What is sciatica?
Sciatica is not a diagnosis in itself, but it is a symptom. The symptom or pain that you might feel is normally a burning, tingling or numbing sensation in the buttocks, hip or back of the leg area. This pain or sensation is usually only on one side of the body. And it may run all the way from the buttocks down to the foot. The pain may be caused by some irritation or inflammation to the sciatic nerve branch.
If you would like to read more about the causes of sciatica, how severe your sciatica is and when to see a physiotherapist – please click here.
Can & should you exercise if you have sciatica?
The short answer is, YES. However, there are a few things to take into consideration. Before you start or continue to run, cycle or go to the gym. You need to be sure that your physiotherapist or biokineticist has given you the go ahead. It all depends on the cause, severity and pain you have. And before we give you guidelines on when and how to exercise, we would love for you to read this next section first.
It is important that you get a proper diagnosis by a medical professional before you start exercising. A physiotherapist will be able to assist you in the diagnosis and initial treatment of your sciatica. It is vital to understand what is causing your sciatica. It is not enough to just know that you have sciatica.
Another aspect is to ensure that you know the severity of your sciatica and what impact it has had on your body. We know you have pain. But we need to identify exactly what type of pain, in exactly which muscle and for how long. You might have some sensory deficits and weakness in the muscles surrounding your pain area due to sciatica.
Read the next section to see when you should exercise if you have sciatica.
How can exercise treat sciatica?
Anyone with sciatica is aware that having a debilitating nerve pain makes exercise less appealing. Exercises like running, cycling and most physical activities can increase pain. The truth is that you can and should exercise, even if you have sciatica. Almost sounds impossible, right? The good news is that you can participate in exercise, as long as it is the right exercises! And you will be able to do the exercises with minimal to no pain with the right exercises.
The goal of doing the ‘right exercises’ is to keep you active and healthy while we address the cause of your sciatica. If it is due to a herniated disc in your low back. The exercises need to focus on low back therapy. If it is caused by piriformis syndrome (deep gluteal syndrome). The exercises need to target muscles in the hip area.
Where can you find the right exercises? Right here at our Biokinetics practice. The biokineticist teaches you various therapeutic exercises and stretches. The exercises and stretches are put together in a therapeutic program designed specifically for you. We call this a guided sciatica exercise program.
In the guided sciatica exercise program, we introduce you to exercise therapy in a graded manner. Meaning, you will only be doing exercises that are easy enough to cause minimal to no pain but good enough to still improve your sciatica. So the exercises will gradually get harder as you progress and your symptoms improve. You will not be lifting heavy weights, but rather taking part in exercises that accommodate your pain and abilities.
If the program is done in a guided and progressive manner, your pain should improve. As well as your overall movement quality. The goal is to ensure that you are able to move better during normal and exercise activities. While working on your muscle flexibility and strength. These improvements can only happen over a period of time, with consistent exercise therapy and sciatica management.
Remember that the exercise therapy program will be developed specifically for you. And it will be adapted to your pain.
When should I exercise if I have sciatica?
Sciatica is a nerve pain that does not always disappear by itself. And the best way to initially treat sciatica is to receive treatment for your pain by a physiotherapist. They assist in finding the cause for your sciatica and treat your pain accordingly. They give you guidelines on how, when and what types of exercises you may do while receiving treatment for your sciatica.
It is recommended that the physiotherapist refers you to a biokineticist for further rehabilitation and prevention of sciatica.
Exercise according to your symptoms
- Pain in only one buttock.
- Intermittent pain.
- Mild ache & stiffness in buttock.
- Prolonged sitting worsens symptoms.
- Pain or discomfort when stretching muscle.
Should you exercise?
- You are allowed to continue with running, cycling and other physical activities if it does not increase your pain.
- You should continue with the exercises given to you by the physiotherapist or biokineticist.
- Guided sciatica exercise program (biokinetics) is recommended to ensure quicker rehabilitation, healing and prevention of future sciatica.
- Sharp burning sensation or ‘electrical shock’.
- Pain is more frequent but not constant.
- Tingling sensation in buttock.
- Pain when standing, especially on one leg.
- Pain when sitting on hard surfaces.
- Prolonged sitting increases pain.
- Stretching buttock muscles is painful.
Should you exercise?
- Most activities like running, cycling and exercise with heavy weights are not recommended.
- Guided sciatica exercise program (biokinetics) is highly recommended alongside physiotherapy treatment.
- Numbing sensation in buttock.
- Constant pain in buttock not improved by change of position, heat or medication.
- Pain radiates down the leg.
- Not able to stand on one leg.
- Unable to climb stairs.
- Pain when sitting on any surface.
- Weakness in your hips and or legs.
- If you have trouble controlling your bladder or bowel you should seek medical attention immediately as this could indicate serious nerve injury.
Should you exercise?
- Most exercise activities should be stopped until pain is reduced.
- Guided sciatica exercise program (biokinetics) along with physiotherapy might be an option. If recommended by the physiotherapist and or sciatica has become a chronic condition.
Main goals of guided sciatica exercise therapy
In our guided sciatica exercise program we want to assist you in the ‘exercise smart’ principle. We guide your training in a coordinate manner so that you can heal and stay active at the same time. You might need to adapt your current training program for a few days or weeks. But we assist you in doing finding an alternative exercise routine that you can do alongside the exercise therapy.
- Learn how to exercise with minimal to no pain.
- What activities to do & which to avoid.
- Reducing your pain by learning how to be aware of your body positions & when to change it.
- Muscle activation in the area of pain.
- Improving muscle strength especially in the involved area.
- Gait training if you started limping or could not stand on one leg without pain.
- Improve confidence & motivation in your exercise & movement abilities.
- Get you back to doing the things you want to do.
What shouldn’t you be doing?
Do not take pain medication (long-term)
Physicians normally prescribe pain medication (ibuprofen, aspirin and diclofenac) for sciatica. This is beneficial for short-term relief and may reduce inflammation. What is the problem with medication then? It does not address the underlying cause of your sciatica. Pain medication will hide the problem without resolving the real cause of your pain.
Relying on medication for long-term benefit will only result in you causing more damage to the nerve, muscles and surrounding tissues. Long-term usage of pain medication may also lead to adverse effects like increased bleeding. If you are increasing your pain by something you are doing, then drinking pain medication will mask this. And the damage to your nerve and surrounding tissues will only get worse.
Do not continue exercise if it increases your pain
Any exercise like jogging, running uphill, sprinting, cycling, walking, single leg jumps, driving and other physical activities may make the injury and pain worse. Most times you hope that the pain will go away. But it doesn’t. You put on some ice or heat and it feels better. Only to return again.
In most cases, people live with their pain for too long before seeing a physiotherapist or biokineticist. In reality, the sooner you see someone to assist in managing your sciatica, the sooner you will feel better. And the sooner you can carry on with your daily routine. Your treatment is likely to be extensive if the symptoms are serious, you have lived with it for a very long time and only seeking help now.
Additionally do not stretch or foam roll through your pain. This might irritate the nerves even more.
So, if you have sciatica and you have not seen a physiotherapist or biokineticist – YOU NEED to book an appointment now, before increasing your pain and causing more damage to the nerves and muscles in the area.
Do not stay in prolonged positions
It will ease your pain and other symptoms if you change positions more often. Prolonged sitting or standing might increase your pain and further irritate the sciatic nerve branch. Change from a seated position to standing every few minutes. If you only have a seated desk, try somewhere in your office or home where you can possibly have a standing desk.
Prevent sitting in a crossed leg position, as this can continue irritating the muscles and nerves in the hip area. Try sitting with your feet flat on the floor underneath your hips. Sometimes elevating your feet onto a small step can relief some pain and pressure.
Avoid sleeping on your stomach and rather lie on your side in the fetal position. Add a cushion between your knees as this might alleviate some of the pressure on your back and hips. Resulting in less pulling on the nerves and muscles. Again, try to turn over during the evening, and sleeping on both sides and not only the one side.