Sciatica pain can often start in the lower back and radiate down your hip and leg. It may also affect the hips, buttocks, feet, and toes. The pain can range from mild to excruciatingly severe. Most often it occurs when a disc between the vertebrae in your spine breaks through its outer lining and compresses nerves in your back.
Whether walking will help relieve or worsen the pain depends on the cause of your sciatica and the severity of your pain. It’s best to consult with a doctor or physical therapist to find a treatment, exercise, and stretching program appropriate for you.
Sciatica usually resolves on its own in a few weeks. Treatments are available to help with pain, and in most cases the prognosis is good.
Fast facts about sciatica
- The sciatic nerve is the longest one in your body, beginning at the spinal cord, and running through your hips and buttocks, and branching down each leg.
- Bed rest used to be prescribed, but now more active treatments are advised.
- The incidence of sciatica annually in the general population is estimated between
1 and 5 percent, but up to 40 percentof people may experience sciatica during their lifetime.
80 to 90 percentof people with sciatica recover over time without surgery.
Is walking good for sciatica? The short answer is, “It depends.”
Whether you should walk and how much you should walk are questions to discuss with your doctor or physical therapist. The general view now is that movement and activity are a good thing for people with sciatica, as long as you walk correctly and are not increasing pain.
J.D. Bartleson, MD, professor emeritus of neurology at the Mayo Clinic and a fellow of the American Academy of Neurology, said, “If walking doesn’t bother the sciatica pain, it’s a good way to stay in condition and to reduce your risk of deep vein thrombophlebitis and blood clots because you’re actively moving your legs.”
“But for some people,” he cautioned, “the pain is aggravated by walking.”
Stuart Fischer, MD, had similar advice. “On the one hand, it’s always good to be moving about and active. On the other hand, too much walking when your sciatic nerve is irritated could even make the problem worse. And what I always tell people who are walking to remember, is that wherever you go, that’s only half the distance. You have to get back.”
Dr. Fischer has been in practice for more than 40 years and is the former editor-in-chief of OrthoInfo, the patient website of the American Association of Orthopedic Surgeons.
Robert Gillanders, DPT, a board certified clinical specialist in orthopedic physical therapy, told Healthline that walking can be helpful because it’s “often one of the first therapeutic exercises one can do.”
“I regularly have patients start this by doing multiple short walks each day. Postural muscles will lose their endurance when in a reactive state, as seen with sciatica, so regular posture changes are helpful.”
He suggested “short walks, gentle stretching, followed by ice, while lying supine [face up] or prone [face down].” Repeat the process often, he said. “Pace should be conversational. The terrain should be flat. Keep distances short, and take breaks…as needed.”
He also advised, “Good posture is essential in both standing and sitting. Supportive walking shoes are a must.”
Fischer stressed that “your goal of treatment is to try to reduce the inflammation so that the pain gets better. So very often, we tell people with sciatica to limit their activity so that the inflammation goes down. And most often it will get better with rest.”
Tip: How to rest comfortably
Fischer advised, “Ideally, you want to rest in position with your hip and your knee flexed a little bit, because that takes the stretch off the sciatic nerve. People with sciatica have the most pain when they do things that stretch that nerve. Usually, the worst of all is driving, because that puts the nerve in an awkward and uncomfortable position.”
When will walking make sciatica pain worse? Dr. Bartleson said that for some people the spine pain can be increased when they stand up.
“If you put your hand in the small of your back, you get a little curve there when you stand up,” Bartleson said, “and that curve narrows the holes where the nerves leave the spine. That can actually increase your spine pain. Walking makes those people worse.”
“Those people are aided by a cane or walker,” Bartleson said. “I’ve seen this especially in what’s called lumbar spinal stenosis, where the spinal canal is narrowed so when they stand up, they get more pain, often more on one side than the other. Lumbar stenosis typically causes bilateral pain (and other symptoms) while sciatica is usually unilateral.”
Physical therapist Gillanders specified when and when not to walk. “When pain is greater than 7 out of 10, I have patients do nothing, just rest. (Red light.) Pain from 4 to 6 out of 10 is a yellow light, where I have people do shorter bouts of walking. Pain that is a 0 to 3 out of 10 is a green light; activity should be only minimally restricted.”
Sciatica pain can range from mild to overwhelming. Remedies for pain relief included:
- physical therapy
- in severe cases, surgery
Depending on your degree of pain and discomfort, you can try some of these measures:
- Apply heat or cold packs alternately to your lower back.
- Take over-the-counter anti-inflammatories such as aspirin or ibuprofen. Some people find relief in alternating types of OTC anti-inflammatories.
- Do gentle stretches designed for sciatica.
- Use massage or yoga to help reduce your pain. If yoga makes it more painful, stop and talk with a medical professional.
- Bracing or taping your lower back may be helpful in some cases, according to physical therapist Gillanders.
- Try water walking or water exercises.
- Avoid sitting in soft chairs and couches, which may worsen the pain.
- Every individual is different, and there’s no one-size-fits-all when it comes to treating sciatica.
- If your pain is severe and persistent, discuss other remedies with a medical professional.
The doctor may also suggest a steroid injection to relieve inflammation and pressure on the affected nerve.
If your pain is severe and disabling after 3 months of conservative treatment, the doctor may suggest surgery. Surgery to remove the herniated disk has a good success rate.
Your doctor may refer you for physical therapy for an individually designed exercise and stretching program. But many health professionals prefer patients to wait and see if the sciatica improves on its own.
Recent evidence may prompt more doctors to prescribe physical therapy.
A 2020 randomized clinical trial found that early intervention with physical therapy for sciatica produced greater improvement in pain and mobility.
A physical therapist may use a variety of techniques to help with pain, improve flexibility and strength, and relieve stiffness in your joints. These may include passive techniques and more active exercises.
Physical therapist Julie Fritz, associate dean for research at University of Utah’s College of Health, describes a program of physical therapy exercises for sciatica that includes repeated movements in certain directions to help relieve pain.
Fritz emphasizes the need for people with sciatica to be proactive and optimistic and inform themselves of available treatments.
It’s a good idea to see a medical professional early on if you have persistent back pain that radiates down your hip and leg.
This will give you an accurate diagnosis of sciatica and what’s causing it. Although in
It will also give you the opportunity to seek out physical therapy or other possible treatments as soon as possible.
Sciatica pain can be disabling, but in most cases recovery prospects are very good.
Walking in moderation may help you stay flexible and in better condition if you can walk without pain.
Many pain reduction techniques are available. New evidence suggests that targeted physical therapy begun early on can help your recovery.