Sciatica Exercises - Let Your Body Be Your Guide

While sciatica exercises are definitely important to both short and long-term recovery, not all exercises promoted for sciatica are actually appropriate during acute symptoms and may actually make things worse.

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 whole point of the McKenzie method is to evaluate different positions/exercises to find what best produces "centralization" of symptoms.

"Centralization" is a term used by McKenzie practitioners that means that symptoms move out of the areas furthest from the spine. To give an example, in a person with sciatica all the way down the leg to the foot, centralization might occur in which the pain left the foot and lower leg and then only extended down to the knee. If the pain extended to the knee at first, an example of centralization would be a situation in which the pain would leave the thigh and only extedown s far as the hip.

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. This position can be maintained for several minutes at a time when helpful, but I suggest using it for one to two minutes at a time with at least a few minutes' break 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. For more complex sciatica exercises, getting detailed instructions either through an illustrated guide or an experienced health care practitioner is advised.