Sciatica Exercises

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by Dr. George Best

Sciatica exercises are extremely important to the long-term relief and management of disc-related sciatica. Although a number of different exercises for sciatica are recommended by various experts and non-experts alike, only a few are actually appropriate during an acute, severely painful sciatica episode, and some of the most commonly-suggested sciatica exercises may actually make things worse when used during times of acute pain.

For example, while commonly recommended to people with sciatica, exercises such as hamstring stretches and the yoga position, "downward facing dog" can be beneficial as part of managing one's condition once the pain is reduced, these exercises can place tension on the sciatic nerve and aggravate an already inflamed and sensitive condition. In general, any exercise that causes pain to increase in the leg and/or extend further down the leg should be completely avoided during the acute phase of sciatica.

During the acute phase of sciatica pain, McKenzie exercises provide one of the best and safest treatment approaches available - more effective than medication and epidural steroid injections in many people. Though often associated with spinal extension and mistakenly called the "McKenzie Extension Exercises", McKenzie method may involve any number of spinal positions/movements. The underlying principle of the McKenzie technique is to test various positions and exercises to determine what will create the most "centralization" of the pain and other symptoms.

"Centralization" is a term used by McKenzie practitioners that means that symptoms move out of the areas furthest from the spine. For example, if you had sciatica that went all the way to the foot, centralization would be if the symptoms left the foot and perhaps only went as far down as the knee. Or, if sciatica symptoms started out going as far as the knee, centralization would be if the symptoms left the thigh and only went as far as the hip area.

A position or exercise that results in symptom centralization is one that will be beneficial, even in situations where symptoms increase for a time in areas closer to the spine. For example, if you had sciatica and low back pain and tried one of of the McKenzie exercises and the sciatica completely went away but the back pain got worse, the exercise would still be considered beneficial and it would be recommended to continue using it. In the long run, a sciatica exercise that produces centralization will usually eventually result in improvement in all symptoms, even if more central (closer to the spine) symptoms get worse at first.

The simplest of the McKenzie exercises for alleviating sciatica is done by simply lying on one's stomach on the floor or a firm surface and propping one's chest up on the elbows. This position puts the lumbar spine into an extended position, which may reduce sciatica by squeezing bulging disc material further forward and away from the spinal nerves that compose the sciatica nerve, thereby resulting in reduced compression and inflammation. Although you can maintain this position for relatively long periods of time, I recommend doing it for short periods of one or two minutes with a rest break of at least a few minutes in between. Taking short, frequent breaks keeps the lumbar musculature from getting tight, but still allows enough time to get good results in the majority of cases. To learn additional, more complicated sciatica exercises, it is advisable to either get an illustrated guide book or to work with an experienced health care practitioner.

Dr. George Best has been treating sciatica patients since 1991. For a free e-book on exercises and self-treatment, including detailed instructions on the McKenzie exercises, visit his Sciatica Exercises website. In addition to the free e-book, you'll also receive a free series of videos about Sciatica, and the treatments for it.

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