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 sunny
    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Sunny. You need to write at least 100 words of details. Saying you have an L4L5 herniated disc doesn’t mean it is so. Even if it is herniated it may not be causing you pain.

      • Avatar for Elsa Gispert

        Dr. I had a surgery for my lower back in May 2014, for L4-L-3, right after surgery started complaining why my left leg was numbed a had difficulties moving my toes, doctors told me because it was anesthesia, and because I needed therapy, months went buy and leg was same , started walking and putting more pressure on good leg, 10 months later had 2nd surgery with another doctor, which results were I have a damaged nerve, was able to move my toes, still have numbness, on the outside part of left leg, and tightness, and swelling over top of my toes, can’t hold the pain and now is 2 years, my second surgery was March, 2015, I have noticed than my left leg is getting skinny, and I’m very worried, please help me , which excersize can I do, will I get any better? I’m only 58, and I very anxious to get better again, don’t want a 3rd surgery, but I don’t want to stay like this, please tell me want can I do….I try not to limp. But I guess I’m putting more pressure on my good leg, and this is why is happening, please help..Thank you and lot’s blessings Dr. Elsa

  • Avatar for Shashi

    Hi Sir, my self shashi. I have a herniated disk at l5-s1(2015 march MRI) I got back pain for one week and went back and then again one month after started my back pain more and more .like lower back pain. Hips pain . Legs tinging, numbe ness and swelling the nee down part and foot and two months I stared the excesses which u shown with the help of one yoga teacher here. Now I am on but but not like before my 2015 life. Now my yoga teacher teaching me some gentle twists to my lower back and after 3 days I fell uncomfortable. So I am writing this
    My 2015 MRI report is l5-s1 shallow eccentric herniated disk and l5s1 facent joint senovities
    My question is can I go head do the twist experiences for my back after herniated disk or not. Please help me on this

    In reply to Shashi.
    Hi Sir. Thanks for you web site and which helped me a lot in doing exercises
    I am just re-framing my problem clearly here. My self Shashi and facing the back pain since more than 1 year
    Initially Its started with very bad pain which i could not control and i took a rest and than went off.
    After a month again, came back and day by day it went worse . So I took a MRI
    Its shows : MRI showing that its Shallow Eccentric Herniated Dis causing minimal thecall compressions
    Lumur Facet Joint Synovties.

    Treatment I took in 2015 was physiotherapy electrical therefy for one week and then one week oil massage therefy . then I started tge excerizes and within one month I am normal but not like the before 2015 life. Stopped driving two wheeler and now I am ok.

    Recently 3 days back , My yoga teacher taught me some new excesizes like some twisting the back by sleeping bending the legs one side and head other side ,Lowerback also. And also by sitting on chair. So now I am not confortable and today I am taking rest because of unconfrtable but while doing yoga no probme at all ( I mean yoga twisting )

    My question is : Can I do my yoga lower back twisting after I got the Herinated disk ?

    Can you help me and I am 33 only and Please help me on this

    • Avatar for Shashi

      Hi Sir. Thanks for you web site and which helped me a lot in doing exercises
      I am just re-framing my problem clearly here. My self Shashi and facing the back pain since more than 1 year
      Initially Its started with very bad pain which i could not control and i took a rest and than went off.
      After a month again, came back and day by day it went worse . So I took a MRI
      Its shows : MRI showing that its Shallow Eccentric Herniated Dis causing minimal thecall compressions
      Lumur Facet Joint Synovties.

      Treatment I took in 2015 was physiotherapy electrical therefy for one week and then one week oil massage therefy . then I started tge excerizes and within one month I am normal but not like the before 2015 life. Stopped driving two wheeler and now I am ok.

      Recently 3 days back , My yoga teacher taught me some new excesizes like some twisting the back by sleeping bending the legs one side and head other side ,Lowerback also. And also by sitting on chair. So now I am not confortable and today I am taking rest because of unconfrtable but while doing yoga no probme at all ( I mean yoga twisting )

      My question is : Can I do my yoga lower back twisting after I got the Herinated disk ?

      Can you help me and I am 33 only and Please help me on this

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Shashi. When you have pain twisting your lower back will hurt it causing it to get worse. When you are better you may consider it but not until then. Yoga teachers are not health practitioners trained to rehab the spine. I find treat many people that do Yoga and hurt their backs. For most people with back problems, it hurts their back unless the Yoga teacher really knows what they are doing with regards to back pain. Most know about the Yoga poses and general health but not the specifics with regarding back pain and even few still know how to customize a program for a specific type of back problem. This has been my experience having treated more than 10 Yoga teachers and hundreds of people that do Yoga. It may be different in India but this is my experience her in Toronto.

      • Avatar for Shashi

        Thanks a lot of your reply Sir and I really and healthfully appreciate it.
        Yes it happened same thing what ever you told exactly ( After starting twisting poses in yoga, pain got started) . Now going for oil massage treatment to reduce the pain and then going for physiotherapist.

        Will you help me on move in right direction online. I will email you all my details if you have time for my treatment or suggestions on line.

        I know that you are really busy & please let me know if you get some time for me

        • Avatar for Shashi

          Will you suggest me like do I need to go to physiotherapist expert or ortho to start the excersizes again?
          Any other sugesstions? I used to swim last month .. Will that be ok to swim after my pain reduce?
          Seimming is good for herinaied disk?
          Is that ok two ride bycyle to strong myself? ( two wheeler bike may hurt my back and bumps and bike weight is more problem for me ) So will that be ok to go slowly on bycyle?
          or any more sugesstions do i need to take or any reference links.
          Curreenly using the 4 wheer vechile to go on bike. Is that ok . Sorry for asking too many questions.
          Please help me

          • Avatar for Dr Ken Nakamura Post
            Author

            Thanks for your question Sashi. Swimming may or may not help you will have to try and find out. It depends on the stroke. Everybody is different. Don’t ride your bike although a four wheeler is fine.

            Find the best chiropractor or physiotherapist in your area.

            Hope that helps your sciatica.

        • Avatar for Dr Ken Nakamura Post
          Author
  • Avatar for Md San

    Hi Sir,
    2 years ago,I had a shooting pain on my left lower back and on left side just above hip area for 4 months after carrying heavy loads and also had a traumatic hard fall onto my lower back.Was sent for MRI and results for 1st MRI as shown below;

    -Degenerative disc disease at L5/S1
    -Posterior annular tear at L5/S1
    -Posterior mild line disc protrusion causing mild spinal canal stenosis at L5/S1

    I was getting better all along for about a year and half by doing physio therapy excecises but unfortunately,I suffered a relapse pain 2 months ago after carrying heavy loads in an cramp space and in a slightly improper posture.

    I then started having additional symtoms such as mild weakness at my left leg and strain pain from my buttocks all the way to calf area at left leg accompanied by the existing shooting pain of lower back on left side just above hip area.
    I had my 2nd MRI done last week,findings as below;

    -L4-L5:
    Disc bulge indenting thecal sac.No significant narrowing of the lateral recesses,spinal canal or neural foramina.

    -L5/S1:
    Posterocentral and right lateral para central disk protrusion with posterior annular tear causing mild narrowing of the lateral recesses,abutting the right descending S1 nerve root.No significant neural foraminal stenosis.

    Please advice me on what are the findings about and what should I do to get it healed and get the pain off.

    Thank you.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Md. First it’s very unusual to get a second MRI for a replapse for the same problem even a year apart. Usually you should be diagnosed by history and examination except when there is some trauma like with your first MRI.

      You can try these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
      However like any exercises you can get worse. You should have your physiotherapist supervise them at least initially. You know you are getting worse if the pain, numbness or tingling goes further down the leg or you it or the symptoms increase in intensity.

      Hope that helps your disc protrusion.

      • Avatar for Md san

        Thank you Dr Ken.
        Just a Quick qtn,is the tingling and pain sensation from my buttock to calf area at left side due to inflammation of nerve? (as Mri states is has abutted the S1 nerve)
        And over time,will the nerve inflammation heal off and it will be as per normal size,therefore will it not cling onto my L5/S1 bulging disc?

        Thanks once again and I sincerely appreciate !

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your question Md San. There are plenty of people that according to their MRI there should be pain the abutted S1 nerve. Your case is likely due to the S1 nerve. There shouldn’t be any inflammation at this point.

          Hope that helps your sciatica.

          • Avatar for Md San

            Thanks for the reply Dr Ken.
            Will my condition be mildly pain free as per 2 Years back when I first got the injury apart from the recent relapse?Im current on PT.Can I ask,in most cases u experienced,Will the clinging on the S1 nerve root be temporary(will it go back to original place) or will it be permanent sciatica feel in having now?
            Cause even by climbing stairs,there’s fatique and weakness and pain at affected mentioned areas of my left side lower back till calf area.

            Thanks once again and I appreciate ur favourable reply Dr!

          • Avatar for Dr Ken Nakamura Post
            Author

            Thanks for your question Md. Your decrease the pain maybe even eliminate it and put the disc back in most cases. However low back pain especially after you’ve had sciatica is recurrent. This means it will happen again. That is normal. You might just get low back pain again or sciatica again. Ask 10 people who have back pain. After 20 years most of them would have it reoccur again. That is the nature of lower back pain and sciatica.

            Hope that helps your sciatica.

  • Avatar for ashraf

    Hi All,
    i cheak xray but there is no problem, then i did MRI And my MRI report is… ***((Spinal canal stenosis with bilateral traversing and exiting nerve root compression at L5-S1 level due to lobulated posterior & posterolateral disc protrusion with leftward accentuation at the respective level as stated above.))
    my doc tells me i have herniated disc L5-S1 and a nerve root compression. Anyone had similar issues? What can i do???
    (I’m 30 used to work out daily, play tennis and my work is such that i sit on computer all day…)Pain started suddenly after an uphill contest.

    The pain in my lower back only occurs when i either sit for long hours, or immediately when i get up after laying on my back with my feet touch the ground. No pain though when i lay on bed with feet on the bed-strange i know.

    The sciatic pain occurs one (on left side) mainly when i stretch, or bend to touch my toes that kind of thing.
    it is 3 week now..
    when i take warm water in my back i feel good.
    can i take 4 time warm water for my back pain?

    Please help, what exercise, treatment, things can i do to get better??????

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Asharf.
      Q:can i take 4 time warm water for my back pain?
      Answer: You can do that but it won’t help your problem it only help the pain. It does nothing to help with the actual disc.
      Try these exercises.
      https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
      Hope that helps your disc herniation. You need a good chiropractor or physiotherapist to make sure you are doing the exercises properly at least at the beginning. Like any exercise you can get worse. If the pain is worse or if the pain, numbness or tingling is going further down the leg you are getting worse and need to stop right away. Any good chiropractor should know that.

      • Avatar for ashraf

        Thanks sir,
        I regular do exercise now i have no pain. but some time i have a little pain for 10 – 20 second. now i can walk very well.
        now i off taking warm water heat.
        could i continue exercise and go physiotherapy center?
        please inform me.
        it will be very helpful for me.
        thanks.

        • Avatar for Dr Ken Nakamura Post
          Author

          Thanks for your question Ashraf. My opinion is that you go to the best physiotherapist or the best chiropractor in your area to get some rehabilitation exercises to stabilise your lower back.

  • Avatar for Ahmed

    Cam you Please give me some treatment excercies for my case, i have mild anterior wedging of L1 with approx 20% loss vertabae height due to an old old compression fracture at local kyphosis at the L1 level that happened around 3 months ago, also i have early multi level degenerate disv desease in my lumbar spine, also there are 5 non rib bearing lumbar height vertabral bodies with with minimal grade 1 rethrolesis on L2, L3, L3 on L4 , L4 on L5 and L5 on S1, the pain is really aggrevating and i just need treatment for physio exercices that would help cure this issue, please if u can help me in any way it would be helpful

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Ahmed. You need to give very detailed symptoms for me to help you. Also you don’t treat the X-ray. For example you might have mild wedging at L1 but it might not be giving you any symptoms as most fractures heal in 6 weeks and later give you no pain. Others aren’t symptomatic at all. There is little point in trying to address an X-ray finding that isn’t causing pain. So without lots and lots of details X-rays by themselves are of little use.

      Hope you understand that if you go to any doctor with the information above and nothing else you will get the same answer. If they say they can help you based on that there is something seriously wrong with that doctor.

  • Avatar for Jason

    I was a competitive Powerlifter for about 12 years and taught lifting for about 15. 2 years ago I was diagnosed with a ruptured disc with MRI confirmation at L5/S1 and herniations at L4/L5 and L3/L4

    Sciatica is getting pretty bad. Burning from lateral right thigh to just above the knee.

    Not sure rehab or stretches for this.

  • Avatar for Thomas

    Hello,

    Thank you for your website. For the past 2-3 years I’ve had lower back pain and it shoots down my leg. I’m very athletic and brushed it aside because I’m 23 years old and felt like it wasn’t bothering me to much.

    It’s gotten to the point now where I walk this pain shoots down my Right Leg and I want to know if I can heal this. I’ve gone to 3 different physicians – a chiropractor, an osteopath, and atlas treatment. None of them helped my situation out so I’ve slowly started to lose hope.

    I know I have sciatica because of the bursts of pain down my right leg, however, I’m not sure what is the cause. I have an MRI scheduled in August to see which disc is the culprit.

    I have a feeling its my S1,2,3 ones from what I’ve read here.

  • Avatar for Gurvinder

    Hi Doctor

    I have pain in my lower back, hips,thighs and in testicle also. Pain mainly occur during day. I get some relief when I sleep.

    Please give me suggestion to get rid of this pain.
    Thanks in advance .

  • Avatar for Jay

    Hello,
    I have an xray showing mild to moderate “arthritis” and disc narrowing at L5 S1 with anterior lipping. My simptoms started off with occasional lightning bolt pain down left leg usually the first few steps going from sitting to walking. 6 weeks later, i no longer have that but much worse deep aching pain in my calf, butt, ankle that is constant. Lately there has been some weakness sensation and more pins and needles. I live in canada and have seen a physio, chiro, osteopath, and 3 different physicians. All assesments are questionable as they dont ask many questions to assess my condition. They are just using percentages saying “most people have a posterior disc herniation with that pain” so thats what they are going with but there are some red flags with that. I get the most relief from laying down, secondly I get relief from sitting. It doesnt hurt at all to bend forward and touch my toes. If I am laying down on my back, it hurts if I lift my pelvis up. Also sometimes I get extra tingling down my leg doing cobra strethes or mckenzie stretches. These stretches my chiro told me to keep doing even knowing that. I am really trying to get better but it sure feels like no one is actually trying. Everyone wants the MRI to indicate what is wrong. In my eyes, if someone knows what they are doing, they should be able to figure it out without the mri. (Mri scheduled in 4 months). Please help, desparate for help so that hopefully im not making it worse. Also, dont advise me to seek out a better doctor or professional as this is actually the best there is in my area… pathetic..
    Thank you.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Jay. Sounds like chiropractor, physiotherapist and osteopath need to know how to customize the exercises to your body. What I have in the article is simply general exercises. However if your disc is out posterior and lateral vs. posterior vs. anterior. I am not talking about the MRI. The MRI is the last thing any practitioner should look at as they are often misleading. If they look at first they are often influenced by the results and diagnose you based on the MRI. For example the MRI says posterior lateral disc herniation but you may need simple posterior disc herniation exercises or the disc may be posterior but when examined you need anterior exercises as that’s how you respond. Lucky you don’t have the MRI yet.

      Any good practitioner will diagnose you based on a thorough history and exam not the MRI as you mentioned. Well never-the-less you need someone that can customize your exercises that means another opinion. Also sometimes acupuncture may help if not it will be for a couple days.

      You can try 10 knee to chest stretches holding for 1 sec to see if they help. Do them 4 times a day. Yes one second.

      Oh and yes you still need to see a better doctor.

      Hope that helps your likely disc herniation.

  • Avatar for Kishore Punjabi

    I am also a chiropractor and I found direction you have suggested to the sciatica patient is good. Thank you for sharing the informational and valuable blog.

  • Avatar for Rachel

    Dear Dr.,
    I got pulled under by a rip current a year ago. By November 2015, I was in so much pain I couldn’t work or function. I had to leave my job as a high school Principal. I went back to work part-time as a teacher February 2016. In my beach accident I tore l4 and l5 discs, dislocated both knee caps, and fractured l4 and l5 vertebrae. I’ve done PT, lost weight, and changed my lifestyle completely to be healthier. This journey to regain my independence is excruciatingly slow. But, I’m getting better everyday. I will return to work full time, but I’m now experiencing what feels like muscle pain up and down my spine. I’m trying yoga. Is there anything else I can do to be free of this pain?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Rachel. Sounds like a terrible experience. You tell what happened but you need to tell me your symptoms in detail. Is it worse with sitting, standing, walking, being still, moving, bending forwards. I find Yoga often makes things worse. Unless it is structured properly. Most times for most back pain it just makes things worse.

      Hope you understand I need details to help you with your sciatica.

  • Avatar for Bilal

    Hello Doctor,
    My age is 25 and from the past 2 and half months i am suffering from lower back pain earlier it was in my righter side but after some times it starts in my left side too , in my MRI report states that there is small nodes seen at L1-L2 i am taking medication from the doctors from the last 2 months but still there is no permanent relief in my back plzz suggest me the medication and exercise

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Billal. First there is no medication that can cure your lower back. Mask it yes but not cure. Nothing will give you permanent relief. That is too unrealistic. Back pain by it’s very nature for the vast majority of people happens over and over again. Sometimes 5 every 10 years later but it happens over and over. That is what is called episodic. Ask anyone with lower back pain. I don’t prescribe medications and wouldn’t for the vast majority of lower back pain even if I could.

      As for exercises https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
      You must have these exercises supervised by a health practitioner as you can get worse. Often as they are not customized to the person.

      Hope that helps your possible disc herniation.

  • Avatar for Larry

    Doctor I have been experiencing pain in my lower left back and left groin area for approx 3 weeks. I’ve seen my GP doctor and she prescribed muscle relaxers and suggested PT. I’ve also been going to a chiropractor for about 2 weeks.

    I’ve noticed a slight improvement in the low back pain but the groin pain/numbness seems to be getting worse. This is obviously a pinched nerve so I was curious if you may have any suggestions.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Larry. You should alert your chiropractor to the situation and find out what is aggravating your lower back and stop that. Also you should be given proper exercises for this problem. If you have trouble with urinating and constipation it can be an emergency situation so be very careful. I wouldn’t be manipulating the lower back at this juncture.

      Hope that helps your lower back pain.

  • Avatar for John

    Hi Dr. Nakamura,

    Thank you for having this site!

    I’m 39yr M. I’m on my 3rd week of S1/L5 Sciatica. My pain seems to be getting a little better day by day but is still around a 7-8 at times. I have pain and numbness from my L buttocks down to the bottom of my L foot along the S1 line and calf weakness. My question is, because of the calf weakness and a limp, I’m having a terrible pain in my Achilles heel now. Any exercise recommendations or a foot brace?

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question John. It’s not really a foot brace that you need but proper therapy for your lower back and leg. In this case the exercises here with the flossing can aggravate you and even make you worse. I would only do the exercises under the guidance of a health professional like a chiropractor or physiotherapist as you can get worse.

      Hope that helps your sciatica John.

  • Avatar for Danielle

    Hi Dr. Ken,
    Thank you for your website. I am finding it incredibly helpful.
    Ok. I have a protruding disk 1.8 cm at L5S1 cause mass *** causing severe radiculopathy down my right leg, hamstring down to my toes. I was hospitalized for 2 weeks as they were unable to control the pain. It was off the charts and remained a constant 8/10 after the initial slip and never let up. I had an epidural in hospital as it was not improving at all and it helped a bit. Then a week ago I had another and it helped quite a lot. I am now able to get some relief from the 24/7 non stop pain. Since my discharge, I have been seeing a physiotherapist and and am following them religiously. I have two questions. Q#1: Will this eventually heal and go back into place with all the physio and strengthing I am doing and Q#2: I don’t understand how the cobra is not squeezing the protrusion more. I am scared to do it because it seems like it could do more harm than good. How does it work exactly with a protrosion without further squeezing the disks that are protruding.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Danielle. First I think when they say 1.8 cm it would be pushing on your spinal cord (cauda equina part of spinal cord) and would be an emergency situation. The fact that they didn’t operate right away indicates that the disc is actually sticking out less. The epidural fortunately helps with pain but unfortunately covers up if you are making things better or worse with the physio. So unless your physio is meticulous and has good baselines you won’t know until the epidural wears out.

      1. It depends on the skill of the physio and if your disc is stable enough be put back in the first place weather your disc can be put back.
      2. If the disc herniation is large you can squeeze the disc and make it worse. Think of a doughnut with bit of jelly just about to come out but not quite there. Then push it the right way and you can put the jelly back. However it’s already sticking out a lot then squeezing that end together makes a bigger mess. So you are right you will likely get worse while most other people will get better as your disc is sticking out more than most other people.

      Hope that helps your understanding of discs and sciatica.

  • Avatar for DJ

    Hi Dr. Ken,

    Your website is very helpful and provides useful information for those suffering from back problems. My question is about the treatment of L5 Degenerative Disc Disease causing Sciatica. My mother has been experiencing left leg pain described as shooting and radiating to the left thigh and sometimes all the way to the left ankle and toe. This has been happening for the last 7 months. She was placed on Gabapentin which initially resolved some of the pain but when she stopped taking it, the pain returned. So we were told to see a Chiropractor. She has been visiting the Chiroprator now who performed some standing X-rays of her back which revealed moderate L5 Disc Degeneration leading pinching of the Sciatic nerve. He also uses the Gonstead method during the visits. Initially, the sessions were going well, but after 6 sessions, her pain has not improved and has become a little worse than when she started with the Chiropractor. She has also been walking more and applying ice-packs as advised by the Chiropractor as exercise is important.
    My mother is worried because she was very hopeful that the sessions would help. The Chiropractor also stated during the first visit that we would start seeing some improvement after 6 sessions but complete improvement may be seen in about 3 months. I just wanted to ask what your opinion is about her condition and if her symptoms can be improved with Chiropractic sessions. What is your opinion about the Gonstead method and about continuing chiropractic treatment? Are there specific exercises that you can recommend for her disc degeneration and symptom relief? Will she require surgical treatment since her pain is now chronic or should she explore other treatment options? Someone also suggested trying Acupuncture but I am not sure if that will work considering her therapy sessions have not helped her pain.
    Your input would greatly be appreciated as my mother’s quality of life is really effected by this problem and she has not been able to do her work the same way she used to.

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question DJ. I would say that if the pain continues to get worse with a few more visits than you should stop. If it stays the same give it one month. After that you should move on to another chiropractor. Gonstead is another method of adjustment it is neither better or worse than other techniques. Gonstead chiropractors like other chiropractors doing other techniques will claim their technique is better.

      You ask if it the condition can be helped by a chiropractor. First you should know that most types of degeneration causes no pain, no matter how severe. It is routine to find moderate degeneration with no pain in the majority of older people. Pain and degeneration found on imaging like X-ray are not correlated at all to pain. That’s a research based fact. Most medical doctors, many chiropractors and physiotherapist alike still say it is but not one piece of research backs it up.

      Your mother’s pain can be degenerative like spinal stenosis or lateral stenosis in which case chiropractic will not help. However if it is disc related chiropractic can help. However if the chiropractor thinks it’s simple degeneration and is only treating degeneration than the treatment will not likely help. The treatment for disc problems is different than simple degeneration which is different for spinal and lateral stenosis.

      A good way to tell if the chiropractor is treating the problem and thinking about things is if the treatment starts to change. If the treatment is the same every time and she is getting no better or even worse and the chiropractor continues with this cook book method then chances are your mother won’t get better.

      You always do conservative treatment before surgery to answer your surgery question.

      Acupuncture may or may not help. Again if she gets relief for two days every time with no cumulative benefit than she won’t get better with acupuncture.

      Hope that helps your moms possible degenerative disc causing sciatica.

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

      Thanks for your question. If you are just going to send me your MRI you can’t. If you tell me your symptoms in detail first than I will share you my email address. As just an MRI is really useless. Unfortunately many people getting diagnosed by MRI instead of the proper way of history or examination.

      Hope you understand that sciatica is just a description and not a diagnosis. You can have sciatica for many reasons.

  • Avatar for Kavya Balakrishnan

    Hi Dr Ken… i had my normal delivery 6 months back. After a month of rest i started my routine includin 40 mins of walking. After 4 months i started having severe low back pain which started radiating to left leg. My physiotherapist recommended traction fr 10 days. This made thigs better but pain was stil ter. MRI says :
    Annular disc bulge at l5 s1
    Annular disc bulge at l3 l4 , l4 l5causing foraminal narrowing
    Subtle anyerolisthesis of l5 over s1

    1.can yu please suggest exercises tat i can do to make things better ?

    Thanks !

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Kavya. You should try bringing your knee to your chest and do that 10 times. Make sure you see the best chiropractor in your city so that they can guide you with the exercises. You should not do the exercises without someone looking at how you are doing them first as you can get worse.

      Hope that helps your possible disc herniations.

  • Avatar for Gloria Cailes

    I have L5 S1 disc bulge just confirmed just 2weeks ago on an MRI
    Sadly I have had the problem since December with
    Extremely painful buttocks and have been unable to sit for more than 15mins at a time.Prior to MRI Physio treated me for piriformas Syndone and her 2 treatments were excruciating ..,chiropractor said there wasn’t anything wrong with my back and walking 2 miles everyday was the answer …
    Now know it’s a disc problem …5 mths on and buttocks still painful but no worse …am I now stuck with this for life …I am 70yrs old weight 53kg and 5ft tall …. I would so appreciate your advice/opinion
    Gloria (UK )

    • Avatar for Dr Ken Nakamura Post
      Author

      Thanks for your question Gloria from the UK. The UK seems to be the biggest readership, surprisingly. Your GP can be wrong. Research has shown that approximately 60% of 60 years olds with no symptoms have disc herniations. So did your GP diagnose you based mostly on MRI or did they do a thorough history and exam. Having worked in the UK my experience from what the patients told me is that the examinations and history regarding lower back was perfunctory. Having said that, that was just the consensus from just a few thousand patients in one area, so it’s very much a generalization to all of the UK. That’s my experience maybe others have a different experience.

      Provided that the diagnosis is correct you should do these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
      These exercises must be supervised by a health practitioner that are familiar with the exercises as you can possibly get worse. If the pain, numbness or tingling goes further down the buttock or into the thigh then you are getting worse and should immediately stop the exercises.

      Hope that helps your possible disc herniation.

      • Avatar for Gloria Cailes

        Thank you very much for your help …in seeing the GP next week so will discuss with him. and certainly try the exercises …I will let you know how things go
        Many many thanks Gloria

  • Avatar for Daniel

    Hi i am 27 year old male with an l4/l5 disc bulge that is pushing on the nerve root on my right side. th disc bulge has progressed where i am feeling a lot of sharp/dull and burning pain in my right leg mostly in my glute and side of calf into ankle and foot. is there any way i can fix this without surgery? i do enjoy my physical activities and i have since been halted from the pain. the injusry occured at work over a year ago and has progressingly got worse. Everywhere i go i talk to peopl who say this cannot be fixed and that im stuck with this for life. i just want to know if there is anything i can do to fix this its been very depressing so far.

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.