sciatic nerve pain

Physical Therapy for Sciatic Nerve Pain


Medically reviewed by Misty Seidenburg

Approximately 40% of people in the U.S. will experience sciatic nerve pain during their lifetime. Symptoms range from mild discomfort to intense and debilitating chronic pain that can radiate down the leg from the lower back into the foot.

Sciatica symptoms can interfere with routine tasks and make sitting, standing, bending, and walking difficult. Learn more about this common cause of low-back pain and how many patients are able to find relief with exercise, stretching, and physical therapy.

What Is Sciatica?

The sciatic nerve is the longest and thickest bundle of nerves in the body. Nerves originate in the low back, or lumbar spine. Those nerve roots bundle together to make nerves like the sciatic nerve.

It runs through the hip and buttock down the back of each leg into each foot. It provides sensation to the back of the thigh, lower leg, and the sole of the foot. It also controls the muscles located in the back of the knee and lower leg.

There are two sciatic nerves, one on each side of the body. The term sciatica describes the symptom felt down the leg. Pressure on this nerve, trauma, decreased mobility, or inflammation of the nerve bundle can cause mild to severe pain in any area where the sciatic nerve runs.

Sciatica Signs and Symptoms

The symptoms of sciatica vary depending upon a number of factors such as how long the symptoms have been present. Symptoms can occur in the lower back, hips, buttocks, legs, feet, and toes.

Interestingly, the symptoms someone experiences do not always to imaging findings like x-rays or MRIs. Why does this happen? The nerve and other sensors in the back and leg can detect ‘danger signals’ and send them to the brain.

If the brain determines there is a threat, it will create symptoms like pain or numbness and tingling to warn us and change how we move. It’s possible for this to happen even if nothing is wrong!

Someone with sciatica may experience mild to severe shooting or radiating pain. Some people describe it as feeling like an electric shock or burning sensation. It’s common to experience sciatica pain with bending or coughing.

“Pins and needles,” tingling, and numbness are also associated with sciatica. These symptoms occur when sensation signals coming from the brain have trouble reaching the nerve. One of the more severe signs of sciatica is muscle weakness.

This can indicate the muscle command signals are not making their way back down to the muscles of the legs. In some cases, bowel or bladder changes can occur such as difficulty stopping or starting the flow of urine or loss of bowel control.f this happens, see your physician immediately.

What Causes Sciatic Nerve Pain?

Sciatica nerve damage and compression have several possible causes. Conditions and lifestyle actors that contribute to sciatica include:

  • Prolonged sitting or other positions
  • Osteoarthritis
  • Nerve disorders
  • Spinal stenosis
  • Slipped or herniated spinal discs
  • Cysts, tumors, and other growths
  • Pelvic fractures and other injuries
  • Contact injuries (including sports injuries and slip and fall accidents)
  • Persistent Pain (sometimes called chronic pain)

Risk Factors for Sciatica

There are several common risk factors for sciatic nerve pain. Previous injuries of the spine and/or lower back can increase the likelihood of developing sciatica. Age and gender, poor general health such as smoking or obesity, and depression all increase the risk of sciatica.

Certain strenuous or repetitive motions can also damage the sciatic nerve. For example, repetitive lifting of heavy objects, or frequent and awkward bending and twisting for sports, hobbies, or work can increase your risk of lower back injuries.

For many patients, sciatica is the result of normal wear and tear on the spine that leads to herniated disks, nerve compression, and other age-related musculoskeletal conditions.

How to Relieve Sciatica Pain With Exercise and Stretching

It may seem counterintuitive to get moving if you have sciatic nerve pain, but movement can be incredibly effective for this condition. Try these movements to relieve your symptoms and improve flexibility. You might even notice immediate relief for sciatica pain. All you need is an exercise band and a small .

It’s important to note that while these movements can help you feel better, it’s always wise to consult your physical therapist to avoid flare-ups and explore other exercises that may be beneficial for your unique symptoms.

1.   Hamstring Stretch nerve slider

Tight hamstrings can cause the pelvis to tilt in a way that disrupts the natural lumbar curve, stressing the discs and nerves of the lower back. These simple stretches release tight hamstrings and improve flexibility.

  • Begin lying on your back on the floor.
  • You can place a small, folded towel under your lower back to support the lumbar spine.
  • Please a flexible exercise band under the bottom of your foot, holding the ends of the strap in your hands.
  • Slowly pull your foot up as high as you can without bending your knee until you feel a gentle stretch behind the thigh.
  • Gently flex and point your toes 15 times. Repeat 2-3 times on each side.

2. Sitting Trunk Stretch

Remain seated on the floor for the seated trunk stretch. This move will help improve flexibility in the back muscles and strengthen your core. Both will help ease pressure on the sciatic nerve.

  • Sit up straight with both legs stretched out in front of you.
  • Flex your toes upward.
  • Bend your right knee and cross your right leg over your left leg, placing your right foot against the outside of your left leg.
  • Place your left elbow on the outside of the right knee and push into the stretch slowly and gently, twisting toward the right side of the body.
  • Hold for 20-30 seconds and release. Repeat 2-3 times on each side.

3. Child’s Pose

Next we will introduce a pose from yoga. Child’s pose offers numerous benefits for mind and body. It opens the hips, lengthens the spine, and relieves tension in the pelvis. It also increase blood flow to the neck and head. It’s incredibly relaxing too!

  • Begin in a kneeling position and shift your buttocks back onto your heels.
  • Open your knees about hips’ width apart and bend your torso forward so it is lying between the thighs.
  • Extend the arms forward out in front of your head.
  • Allow your buttocks to rest on your heels, without forcing the stretch.
  • Hold this position for 20-30 seconds before releasing. Repeat 2-3 times.

4. Pelvic Tilt

Pelvic tilts are a great way to reintroduce movement to the lumbar spine muscles.

  • Begin lying on your back. Bend your knees and place your feet flat on the floor.
  • Place your arms to your sides with your palms facing down.
  • Gently lift your tailbone toward the ceiling while contracting your stomach muscles.
  • Hold for 3-4 seconds and release. Lower your tailbone to the ground.
  • Repeat for 8-12 reps.

5. Glute Bridge

Because glute bridges require a bit more strength, you may need to work up to these gradually. If so, you can start with 2-3 reps and add one more every other day.

  • Begin in the same position that you started with for pelvic tilts. Bend your knees and place your feet flat on the floor, arms at your sides.
  • Gently life your buttocks and back off the ground keeping a straight spine. Go as far as you can without forcing the move.
  • Hold for 10-20 seconds and release.
  • Lower your buttocks and back down to the floor.
  • Repeat for 8-12 reps.

6. Knee-to-Chest

This move also helps to stretch out the lower back muscles. It also specifically targets the piriformis muscle in the buttocks which may aggravate the sciatic nerve.

  • Begin lying flat on your back with your legs extended straight out in front of you.
  • Inhale deeply and as you exhale, bring your knees into your chest.
  • Hugs your knees to deepen the pose, while keeping your back flat on the ground.
  • Hold this position for 20-30 seconds and release your legs.
  • Repeat 5-6 times.

7. Cobra

Cobra or “prone on elbows” is another popular yoga position that can help take pressure off the nerves.

  • Lie flat on your stomach on the bed or ground.
  • Prop yourself up onto your elbows with your stomach relaxed. This creates an arch in your back.
  • Hold this position 2-5 minutes and release.

Treating Sciatica With Physical Therapy

Physical therapy is typically prescribed as a first-line conservative treatment for patients who cannot achieve lasting relief with heat, medication, and stretching and exercise at home.

Physical therapy uses targeted stretches and exercises to ease pressure on the sciatic nerve and reduce pain. In addition, physical therapists will look for the underlying causes to your pain and work towards addressing those impairments to decrease the pressure on the nerve.

Generally, these involve bodyweight and resistance movements designed to stretch and strengthen the muscles of the abdomen, lower back, hips, and thighs which help ease pressure on the nerves throughout.

Low-impact aerobic exercise helps loosen stiff muscles and increase circulation. Aquatic therapy is one form of aerobic exercise that ideal for patients with back pain because it is gentle and effective—and not to mention fun too!

Physical therapy also includes functional training. This is the reintroduction of routine movements like bending and lifting, but with proper technique and healthy movement patterns to avoid the structural problems that contribute to sciatica symptoms.

Your physical therapist may also incorporate soft-tissue mobilization and joint mobilization or manipulation into your treatment plan to reduce symptoms and facilitate movement. Every physical therapy program is customized to address the patient’s symptoms, limitations, and treatment goals.

What Is the Prognosis for Sciatica?

Most people recover from sciatica with physical therapy and other conservative treatments. For mild cases, it can take 4-6 weeks to feel better. More severe cases can take several months to improve.

It’s best to seek treatment at the first sign of a problem because symptoms often respond well to early intervention. You can take what they learn in the physical therapy clinic and continue that program at home to prevent pain and other symptoms from recurring.

Although research on the benefits of physical therapy for sciatic nerve pain is fairly limited, some studies suggest early physical therapy offers better outcomes compared to “usual care,” One clinical trial published in the Annals of Internal Medicine found that adults who started physical therapy within 90 days of sciatica symptom onset had less pain and better function that those who did not.

Is Surgery Necessary for Sciatica?

In rare cases, physical therapy and other noninvasive treatments offer some relief for sciatic nerve pain, but cannot cure it permanently.

For these patients, surgery may be beneficial. Post-surgical physical therapy is generally prescribed to help patients regain strength, mobility, and function in the back and lower body. Always discuss the benefits, risks, and alternatives of various treatments with your healthcare provider and physical therapist to find the best course of care for you.

Relief for sciatica pain without surgery may be possible. Find a physical therapy clinic near you to schedule an assessment and find out if noninvasive movement therapy can help you.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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