What are the best exercises for sciatica?

I get asked all the time what exercises I should do to help relieve sciatica, which is something I’ve dealt with, and many of my clients have as well.

Sciatica is an irritation of the sciatic nerve, which runs down each leg from your lower back. You can experience pain, numbing tingling, and oftentimes more symptoms in your legs than in your lower back.

My disc herniation resulted in an irritation of my sciatic nerve, and I felt symptoms throughout my right leg. Sometimes I would feel it in my lower back, and other times I would feel it in my hamstring or even my calf. The unpredictability was frustrating.

The good news is that exercise is great for sciatica. Movement helps keep things loose and relieve tension and irritation on the sciatic nerve.

Dr. Stuart McGill, a renowned back pain researcher, put forth three exercises he deemed appropriate for rehab. These movements are the partial curl-up, the bird dog, and the side plank. These were thought to be low-load, low-risk, and beneficial.

However, many studies investigating movement and its effect on lower back pain have found nothing special about these three exercises. They help, but they're no better than any other exercises you might do for lower back pain. (1)

So what exercises work best then?

I don’t know.

There's nothing special about planks, or deadbugs, or glute bridges, or pigeon stretches, even though they're some of the most commonly prescribed exercises. They all can work.

I look at it this way. With sciatic pain, you’re not looking for an exercise to specifically address it. You’re finding ways to move that don’t irritate the existing issue.

If squats feel good and don’t irritate my sciatica, then it’s a great exercise for sciatica. If chest-supported rows are a method of training my back without irritating the nerve, then it’s a great exercise for sciatica. If walking is the only thing that seems to help it, then that's where I start.

Get the point?

It requires some experimentation and some trial and error, but your body will guide you. For me personally, back extensions and Jefferson curls or anything that moved my spine felt amazing. But anything that stretched my hamstrings in a more static position felt irritating. So I stuck with what felt good, and my symptoms improved. Over time, I continued to progress movements more and more until I didn't have to think about the irritation.

The thing about sciatica is that rest doesn’t always resolve it, so you need to find other ways to calm things down, and exercise is a fantastic way to tell that body that movement isn't a threat.

To your good health,

Coach Stephen

References:

1. https://www.medrxiv.org/content/10.1101/2022.01.21.22269311v1 - The McGill method versus other exercises for low back pain.

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Thanks for reading.

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