Sciatica Stretches for Sciatica Pain Treatment
Find out what’s causing your Sciatica and which treatment is going to be the most effective for you.
by Brad Walker | First Published April 18, 2007 | Updated September 30, 2018
Sciatica pain often results in a burning pain radiating down the back of the leg, or a dull throbbing pain in the buttocks. If you have ever suffered sciatica pain you know all too well how aggravating this pain can be. Even more so, you know how difficult it is to get rid of sciatica pain.
If you are reading this article you have probably experienced, or want to avoid the experience of sciatica pain. With the proper treatment and sciatica stretches, sciatica pain does not have to linger. Sciatica pain can be prevented or treated with some simple steps.
What is Sciatica?
Sciatica is a name given to pain caused by pressure placed on the sciatic nerve. When a nerve is placed under pressure it sends out pain signals. It may radiate down the length of the nerve or be focused in a specific area. The muscles innervated by the nerve may or may not be directly affected.
Anatomy of Sciatica
The sciatic nerve runs from the lower back, down through the hips and buttocks, and along the back of the leg into the foot. It actually originates from the L4 through S3 spinal nerves. It innervates the deep muscles of the buttocks and hips. It also serves the muscles of the hamstring group, the lower leg, and some of the muscles of the foot.
It runs directly under (or in some cases around or through) the piriformis muscle, but it does not innervate this muscle. Any of the muscles that are directly supplied by this nerve can become affected.
Both the Sciatic nerve and the Piriformis muscle can be seen in the diagram to the right: The sciatic nerve is the yellow nerve running vertically down the middle of the leg; while the piriformis muscle is the horizontal muscle at the top of the sciatic nerve.
What Causes Sciatica Pain?
Sciatica has several possible causes. Any condition that puts pressure on the sciatic nerve can result in pain in the lower back, buttocks and back of the leg. The pressure may come from vertebral discs, bones or muscles. The causes of sciatica may be acute or chronic. A traumatic event may result in injury to the lower back or hip area causing pressure on the sciatic nerve through misplaced bones, spasm of a muscle or inflammation from the injury.
Chronic causes of sciatica may be due to muscle imbalances, misaligned bones, or narrowing space in the vertebrae. There are four conditions that most commonly cause sciatica.
- Piriformis syndrome is one common cause and is the result of the piriformis muscle putting pressure on the nerve. This may be caused by misalignment of the pelvis and/or hip joint, which changes the position of the piriformis, placing pressure on the sciatic nerve. This misalignment is often caused by muscle imbalances.
- Herniated discs in the spinal column can also put pressure on the nerve. A herniation, or protrusion, of the disc can result from a traumatic event or from years of pressure from muscle imbalances.
- A third possibility is spinal stenosis, or a decrease in the space between the vertebrae. This reduced space compacts the nerve where it leaves the spinal column. The narrowing is often caused by compression on the spine due to muscle imbalances.
- The fourth cause is Isthmic Spondylolisthesis, which is a condition where the vertebrae slips or moves out of position, pinching or placing pressure on the sciatic nerve. This may be caused by a traumatic event or a chronic muscle imbalance.
Muscle imbalances are a common thread through the four possible causes listed above. This makes treatment and correction of the muscle imbalances paramount in the recovery and prevention of sciatica.
Sciatica Signs and Symptoms
Sciatica is classified as pain in the sciatic nerve. This pain may be sharp, dull or burning. It may be focused in one area or it may radiate the entire length of the nerve. It is often felt in the lower back and buttocks region, and often spreads down the back of the leg. The pain is usually only felt on one side.
Coughing, sneezing, squatting or extended periods of sitting can cause an increase in pain. The muscles that are innervated by the sciatic nerve may also spasm or cramp, causing additional pain. The pain in the lower back and hamstrings can also lead to inflexibility in the back and hips. Pain and stiffness in the opposite side may also result over time.
Common signs and symptoms of sciatica include:
- Pain – This pain can vary from dull, aching pain, to sharp, burning pain anywhere along the nerve pathway.
- Numbness – This can also occur anywhere along the nerve pathway. Pain may be experienced in one area with numbness below it.
- Weakness – The muscles innervated by the sciatic nerve may become weak due to a decreased ability to send signals along the pathway.
- Tingling or “Pins and Needles” – This may be felt in the lower legs and feet.
- Cramping or Spasm – The muscles of the hamstrings or calves may spasm or cramp as a result of incomplete signals being sent through the nerve pathway.
Sciatica Pain Treatment
When sciatic nerve pain is caused by an acute injury the first step is to treat the injury. The R.I.C.E.R. formula (Rest, Ice, Compression and Elevation, followed by Referral) may be used for the first 48 to 72 hours. Reducing the inflammation caused by the injury will help reduce the pain. After the initial 72 hours heat may be used to warm and relax the muscles around the nerve. Stretching the muscles of the lower back and hip will also reduce the stress on the nerve. Once tolerated, some light exercise to strengthen the injured muscles may also alleviate some of the pressure.
Sciatica caused by a chronic condition requires a correction of the underlying problem that caused it in the first place. If it is caused by a bone displacement, then a correction or realignment of the bones will be required. If the pain is caused by a muscle imbalance the imbalance must be corrected. While the underlying problem is being fixed, non-steroidal anti-inflammatory medications can be used, along with ice, to reduce the pressure on the nerve caused by the inflammation. Later, ultrasound, massage, heat and stretching may also help to relax the muscles around the sciatic nerve, reducing the compaction on the nerve.
Correcting the underlying causes and taking the time to fully rehabilitate the muscles will help ensure proper healing. It will also reduce the chance of a chronic condition developing. Since the piriformis muscle is a common offending muscle it is important to work this muscle with quality strengthening and stretching exercises. If the muscle remains tight and/or weak it will lead to additional problems in the future. Strengthening and improving the flexibility of the muscles of the lower back and hamstrings will also reduce the pressure on the nerve, as well.
Surgical intervention is rarely needed with this condition. It may be used to open the space for the nerve, but most people respond to rest and ant-inflammatory treatments within a few weeks to a few months. Strengthening and stretching exercises help speed the recovery process along, as well.
Sciatica Pain Prevention
As the old saying goes, “An ounce of prevention is worth a pound of cure.” In the case of sciatica this is very true. Preventing the problem from developing in the first place will prevent the weeks of pain and possible debilitation while you treat and rehabilitate the injury.
While you cannot prevent every acute injury, you can take steps to make the area around the sciatic nerve less susceptible to injury. Strengthening the muscles of the hip will help to prevent injury to these muscles, which could place the nerve under stress. These deep hip muscles pull the leg outward and causes an outward rotation of the foot. Exercises that require the leg to be forces outward against resistance will help strengthen these muscles. Strengthening the lower back and hip muscles will help support the spinal column preventing injury there that might compress the nerve.
Proper posture, a good warm up before physical activity, and healthy, flexible muscles around the lower back and hips will help reduce injury in this area that might place the sciatic nerve under pressure.
Flexibility of the muscles around the sciatic nerve is another common concern. Since these muscles are seldom stretched in everyday activities they may stay shortened. Then when forced into a stretch position they may not have the flexibility to withstand this forced stretch. Increasing flexibility in the muscles around the sciatic nerve will reduce the chance of injury. The sciatica stretches below are an example of many sciatic nerve stretches for the muscles around the hip joint.
Sitting Knee-to-chest Buttocks Stretch (1:22) Sit with one leg straight and the other leg crossed over your knee. Pull the raised knee towards your opposite shoulder while keeping your back straight and your shoulders facing forward. Keeping your back straight and your shoulders facing forward will ensure that your buttocks get the maximum benefit from this stretch. Resist the temptation to rotate your shoulders towards your knee. Hold the stretch position for a minimum of 20 seconds and then repeat on the opposite side.
Sitting Foot-to-chest Buttocks Stretch (1:22) Sit with one leg straight and hold onto your other ankle. Pull it directly towards your chest. Use your hands and arms to regulate the intensity of this stretch. The closer you pull your foot to your chest, the more intense the stretch. Hold the stretch position for a minimum of 20 seconds and then repeat on the opposite side.
Sitting Cross-Legged Hip Stretch (1:05) Sit cross legged and keep your back straight. Then gently lean forward. Make the emphasis of this stretch keeping your back straight, rather than trying to lean too far forward. Hold the stretch position for a minimum of 20 seconds.
Cross-Over Hip Stretch (1:27) Lie on your back and cross one leg over the other. Bring your foot up to your opposite knee and with your opposite arm pull your raised knee towards the ground. Keep your shoulders on the ground and concentrate on pulling your raised knee to the ground, not up towards your chest. Hold the stretch position for a minimum of 20 seconds and then repeat on the opposite side.
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About the Author: Brad is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 100's of testimonials. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.