeth but a different kind of flossing is good for your spine and spinal hygiene.

First, determine if you can floss safely:

  • Sit on a chair or relatively hard surface. Please don’t sit 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 decreases 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:

Nerve Flossing for Sciatica
Nerve Flossing for Sciatica   photo by ahskc.com

 

  • 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 possible and straighten the knee (5 seconds)
  • Repeat 3 sets of 10X on each leg. You can do this for up to 5/day.

2. Piriformis Stretch   A) Sitting and    B) Lying Face-Up

A: Sitting:

Sciatica: Seated Piriformis Stretch
Sciatica: Seated Piriformis Stretch -photo by double your gains
  • 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
Sciatica: Piriformis Stretch Best Toronto Chiropractor
Sciatica: Piriformis Stretch to help your sciatica -photo by dhbiokineticists.webs.com

 

B: 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.

3. Ball Exercises:  Piriformis, Gluteus Maximus, Gluteus Medius

Sciatica:Ball exercises to Help Sciatica

Piriformis

  • 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 piriformis go lean at about a 45-degree angle.
  • Stop at each tender point and hold until each one is ironed out or feels less tender.

Gluteus Maximus

  • Same as the piriformis except that you don’t need to cross the bad over the good.

Gluteus Medius

  • 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

4. Cobra

Herniated DIsc Cobra Exercise to Put your Disc Back In & Prevent Herniated Discs
  • 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 hold 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. Also, let us know your vote for the best Toronto Chiropractor below. Connect with me on LinkedIn.

Related Categories: Disc Herniation, Elbow, Hip, Low Back Pain, Shoulder, Stenosis

Leave a Reply

  • Avatar for Rodrigo

    Thank you very much for your reply!
    Can these exercises be performed with L4/5 -7 mm , L5S1 -5mm hernia?
    What is the possibility of full recovery with the hernia of my type and size? What are some recommendations in order to achieve the most complete recovery? Will I be able to play football (soccer) in the future?

  • Avatar for Rodrigo
    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Rodrigo. Light squats without weight at first while you are in the acute stage. When you get out of the acute stage you can try squats with light weights. Lunges are great. I wouldn’t do dead lifts, power cleans, good morning (bent over rows) unless you have perfect form for the rows. Instead of sit-ups and cruches do planks and hang off a chin up bar and raise your knees straight up and bent sideways.

      Step-ups are also great.

      Try these exercises also to get your disc back into place. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      Hope that helps your L45 and L51 disc herniation.

      • Avatar for Rodrigo

        Thank you very much for your reply! Can these exercises be performed with L4/5 -7 mm , L5S1 -5mm hernia?
        What is the possibility of full recovery with the hernia of my type and size? What are some recommendations in order to achieve the most complete recovery? Will I be able to play football (soccer) in the future?

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your questions Rodrigo. When you have a disc herniation that is less than 8 mm it is not a good choice for surgery and a perfect choice for exercise therapy. There are no guarantees though, you simply have to try the exercises and see if they are suitable for you. If you get a sharp pain, increasing pain for more than 1/2 hour after the exercises than the exercises are not for you.

          Hope that helps your disc herniation.

  • Avatar for Asim khan

    Doctor I want to sent you my MRI report. Is it possible. I wanted to attach my report with this email but there is no option of attachment plz guide me. I will be greatful.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for reading my article Asim. You need to read to the bottom of the article. There you will find my email. However simply attaching an MRI only tells me what your MRI says. MRIs can have severe herniations with no pain for some while MRI for others will have no herniation and a simple bulge yet cause immense pain.

      Hope that helps.

  • Avatar for gangadhar

    Hello sir,am very thankfull to u by giving such a good information on disc herniations and sciatica….sir i have posterior central disc protusion at l5 s1….but i have less in my back..but very more pain in my left calf..wat it mean …please help me sir…becoz i have marriage proposal in next month…wat i can do…whether i can do exercises given above…is it problem will be completely solve or not..i mean disc will come to original place or not….please help me sir……

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Gangadhar. It means that you have a disc that is pressing on your nerve. Assuming that the diagnosis is correct (many people have protrusions on MRI with no symptoms)

      However I looked at the other comments you have made and as I previously said you have a possible red flag. You should not do the exercises and consult someone that can examine you in person like an orthopedic surgeon or neurosurgeon.

      Hope that helps you disc herniation.

  • Avatar for mahesh
  • Avatar for mahesh

    Hi i am 38 years i have pain in my right hip and calf from last 4 months last month i consult orthopedic he examin me and told me that i have slip disc and adv me for MRI and my mri report is as follows Disc desiccation with diffuse annular disc bulge,large posterior and foraminal disc protrusion, early facet joint arthropathy and ligamentum flavun thickening at l4l5 level resulting in marked effacement of bilateral neural foramina bilateral lateral recesses stenosis and mild circumferential canal stenosis with compression over thecal sac and existing nerve roots. Doctor adv. Me for bed rest .pl.suggests.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment. I hope you are joking about the bed rest for lower back pain. Research has shown that bed rest will not help you. At the most 2 days for the most excruciating pain. Best rest was suggested by doctors many decades before. Not anymore. Now we know better.

      You should try conservative care first. I would find yourself a chiropractor who does rehabilitation or a physiotherapist. You can get an injection if the conservative care doesn’t work after 2-3 months. Just try the exercises in this article. Also you try this link https://www.bodiempowerment.com/disc-herniation-part-1/ so you stop aggravating your pain.

      Hope that helps your slipped disc.

  • Avatar for John

    Dr. Ken,

    I have had muscle tightness in my right glute, hamstring, and calf. In addition to this, I have had tingling sensations on the inside part of my right heel below the ankle bone, the arch of my foot, and the webbing between my big toe and the adjacent toe. MRI revealed herniated L5. My orthopedist recommended the following options in order of invasiveness and severity: PT with oral steroid regimen, corticosteroid injections, then surgery as a last resort.

    My questions for you Dr. Ken are: 1. How will the exercise regimen you promote fix the herniation (tearing of the disc)? 2. Are the steroid injections helpful in curing this condition 3. Can the problem get worse and/or cause permanent nerve damage if not corrected (i.e. what happens if I do nothing at all and just continue to live with the discomfort)?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comments John. These are good questions. Here are your answers

      1. Provided your disc is like most disc bulging out the back of the disc vs the front of the disc than the exercises will put the nucleus (jelly of of jelly doughnut) back to where it was.
      2. Steroid injections are sometime helpful in curing this problem but by no means guaranteed.
      3. Yes the problem can get worse but not likely do permanent damage but it depends how much pressure is on the nerve right now. Studies how shown that doing conservative therapy first vs doing surgery right away resulted in no real difference in results, unless you have bowel and bladder problems, foot drop that is getting worse, other neurological symptoms like reflexes that are continually diminishing or saddle anesthesia(numbness, tingling on the inside of your thighs and buttock where a saddle would touch if you were on a horse). Keep in mind surgery is only for those with more than 8mm sticking out on MRI.

      In your case I would do the exercises first along with rehabilitation by a chiropractor of physiotherapist and any pain reducing treatments.. It is not necessary to do the steriod injections unless the treatments by your health professional aren’t helping.

      Hope that helps your sciatica.

  • Avatar for Laila

    Hello Dr. Ken,

    I have had sciatica on and off for 2 yrs now and exercises similar to these have helped when it flares up again! Thank you. I was wondering if you had any other advice for me though, my doctor has told me that I have both a L2 and L5-S1 pinched nerve with a disk bulge in L5-S1. He does not have any further recommendations in treating this as I am only 25 and do not want any surgery. Is there anything you could please recommend, besides stretching?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Laila. You will find that in the article above, you will find out that these exercises include stretches but also exercises designed to put the disc back in place, and detach the nerve from adhesion or scar tissue that can be causing you continuing pain. Try the exercises.

      Hope that helps your sciatica.

  • Avatar for vishal

    I am 45 years old Male. I have pain in my lower thigh and buttock since last 5 weeks. didn’t take rest initially for first 3 weeks. Then got some treatment from ortho. But no major relief. then went for MRI. Here is what my MRI says :
    Modic type II endplate changes seen at L5/S1 level.
    L4/5 disc dessication with mild posterior diffuse disc bulge with minimal bilateral lateral recesses narrowing with left foraminal narrowing without significant exiting nerve root compression.
    L5/S1 disc dessication with disc height reduction with posterocentral disc extrusion thecal sac indentation with narrowing of bilateral lateral recesses (right > left) with compression of right traversing nerve root (S1) and left traversing nerve root (S2) without significant foraminal narrowing or exiting nerve root compression. AP canal diameter at L5/S1 level is 6.5mm.
    Visualized vertebral bodies appear normal in height, alignment and marrow signal intensity.
    Posterior spinal elements appear normal. No definite obvious focal osseous lesion is apparent.

  • Avatar for Nuno
    • Avatar for Dr Ken Nakamura Post
      Author

      Great question Nuno. We are essentially talking about two different things. While nerve flossing does involve stretching of the hamstrings. Nerve flossing is reserved for persistent sciatica to move the nerve to dislodge adhesions. Simply stretching the hamstring will not accomplish that no matter how many times you stretch the hamstrings.

      Early on with disc herniation you shouldn’t stretch your hamstrings. However if persistent adhesions or scar tissue are trapping the nerve root a great way to temporarily aggravate your problem but free the nerve is nerve flossing. In the end it frees the nerve and you gets you better.

      So yes you shouldn’t stretch your hamstrings. Yes you can do nerve flossing if your sciatic nerve is stuck.

      Hope that answers your question about disc herniations and nerve flossing.

  • Avatar for Karthik

    Hi Dr.Ken,

    I am 23 years of age and ahave been suffering from a disc bulge at l4/l5 and l5/s1 for the past one month.

    The report mentions a major posterocentral bulge at l4/l51 casing major indentaion on anterior thecal sac and l5/s1 bulge causing mild indention of anterior thecal sac.
    Symptoms are – i am unable to wlak properly for more than 100 feet at a time as I need to sit because of severe radiating pain in my right leg. I am also suffering from bouts of pain whenver i sleep/sit for long periods.
    My physio is giving me traction sessions and has advised rest till the pain subsides. Its ben a month and I feel there’s no major improvemtn. I am also taking pain killers daily. I wear a belt when driving and ice my back twice a day. Is there any specific exercise that I should start doing now for my condition as I feel that might be the way forward.
    Thanks!

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Karthik. Your MRI mentions indentation of the “anterior thecal sac”. This means that there is pressure on the outer covering of the tail end of the spinal cord. For most people the spinal cord ends around L2. From L2 there are still large bundles of nerves that keep going down to the end of your spine. The theacal sac surrounds these bundles of nerves. T

      The pressure on the thecal sac often cause pain down both legs but it sounds like yours is slightly off to the right thus causing you right sided leg pain.

      First I would try lying down face down to see if that is tolerable. If you can do that try doing the sphinx exercise here.
      https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      If you get sharp pain with the exercises you should stop. If you get increasing pain while doing the exercises you should stop. If you get pain for more than 1/2 after the exercises you should not do that exercises.

      If you can do the sphinx you can try doing some of the other exercises here.

      The good news is large herniations over 8 mm get reabsorbed by the body. Smaller herniations that have an intact discs don’t reabsorb. The herniations tend to reabsorb in 4-6 months.

      Hope that helps.

  • Avatar for Andy

    Dr. Ken-san,

    This is Andy age 47y having a history of lower back pain from past 6/7 years, in the recent past diagnosed clinically by a neurologist with left sciatica for a lower back pain with radiating pain in the left leg (first time) followed by a MRI scan with below results

    1. L2/L3 & L3/L4: Bilateral foraminal bulge causing mild bilateral neural foraminal stenosis

    2. L4/L5: 3 mm diffuse disc bulge and 5 mm left paracental protrusion causing mild central canal and moderate right lateral recess stenosis. There is indentation on left L5 traversing nerve root. Mild bilateral neural foraminal stenosis due to disc bulge and facet arthrosis

    May I request you to suggest some of the specific exercises that I can do, appreciate your response

    Regards..Andy

    • Avatar for Andy

      Dr. Ken-san,
      Additional info. for your reference…
      After medication I do not find pain in the left calf muscle but experience dull pain in the thigh (also stiffness) and left butt, this is not always, but during certain body movements and sitting/standing/sleeping positions. Right now am avoiding sitting on the chair for long and resting at regular intervals on a flat surface.
      Thanks and regards….Andy

      • Avatar for Dr Ken Nakamura Post
        Author

        Andy: It is good to adapt different postures. Sitting is most painful for most while standing is usually better and lying down is usually the best. You should change between the three throughout the day and go through some pain. Simply lying down and getting bed rest only have been shown to make you worse.

        Get better soon.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for stopping by Andy-san. First with when the pain is in your calf it is more difficult so you should expect a longer recovery especially if it is constant. The good news is you are not a candidate for surgery. Discectomy surgery is not very sucessful when there is a bulge less than 8 mm. Armed with that knowledge you shouldn’t let a neurlogist, neurosurgeon, orthopedic surgeon talk you into surgery. That’s what the research says not just what I’m saying right now.

      First try the exercises here in this post on sciatica and the disc herniation exercises here. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

      If the exercises causes sharp pain you should stop. If you feel discomfort during the exercises that is OK but if you feel increasing pain while doing them you should stop. For the exercises using a medicine ball that one is supposed to hurt a lot. Even if it aggravates your sciatica. As long as the aggravation is not longer lasting than 1/2 hour. Try going gently at first than more harder.

      Hope that helps your disc herniation causing stenosis.

      • Avatar for Andy

        Dr. Ken-San,
        Thanks and appreciate very much for your prompt response. Wonderful to know the content and indeed it’s really a very happy news that surgery is not required and the neurologist who examined too told me that surgery is not required in my case. had responded to your comments very next day but some how the same is missing…

        He has prescribed me to take Pregabalin and Methylprednisolone tablets to keep the condition under control for both muscle and nerve signals and it’s still on for next 15 days. In this regard can you please clarify the following
        1. would it be good to start the exercises after completion of medicines or is it ok to start the advised exercises
        2. can I go for long walks and also do swimming at this point
        3. also like to know in my case would the bulge will go-off completely with the exercise or would it just reduce the bulge

        With regards to
        – Calf pain, it’s reduced and has moved to thigh and left butt, it’s more of dull pain (not sharp) which I experience only when I sit for long (avoiding the same)
        – Exercises advised, thanks for sharing them; will surely go through and perform them carefully as per your follow your instructions and update the result. Also would get back to you in case of any further assistance/advise if required.

        Thanks once again for your time and response
        Warm regards….Andy

        • Avatar for Dr Ken Nakamura Post
          Author

          Andy: It would be great if you started the exercises right away making sure you are careful and not aggressive with the exercises. If you start to feel sharp pain or increasing pain while doing the exercises you should stop right away. Pain after the exercises that last more than 1/2 hour means you went a little too hard or the exercises are not right for you at this time.

          2. Breast strong and side stroke gently done are often helpful. Front crawl can be tolerated by some. Walking for short distances is encouraged.

          3. The bulge improves and it may be possible to achieve no pain but the disc is not completely normal. You would more susceptible to disc herniations /bulges again. Usually they come with a warning so that is when you do the exercises again.

          The fact the calf pain is reduced and you get more thigh and butt pain means you are improving well.

          • Avatar for Andy

            Thanks and appreciate for all the clarifications and very useful advises Dr. Ken-San. Will start the exercises with immediate effect as advised with precautions and would keep you posted on the status.

            Thanks again,
            Regards…..Andy

          • Avatar for Dr Ken Nakamura Post
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  • Avatar for Gangadhar Chowdary

    Hello sir ,is nerve flossing is good for sciatica due herniated disc and is nerve flossing will do on both legs or affected leg only ,if I do both the legs there is very very bad pain in calf of affected leg,please tell me goog suggestion sir

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Gangdhar. The idea behind the nerve flossing is that it slides the nerve freeing it from adhesions and scar tissue. At the beginning go gently by bringing the leg up just to the point of pain. You might want to wait to bring the head back until you can tolerate straightening out your leg. Sciatica can be tough to deal so take it one step at a time.

      Hope that helps your sciatica.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks again for your numerous comments on many different articles Gangdhar. As I said before you have a possible red flags. You need to consult someone that can examine you. The exercises may cause you harm so you should not do them. For most people it is fine but when you have groin area pain that means you may need possible surgery.

      Hope that helps.

  • Avatar for Aizudin Aizat

    Hello doctor,
    My orthopaedic doctor just told me that i got Degenerative Disc Disease base on MRI result. My L4 and L5 disc was showing black color in MRI result and the doctor told me that it cant be back to normal anymore.is that true? I’m active in sports and always go to gym. Should i stop all this axtivities?What exercise u would recommend to me?
    Thank u

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Aizudin. The vast majority of people have degenerative disc disease by the time they are 40 years old. The black color means that the disc isn’t as healthy as it should be. More specifically the water content has diminished as the disc isn’t functioning the way it is supposed to. Most people with this condition don’t have pain. in your case, I am assuming you have sciatica as you are reading this article. When you are better you should resume all your activities.

      You should do the exercises in this article and see how they help. If they are causing more pain while you are doing you should stop. If you have sharp pain stop. If you have pain for more than 30 minutes after doing the exercises than you should also stop.

  • Avatar for Kashan Khan

    Hello doctor,
    I have had pain in my left buttock which causes pain in my front left leg when walking. I went to chiropractor and physical therapy for about a month and a half, didn’t help. My primary doctor recommended me to a spine specialist. From the lower back mri, I have a pinched nerve between l4/l5. Is there something that can be done without surgery to relive this pain
    Thank you

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Khan. Assuming you went to a chiropractor and a physiotherapist (physical therapy) for treatments there are a couple of things. First did they give you the correct diagnosis. It sounds like the MRI was done after they treated you. Giving you the treatment for an incorrect diagnosis usually results in no or little results.

      Why don’t you try the exercises here first and see if they help. Try them for a month and see how your sciatica improves.

      Hope that helps your sciatica.

  • Avatar for rafik ahmed

    helo doctor.
    pls tell me about d problm of disk L4 n L5 points
    mah wife z suffrng frm dis problm
    she feels her foot in fire mean fr l4 l5 points she feel nt gud fr her foot
    she does nt stndng walkng clearly olso
    fr 2 years her treatmnt gong on doctor says if she does nt feel relax
    thn oprate her. except opration any teratmnt pls tell me
    thnx

  • Avatar for Tayna

    Thank you Mr. Nakamura. You hit the nail on the head. For a year they keep telling me it was Sciatica. But the treatment was not working. Then after the MRI they informed me I had three Bulging disks: L3/L4, L4/L5, L5/S1.
    And just as I told my kids to sit up straight I myself learn the hard way of what happens when you do not, lift things too heavy. wear gear that is too heavy, and “walk like a Man (I am Knock Knee). The information you gave was not only thorough but you gave clear explanation.
    All pain management wanted to do with me is give me steroids, I said NO WAY and left it to stretching and understanding I am not in my 20’s anymore and need to listen to the pain in my body that I did not listen to back then. I have done all 4 exercises and will refer others to this site.

  • Avatar for Ron

    The exercises are chosen very good. Also the description about what Sciatica is and the anatomical construction are very professional. I think the side can help a lot of people with sciatic symptoms. I tried the treatment with the tennis ball, ooh sooo painful, but it helps a lot 🙂

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for the comment Ron. I am so happy that the exercises are helpful for you, but I am sorry that it is painful for you. Just think of it as good pain. Whenever you give yourself good pain the better your sciatica or sciatic pain becomes. To a certain extent the more good pain you have when you do the exercise the better, as long as the pain is still within that “comfort” zone of pain. I hope you know what I mean.

      If you have any questions about your sciatica or more specific questions about your condition such as a disc herniation or stenosis let me know.

  • Avatar for Larry

    I Herneated my disc 8weeks ago. I have no pain but weakness in right calve a foot drop. I did light exercises for 6 weeks. I think I made more improvement not exercising. Does that make sence ? Today I walked a quarter mile and my foot and calve are pretty weak. Am I just not ready to walk that distance? Could you please e mail me. Thank you

  • Avatar for Pooja
    • Avatar for Dr Ken Nakamura Post
      Author

      You are most welcome! If you have any lingering problems let me know your specific issue and I can make further recommendations. If you find the exercises helped you please let me know.

      • Avatar for su

        pl suggest excercise to cure numbness in the feet & calf areas.
        Difficult to walk.
        to releave pressure of bulging disc in L3-L4-L5 AREAS

      • Avatar for Shaq

        Hi..sir I was having a back pain on my right side and there is swelling on my right hip, I went 2 the doc he did my ultrasound and xray my ultrasound was clear my xray showed..reduced disc space at L 3-4, L4-5 level…im worried alot..and now at times I have numbness on my right and left feet..plzzzz help me im worried

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your comment Bathroomsinger. First you should understand that reduced disc space is a normal part of ageing along with low back pain. The good news is that level of degenerative disc disease or reduced disc space or osteoarthritis has no relation to pain. You can have severe degeneration and no pain. You can have no degeneration and severe pain. Don’t let anybody tell you different. I am sorry if somebody told you this. These statements aren’t just my opinion they are backed up by research. While you should be concerned you should not think that this is the end of your back.

          I have an article of degenerative disc disease if you are interested. https://www.bodiempowerment.com/part-2-degenerative-disc-disease-exercises-help-lower-back-pain-spondylosis/

          As for your hip it might be bursitis of the hip called trochanteric bursitis. This can be due to a flat foot which puts pressure on the ITB band that runs over the bursa. Sometimes overuse of the thigh can cause this. That’s a guess as I don’t have enough information

          Hope that helps your sciatica.

      • Avatar for Raghavendra

        My age is29 male,
        Im suffering from posterior central disc protrusion of l3-l4 and l4-l5.i getting pain in neck and lower back and legs …iv consulted doctors and neurosurgeons they prescribed me medicine and exercises ,but my pain is not getting better, they told that it ll be cured without surgery but pain is coming regularly can u help me sir.. What i can do know…how it can be cured….pls helps me

        my MRI report says..
        Posterior central disc protrusion of l3-l4 and l4-l5. and klippel feil anomaly is noted(fusion of c 5 and c 6 vertebrae no syrinx/diastematomyelia.
        Nerve roots are not compressed.
        Reaming all are normal..Like facial joints spinal canal, cones soft tissues..

      • Avatar for Aman

        sir plz help me actually my father have the same his L3-L4 L4-L5 L5-S1 he is not able to walk also his pain he getting high he even can not able to take sleep or reat the medicins are not working the medicins are ultracet, dicalci-k7, gaba pantene plz help me if you can reply fast

      • Avatar for Ebony

        I am a 26 yr old female and new mother.I slipped on ice and herniated my l4-l5 at age 19. At my young age no doctors took me seriously so i langushed at home, bedridden for 6 months and gained almost 50 pounds. Thankfully i had a caring boyfriend to help me get in and out of the tub, off the toiler etc.. But my studies suffered and i couldn’t finish my university studies.after 6 i developed a foot drop and finally the docs were handing me pain killers hand over fist. I turned them down and opted for holistic treatment ( yoga, and medical marijuana for pain) the Yoga helped and i managed life for half a decade with minimal discomfort, but i was overweight. I started losing weight and felt the best i ever had up until last summer when i became pregnant with my first son. I almost miscarried and was ordered to bedrest, i put all my weigt back on and developed symphasis pubis. I had a very rough time of it and once my son was born i was commited to weightloss. Jogging, cardio, areobic excersize videos 2hours a day an intense squat regimine. Too much too soon. The wear and tear on my already weak spine came to a precipice in august when i took an 8 hour drive up to manitoulin island. Cramped in the car hunched ovef the entire way, my sciatica was screaming!!! Well i went for a jog when we arrived and i felt something “pop”. Now i have metal in my wrist that prevents me from getting another mri but i already know what the problem is. Now, in august my doctor put me on percocet and naproxone for 6 weeks then stopped the pills and sent me to a chiro who said he couldn’t manipulate but does the same excersizes ive sern here on your site 2-3 times a week. With no pain management the days in between the chiro left me bruised and sore, unable to even lift my son from his crib. I am desperate for help, i need a doctor that will take me seriously, up until surgery even. Do you have any advice to give? I looked you up one of the best in Toronto, i live in town. Do you think your clinic could help me any?
        -Ebony

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your question Ebony. Sorry to hear about your situation. You’ve been through a lot. First usually when you get foot drop it means there is a lot of pressure on the spinal cord (cauda equina). If the foot drop gets worse you are supposed to get surgery. I am assuming that it didn’t and that your foot drop is actually better. If so then you don’t need surgery.

          I can’t guarantee anything but I can often help most of the people most of the time.

          Hope that helps your disc herniation.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Pooja. I hope that you keep up with the exercises to keep that disc from flaring up. You never get rid of the damage in the disc but you can decrease the pressure on the nerve.

    • Avatar for saqib

      My age is 20 male !!
      im suffering from left disk bulge at L4-L5 position, at first i felt the pain in the whole leg, sciatica but now its just feel in the disc, im too much worried about this i’ve consulted many neurosurgeons they all prescribed me medicine and exercises, but my pain is not getting better in the dick, among all of them one Dr suggested, me to go through surgery it is the last option but majority of them are saying surgery is not suitable in your case em too much worried and annoyed cause of my pain, my studies my body workout all my lifestyle has been ruined in these 16 months what should i do i cant understand plz help me sir 🙁 🙁 🙁

      • Avatar for Dr Ken Nakamura Post
        Author

        Thanks for your question Saqib. You may have to consider that the two pains one in your groin and the other in your lower back may be separate causes. A doctor should be able to determine that.

        It might be your lower back causing the pain in your groin if your lower gets painful and which makes your groin painful ie. at the same time. Sometimes you can have a referral from the psoas muscle. The psoas muscle is aggravated by disc bulges sometimes so treating the psoas or iliacus muscle can help your groin.

        Really you have to get good doctor to determine this.

        Hope that helps your understanding of your disc bulge and groin pain.

    • Avatar for Asim khan

      I have straightening of dorsal lumber spine noted which is consistent with muscular spasm. Disc desiccation noted at multiple levels in the lumber spine including L3/L4, L4/L5 and L5/S1 levels.
      at L5/s1 level central and right paracentral disc protrusion noted causing moderate pressure on the thecal sac and right lateral recess. Hypertrophic facet joints are also present at this level.
      at L4/L5 level circumferential disc bulge seen together with central disc protrusion. The abnormality is more towards left side together and with hypertrophic facet joint these are resulting in moderate pressure on the left lateral recess.
      At L3/L4 level circumferential disc bulge seen together with hypertropphiic facet joint are resulting in bilateral minimal to mild foraminal narraowing. Hypertrophic facet joints are also present at this level.
      Rest of the intervertebral discs return normal signal.
      Vertebral bodies have normal morphology and signals.
      Conus medullaris terminate normally at L1 level.
      No Para vertebral soft tissue abnormality seen.
      Sir this is my MRI report and I been suffering from pain for more than two months will this four step exercise will help me. What should you suggest me me to start these four exercises is suitable for me or any medicines or tharapy is good for me . Please advise me I’ll be very very grateful to you waaiting for your reply please asap. Thanks have a wonderful day.

    • Avatar for Mark M

      Hello Dr. Ken,

      I have an L4/L5 bulging disc/annular tear that’s been a lot of trouble the last 4 years. It makes me constantly pull my back out if I strain it too much which makes it hard to ever do exercises. I have a very hard knot that forms about an inch to the left of my spine on the side the disc is bulging. It pulls everything up through my shoulder. How can I get rid of this knot?

      I’ve tried having people massage it out, daily stretching, etc, but it just results in excruciating pain and spasms.

      I feel like this knot, which probably forms to protect the disc, is causing more trouble than it’s preventing and if I were able to loosen it up, I might be able to heal my disc without surgery.

      Thank you!

      • Avatar for Dr Ken Nakamura Post
        Author

        Thanks for your question Mark. First it’s important while you are healing but even afterwards that you stop aggravating your lower back and your L45 bulging disc especially when there is a visible annular tear. This means that your disc is hanging on by a maybe a layer or two of the annulus and one ligaments. You can stop aggravating yourself by reading and doing the recommendations in this article.
        https://www.bodiempowerment.com/disc-herniation-part-1/

        Than you can do the exercises that are available right here in this article and also this article. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/

        Hope that helps.

      • Avatar for arvind sharma

        Hello
        Dr. Ken sir
        I am 26,years old . I have a more back pain in my left buttox .and its pain up to hole left leg. When i am trying to walking max i walk 10 min.after that i can able to walk bcoz of that pain.
        in MRI reports
        there is straightening of lumber spinal curvature ,with minimal retrolisthesis of L5 over S1.
        Mild disc bulge with left paracentral protrusion is seen at L4/5 level causing canal stenosis with attenuation of left lateral recess and neural foramen with resultant compression of left traveraing L6 and left exiting L4 nerve roots respectively.
        there is e/o mild dessicatory changes seen at L4/5 and L5/S1 intervertebral discs seen as reduced normal T2W hyperintensity .posterior annular tears are seen at L4/5 and L5/S1.
        This is mri reports.now sir what should i do.which exesics is best for me.plz suggest sir .i am facing too much of pblm bcoz of that pain .
        Best Regards
        arvind sharma
        mob-8285520777

    • Avatar for Devendra

      I am Devendra, aged 34.

      I have undergone surgery for slipdisc 10 yeras ago. Now again the back pain is increased. I have numbness in my right leg. Too much of pain at the sacrum position. I dont have old report with me.
      My recent MRI says:
      1) There is evidence of posterocentral protrusion on intervertebral discs noted at C5-C6 and C6-C7 levels causing compresssion of dural sac.
      2)Mild degree of retrolisthesis of L5 vertebra over S1 noted with los of lumbar lordosis.
      3)Moderate degree of disc desicaation noted at L4-l5 intervertebral disc.
      4)Posterocentral protrusion of intervertebral disc noted at L4-L5 level with mild inferior migration causing significant compression of traversing nerve roots at right lateral recess.

      Plz Plz Plz help me … what should I do ? suffering lot with this pain.

      • Avatar for Dr Ken Nakamura Post
        Author

        Thanks for your question Devendra. The exercises are likely to aggravate you. You are likely a surgical case as it sounds like your disc has sequestered. You should get an immediate second opinion about your choices.

        Hope that helps your likely sequestered disc herniation. This comment is for educational purposes only.

img 9195 4 depositphotos bgremover
img 9195 4 depositphotos bgremover
Dr. Ken, has been recognized as the Best Toronto Chiropractor in 2024, 2023, and 2018, here in downtown Toronto. As a sports chiropractor, he excels in treating a wide range of conditions including concussions, temporomandibular joint disorders (TMJ), sports-related injuries, and spinal issues. Beyond his clinical skills, Dr. Ken is an accomplished athlete, having represented Ontario in the Canadian Judo Championships and completed the Toronto Marathon on two occasions. He employs the innovative C3 Program to provide targeted and effective care to his patients, ensuring a holistic approach to their well-being and athletic performance.