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.

Leave a Reply

  • 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?

  • 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…

  • 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.

  • 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?

    • 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?

  • 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

  • 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.

  • 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 🙂

    • 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 🙁 🙁 🙁

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.