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 Laura

    Hi thanks a lot for answering my question. Been to see my physiotherapist as she thinks it’s piriformis sydrome and has told me to do nearly the same exercises and strectches you have said. She thinks it’s not SI joint problem because it doesn’t hurt when I turn over in bed or stand on one foot. It makes a lot of sense of what your saying that it still could be a disk problem. Most probably a silly question but if I do piriformis strectches, could it cause the muscle to become to long and therefore not support the SI joints? At the moment im terrified of having SI joint dysfuncstion. I have heard some really horrible storys about it. Thanks again for taking the time to answer.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Laura. Your piriformis naturally gets tight, if you stretched it all the time I think you could cause a problem theoretically, but I have not come across anybody in my experience that has ever done that. I also have never heard of anybody with terrible SI joint problems. Most of the time a disc or stenosis causes a lot more pain that can refer to the SI and seem like an SI problem.

      With the recommendations I made in the piriformis article you could not cause such a problem.

      Hope that helps your pain.

  • Avatar for Roshan

    Hi Dr Ken

    Thank you very much for your kind advice.

    I would like to inform you the exact details of the findings of the MRI of the lumbar spine.

    The vertebrae are of normal heights. features of small S1 vertebral hemangioma. the dimensions of the central and laterals canals are normal as the neural foramina. posterior facets & ligamentum flavum appear normal. the conus is normal & id situtaed at the level of T12/L1

    Impression

    L4/L5 broad based posterior discal protrusion indenting on the anterior thecal sac & containing both L5 nerve roots.

    Also, i do not play football at the professional level, it is only for fun but running trail is at a semi professional level.

    i would be grateful if you could please advice me on the findings of the MRI.

    I also wish to inform you that that i have practice the exercise for three continuous days, but i am having a lot of pain. it is only the squat position which is helping most.

    Roshan

  • Avatar for Laura

    Hi
    I’m woundering if SI joints that get inflamed could cause sciatca? Do any of the nerves go near there? I’m get mild sciatica symptoms in my left leg I also get sharp stabbing pain in left SI joint and hip pain as well plus burning pain in bum. I’ve had mri and my spine is fine plus xray on hip also shows no problem. This tends to flare up when I’m active plus doing clam exercises and the fire hydrant one cause the pain also squeezeing plevic floor muscles brings it on. I’ve had the pain now for 10 months and have had to stop doing a lot of activitys I use to love. Any help or suggestions on what my problem could be would be a great help. Thanks.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Laura. Yes SI or sacroiliac joint irritation can cause sciatica or pain down the leg. First your sacroiliac diagnosis can be wrong. A diagnosis is made clinically not by MRI or X-rays. What I mean by that is MRI and X-rays should only be used to confirm a diagnosis.

      You can possibly have a disc bulge, piriformis syndrome which will not show up either. For example MRI and X-rays won’t show piriformis syndrome and a disc has more pressure on it while you are sitting, standing and bending forward. A MRI on the other hand is usually taken lying down which puts the least amount of pressure on the disc, so won’t show up on MRI and never shows up on X-ray.

      You can still have a disc problem, piriformis syndrome, SI syndrome or even a hip problem. A tear of the joint cartilage won’t show up even with an MRI unless you get an injection.

      Why don’t you get a second opinion on your pain.

      You can try the piriformis exercises here which are helpful for piriformis syndrome but also most hip problems but won’t likely solve your problem completely. https://www.bodiempowerment.com/exercises-to-help-piriformis-syndrome-how-to-tell-the-difference-from-disc-herniation/

      Hope that helps.

  • Avatar for roshan

    Thank you very much for your advice Dr Ken. According to you after how long after doing the exercises, I can start playing football. its my favourite hobby.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Roshan. First you need to be able to have a full range of motion in your lower back, with no pain. Then you need to able do functional tests. ie if you are a running back you need to be able to reach in all directions and catch the ball with no pain. Your strength and stability should be as such that you can do lunges, squats (only in perform form – have a personal trainer look at you) etc… without even a twinge. This is assuming you are playing amateur house league type football. If you are playing rep or semi-professional you should consult your team chiro or physio.

      If you are playing European Football you can get back on your feet sooner.

      Either sport you are taking your chances as the nature of the game is not always predictable. Anytime you can get hit. You can be perfectly healthy and still get hurt.

      Hope that helps.

  • Avatar for Roshan

    Hi

    I have a disc bulge at l4 l5 since august 2013. I had been to chiropractor , orthopedic surgeon which recommended for physiotherapy. it is nearly one year since i am doing PT but the pain is still here, the pain is only in my buttock and does not through my leg. i am even considering for epidural steroid injections which has been recommended by a friend, but fears it did negative side effects. i do not know exactly what to do. please advise

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

            Thanks for your question Roshan. I wouldn’t recommend playing football and running trail right at the moment but it is possible to get back to trail running. Football is a little more tricky as there are a lot of hits that you can’t control. Any hit at any time could set you back. Even when you get out of pain completely doesn’t mean you have completely recovered 100%. What I mean is there is still a hole in your disc. You are more likely to get back pain again.

            Although if you keep up with the exercises you are less likely to get the problem as seriously again.

            Hope that helps answer your question.

  • Avatar for Steve Mbui

    Dear Dr. Ken,
    First is to thank you very much for the excellent advise you continue to provide via this blog. God bless you mightily! I have been diagnosed with “L4/5 posterolateral disc herniation with mass effect on the right L5 traversing nerve root”. The MRI report further says “the L4/5disc is dessicated and it shows a diffuse buldge with a right posterolateral component that is elevating the posterior longitudinal ligament”. I have no back pain but do have on and off moderate to severe pain on the right butt near the hip joint that radiates to the lower right leg. I wanted to use the exercises you have advised to see if the condition will improve before accepting the surgery recommended by my doctor. Please advise if this is ok. also please advise if it is safe to perform push ups, squats, crunches and sit ups which have hitherto been my preferred exercises. Thanks a lot.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Steve. First you should always do conservative therapy before recommending surgery. Any surgeon that does not recommeend conservative therapy first is compromising their integrity unless there are the following:

      Drop foot that is getting worse.
      Neurological symptoms that is getting worse such as muscle wasting, or decreasing muscle strength that is getting worse. Smaller calf circumference, reflexes that were there before disappearing.
      Bowel and bladder function getting worse.

      I would simply do the exercises but keep in mind the flossing can make you worse if you don’t follow the instructions properly, Sometimes even when you do.

      Hope that helps.

  • Avatar for Dyann Romeijn

    I am super confused. I went to a neurosurgeon for sciatic pain and they referred me to a physical therapist. The physical therapist asked if I had hip problems because my pelvis was tilted and she thought that may be putting the pressure on my sciatic. I told her knee issues in past…no hip. She sent me to an orthopedic doctor who took x-rays of my knee and found it was complete bone on bone on the outside of the knee, affecting my alignment. They figure it could be the underlying cause of the sciatic pain. Waiting to see the surgeon for replacement. In the meantime sciatic pain got so bad I went to the chiropractor. My whole leg is weak. I have an extremely high pain threshold but was nearly in tears from the pain today. He checked and said my achilles reflex is absent and he thinks it is likely a discount issue rather than leg alignment. What do you think? I can handle the knee pain. I honestly didn’t even know it was an issue. I walk up and down stairs normally. I can’t handle the sciatic pain and don’t want a knee replacement only to have the same sciatic pain.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Dyann. Sounds like a complicated issue you are dealing with. It is true that the knee issue can be putting pressure on the nerve. It also may be that your pain is being aggravated but not the cause of the sciatica. Here is how you find out.

      If the wear and tear in your knee is causing the problem you can put a wedge that is thicker on the outside of the shoe which will increase the height of the outside of the leg. The pain from sciatica will likely decrease. You can find a wedge by buying shoe insert. http://www.superfeet.com/ Cut off if off around the two third mark with scissors. Put in backwards. ie Most inserts support the inside of the foot not the outside. If you put it on backward it will support the outside of the foot. You are cutting off the top part of the insert so it will fit in your shoe backwards.

      If the pain decreases with this method you can keep the insert there for a while and get your sciatica treated.

      Hope that helps your disc herniation.

  • Avatar for Vijay kapoor

    Dear Dr.Nakamura, I get numbness in both feet after walking about 100 yards, or when I stand for about 15 mins. Or so . My MRI and EMG say it is radiculopathy. L4 L5 S1 nerve is pinched. Am suffering since 2 1/2 years. Age is 67yrs. Non diabetic, overweight , vit B12 and D3 is normal. Lyrica, Nuroday P did not help . Please help me out . I also get cramps in the legs any time in the day./ night. Now on Pentoxyfylline 400 mg. 1-1 and Evion LC 1 daily .would appreciate urgent advice from you. Will Accupuncture , surgery or any massage etc. will be useful ?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Vijay. Sound like you have spinal stenosis with neurogenic claudication. Let me translate. You basically have wear and tear of your spine that is trapping your nerves. When you walk you are in extension (slightly backward) at your lower back. You need to be able to change your posture while walking so you can open up the space for your nerves.

      When you are in flexion you increase the space for your nerve. You can learn how here. https://www.bodiempowerment.com/spinal-stenosis-comprehensive-guide-5-exercises-spinal-stenosis-lateral-stenosis/

      Your “MRI and EMG say it is radiulopathy” That’s not a diagnosis. Your EMG and MRI should be more detailed or your doctor should be more detailed. Radiulopathy simply means pain along the nerve. Well you need to know the cause as if you have a herniated disc vs spinal stenosis causing radiculopathy the exercises are the exact opposite. Meaning if the diagnosis is wrong and you do the wrong exercises you will get worse.

      Looks like Spinal stenosis to me with the information so far. Just follow the exercises in the link above.

      Hope that helps your sciatica, radiculapthy and most likely spinal stenosis.

  • Avatar for Simon

    Hi Doctor Ken, stumbled into your page when I was searching exercises to ease sciatica pain. I had a L45 slip discs and went for a disc nucleoplasty procedure 3 months ago. Although I don’t feel numbness and jolting pain down my left leg often now, I am restricted in most bending activities. There are good and bad days. On bad days, it just gets so uncomfortable to even sit upright. I am seeking physiotherapy treatments twice a week, but with limited improvements. Most physiotherapy sessions will consist of an assessment of current situation, a rubdown and repeat of exercises targeting the core muscles. Questions: 1) In your opinion, will more physiotherapy sessions help in the recovery? 2) Is it normal for me to still feel sciatica soreness after the procedure? 3) how long is a typical recovery period? Look forward to your response. Cheers.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Simon. Disc Nucleoplasty is a procedure where they insert radio transmitter through your disc to dissolve part of the disc. To put things in perspective micro-discectomy surgery which is more commonly done procedure as it is more proven, takes out a part of your vertebrae followed by cutting off the piece of the disc that is pressing on the nerve. After microdiscectomy surgery you can typically go back to work in 2-4 weeks for most office workers. This means that they are sitting most if not all day by this point.

      Disc Nucleoplasty on the other hand doesn’t take out any bone and only uses a needle in a 20-30 minute procedure. The problem is it makes a new hole in the side of the disc. The typical recovery time is 1-6 weeks with office workers going back to work much earlier. You should go back to the surgeon for a follow-up consultation to see what is wrong.

      If they say nothing is wrong you then need to focus on decreasing the scar tissue made from surgery. If the pain is from the hole in the disc that was not before than you can try side bending exercises if the incision was on the side. If the incision is more toward the back close to the vertebrae than you would typically do extensions. You should let the physiotherapist or chiropractor determine this.

      Glad you don’t have the sciatica anymore.

      Hope that helps your recovery from nucleoplasty.

  • Avatar for Shane
  • Avatar for Shane

    Hi there! I’m 20 y/o and have been battling a l5s1 bulge since July of 2013 that I got through deadlifting. I have been through 2 chiropractors, a physical therapist, and a cortisone injection. The only thing that has really helped significantly is spinal decompression with my most recent chiropractor, but I have ceased going to him as it is not helping anymore. I’ve improved a lot, but still have lingering annoying foot tingling/ burning in my left. I since have contacted a chiroprator online who recommended flossing. I tried it yesterday doing 15 reps twice a day, and notice that my tingling is a little more noticeable today. Is this normal?

  • Avatar for Richard

    Thanks Dr Ken,
    I will certainly try exercises – but what is the long term outlook of this condition?
    How can it improve quickly?
    Is surgery an option?
    And what does Rehabilitation mean as far as a Chiropractor is concerned?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for the question Richard. Most people with your condition can get to a pain-free condition. This does’t mean you are 100% it means you are pain-free but with heavy lifting or sloughing all day for months you will likely get some pain again. Likely not as severe but it depends on how stable the disc is. In your case surgery is an option but only after all conservative options have been exhausted unless you are getting worse. ie. reflexes dissappearing, foot drop that is getting worse, etc….The problem is which level do they do surgery on. Likely you need to address at least two level L45 and L5S1.

      Before getting to that state it would be advisable to do 3 months of conservative care including exercises. Switching to other treatments after a month eg. traction or decompression is another option.

      Rehabilitation for a chiropractor is the same as physiotherapist. You want to to do stabilization exercises as well as exercises to put the disc back into place. At this time you should to the stabilization exercises and continue the flexion exercises. You should also treat your hamstring. Don’t stretch it. Take a tennis ball and put it under the most sore spot in your hamstrings. Put as much pressure as you can take by holding onto the chair. Then bring you knee up and down.

      https://www.youtube.com/watch?v=7MFmwmmKQao

      This video is with a foam roller but you can use a tennis ball or any other harder ball like a lacrosse ball, ball hockey ball or baseball.

      There is no guarantee you wil improve quickly.

      Hope that helps your disc herniations.

  • Avatar for Richard

    Hello Dr. Ken,

    I had an MRI in February this year.
    The results are:
    L3-L4 there is mild disc bulging mildly effacing anterior thecal sac with mild bilateral neural foramen narrowing.

    L4-5 there is mild disc height loss desiccation and disc bulging with superimposed left paracentral disc protrusion. There is a narrowing the left lateral recess with mild impingement of the traversing left L5 nerve root. There is a mild spinal stenosis overall and mild to moderate bilateral foramen narrowing.

    L5-S1 there is a left subarticular disc protrusion mildly contacting and displacing the traversing left S1 nerve root. There is mild bilateral foramen narrowing.

    My doctor recommended Pysio which I resisted to start with but the pain in my right hip and lower leg got so bad I did 5 weeks of Physio recently – I was recommeneded to do Extension exercises. However the pain got worse and my knee started to hurt and then into my foot and big toe!
    I had more pain when walking generally.
    My Physio guy then switched me to Flexion which I’ve doing for the last 3 weeks – but not really seeing too much improvement!
    Not sure what to do!
    Glad of any suggestions!
    Would a chiropractor help?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Richard. First the problem is you have two levels that are causing pressure, one with spinal stenosis and the other causing your S1 nerve to be trapped. Exercises may or may not help you. Some would argue that you really have three significant levels affecting as there is pressure on the thecal sac. Remember MRI are taken lying down, it’s not real life. In everyday life you sit, lift and stand. There is more pressure on all the nerves in real life.

      Exercises may or may not help you in this case. It’s still worth a try giving the sciatica exercises I have explained in this article. With flossing make sure that you don’t start until you have followed the instructions and determined if you are right for flossing. I would try the exercises for a month as long as they don’t give you sharp pain.

      Also a chiropractor that does rehabilitation and acupuncture may help. Really though while qualifications are important, it is the person that is most important. Make sure go with referrals and reviews. If the person referring you to a chiropractor is not picky they are not likely a reliable source. You definitely want someone picky.

      Hope that helps hour disc protrusion and bulges.

  • Avatar for kuldeep kaur

    Hello dr. I m suffering from l5s1 disc problem sometime I suffering too much pain in my left leg I take medicine then I ok but if I don’t take medicine then I suffer same ple

  • Avatar for Heather Paisley

    I have mod. Degenerative arthritic changes at l5—s1. No fracture or stenosis. I get variations of nerve pain down my right leg and buttuck. When the nerve pain settles I have a constant achiness at L5—s1. Thank you for posting the 4 exercises. I cant wait to try flossing to see if that helps!

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your comment Heather. Remember to test if the flossing is for you as it can make some people worse. Some people get worse temporarily than get better than started others get worse for a few days to a few weeks.

      Hope that helps.

  • Avatar for Indira

    PS. I was having back pain throughout July and August, and diagnosed with the herniation in Mid-August (~3.5 weeks ago) after having an MRI and seeing a Neurologist.

    Thanks once again.

  • Avatar for Indira

    Dear Dr Nakamura,

    Thank you for your posts they are very informative and helpful. I have been diagnosed with herniated disc at L5-S1 and a bulge at L4-L5. I have medications including NSAIDs and muscle relaxants and vitamin B complex. The pain in my back was really helped through mckenzie exercises. But I had mild sciatica and tried the sciatica stretches and might have gone too hard or something, because since a few hours after flossing and the stretches and day before yesterday, I have a cramp-like pain in my right calf and sometimes muscle twitching in my buttock and calf. No muscle weakness, just calf pain like a cramp when I walk, really painful to put my weight down. The pain is not there when I lie down.

    Please advise what to do in this situation as I am really scared that I might have worsened my condition and done something to my sciatic nerve. I really don’t want surgery. Do I continue with exercises or take it easy and see if calf pain goes down. I am still taking the medication but it is not doing much for the calf pain.
    I would really appreciate your advice. Thank you very much in advance.

    Best,
    Indira

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Indira. Sounds like you did go too hard with the flossing. There are times when flossing is not appropriate. You should self massage your calf or every 2 hours for about 5-10 minutes. For the buttock try using a ball like the picture in the article.

      Don’t do any more flossing or other exercises except for sphinx and cobra if it doesn’t hurt you. Mild pain is Ok. Nothing sharp.

      Hope that helps your herniated disc and sciatica.

      • Avatar for Indira

        Dear Dr Nakamura,

        Thank you for your kind reply. I am following your advice now.
        I also went for my first chiropractic adjustment today. Whilst the chiropractor told me that there will be a treatment phase of 12 adjustments spread over a month (I have misalignment not only within lumbar area but the neck as well) and that I will have to ice the area after the appointment plus 2-3 times for the next few days until my next appointment, she did not say to do the exercises now.

        Is it still okay to continue with cobra and sphinx exercises whilst I am having adjustments? As the chirporactor told me that she will prescribe the exercises after the initial treatment phase of 12 adjustments.
        Thank you for your help once again!!

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your question Indira. It’s OK to do the ball exercise for your piriformis and glut medius, even your hamstrings. As long as the exercises are improving you and not hurting you I’m of the opinion that you should do the exercises. Getting better is a team effort. You need to do some work too.

          Hope that helps.

  • Avatar for Nicola
  • Avatar for Nicola

    Dr. Ken:
    Was supposed to ask that I do not have much pain now and assume that I am strengthening my core. A recent MRI showed that “something” was going into the canal and the Dr. told me to watch for increased bladder issues over time..I will have to get the report to see…

  • Avatar for Nicola

    Hi Dr. Ken: This is an excellent article and one of the best that I have read on back issues. It is very clear and easy to understand. Through MRI’s I have been told that my L4-L5 discs are partially desiccated and L5-S1 is desiccated with loss of normal height. Additionally, L4-5 focal left foramen bulge with narrowing of the neural foramen. L5-S1 protrusion.
    I used to have pains running down my legs and back, but I have lost weight and am a part of an outdoor fitness group, so I exercise consistently about 3 times per week. My concern is whether some of the exercises may be ones that I should not do considering the above like squats; sit ups, etc. I also have a slight bulge in my neck.
    Are there any exercises that you suggest I should do more of of and ones I should not do? I do “granny jogging, very slow pace” for short periods at times but mostly do speed walking if running is required. Thanks much for any help.

Dr Ken Nakamura downtown Toronto Chiropractor
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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.