Sciatic nerve pain can be so excruciating and debilitating that you don’t even want to get off the couch. Common causes of sciatica can include a ruptured disk, a narrowing of the spine canal called spinal stenosis, and injury.
The sciatic nerve runs down the spine and branches off, like a zipper, down the legs. The pain of pressure on the sciatic can feel like sharp shocks running down your leg (generally just one at a time) or nagging lower back pain. Sometimes people experience numbness or tingling in the leg, too.
Certified physical therapist Mindy Marantz says that sciatica pain can occur for a variety of reasons. She says, “Identifying ‘what doesn't move’ is the first step toward solving the problem.” Often, the most problematic body parts are the lower back and hips.
Dr. Mark Kovacs, a certified strength and conditioning specialist, adds that the best way to alleviate most sciatica pain is to do “any stretch that can externally rotate the hip to provide some relief.”
Here are six exercises that do just that.
Pigeon Pose is a common yoga pose. It works to broadly open the hips. There are multiple versions of this stretch. The first is a starting version of the pigeon pose, known as the reclining pigeon pose. If you are just starting your treatment, you should try the reclining pose first. Once you can do the reclining version without pain, work with your physical therapist on the sitting and forward versions.
- While on the back, bring your right leg up to a right angle and grasp it with both hands behind the thigh, locking your fingers.
- Take your left leg and place your ankle against the knee. Hold the position for a moment before changing legs. This helps stretch the tiny piriformis muscle, which sometimes becomes inflamed and presses against the sciatic nerve causing pain.
- Repeat by switching sides and doing the same exercise with the other leg.
- Sit on the floor with your legs stretched out straight in front of you. Then bend your right leg, putting your right ankle on top of the left knee.
- Lean forward and allow your upper body to lean toward your thigh. Hold for 15 to 30 seconds and then switch sides. This stretches the glutes and lower back.
- Kneel on the floor on all fours.
- Pick up your right leg and move it forward so that your lower leg is on the ground, horizontal to the body. Your right foot should be in front of your right knee while your right knee stays to the right.
- Stretch the left leg out all the way behind you on the floor, with the top of the foot on the ground and toes pointing back.
- Shift your body weight gradually from your arms to your legs so that your legs are supporting your weight. Sit up straight with your hands on either side of your legs.
- Take a deep breath. While exhaling, lean your upper body forward over your lower leg. Support your weight with your arms as much as possible.
This simple stretch helps relieve sciatica pain by loosening your gluteal and piriformis muscles, which can become inflamed and press against the sciatic nerve.
- Lie on your back with your legs extended outward and your feet flexed upward.
- Clasp your hands around your knee and gently pull your right leg across your body toward your left shoulder. Hold it there for 30 seconds and then push your knee so your leg returns to its starting position.
- Repeat for a total of 3 reps, and then switch legs. Remember to only pull your knee as far as it will comfortably go. You should feel a relieving stretch in your muscle, not pain.
Sciatica pain is triggered when vertebrae in the spine compress. This stretch helps create space in the spine to relieve pressure from the sciatic nerve.
- Sit on the ground with your legs extended straight out with your feet flexed upward.
- Bend your right knee and place your foot flat on the floor on the outside of your opposite knee.
- Place your left elbow on the outside of your right knee to help you gently turn your body toward the right. Hold for 30 seconds and repeat three times, then perform this stretch with your left leg bent and body turned to the left side.
This stretch can help ease pain and tightness in the hamstring caused by sciatica.
- Place your right foot on an elevated surface at or below your hip level. This could be a chair, ottoman, or step on a staircase. Flex your foot so your toes and leg are straight. If your knee tends to hyperextend, keep a slight bend in it.
- Bend your body forward slightly toward your foot. The further you go, the deeper the stretch. Do not push so far that you feel pain.
- Release the hip of your raised leg downward as opposed to it lifting up. If you need help easing your hip down, loop a yoga strap or long exercise band over your right thigh and under your left foot. Hold for at least 30 seconds, and then repeat on the other side.
Kovacs emphasizes that you should not assume that you will be able to be as flexible as the exercises ideally call for. “Don’t think that because of what you see on YouTube or TV that you can get into these positions,” he said. “Most people who demonstrate the exercises have great flexibility and have been doing it for years. If you have any kind of pain, you should stop.”
Corina Martinez, a physical therapist at Duke Sports Medicine Center and a member of the American Medical Society for Sports Medicine, says that there is no one-size-fits-all exercise for people suffering from sciatic nerve pain. “Do you feel better when you bring your knees to the chest, or when they extend back a little more? If one feels better, that is the treatment you want to pursue.”
Martinez says that anyone experiencing even mild sciatic nerve pain symptoms for more than a month should see a doctor or physical therapist. They may find relief with an in-home exercise program tailored specifically to how their pain presents itself.
The clue is to find experienced, manual trained physical therapists who combine an understanding of alignment, movement, and therapeutic exercise, and who set up a clear plan of care to reach measurable goals. After that, what's left is to actively participate in the program!