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Should I Exercise With Sciatica

03 January, 2018

First of all, before we get into the subject of exercise, and how it can help or aggravate sciatica, it’s important to understand what sciatica is. Sciatica is a term used to describe pain (or tingling/numbness/pins and needles) that is felt in the leg (you can’t get sciatica in your arm), in the region that is innervated by the sciatic nerve – basically the whole leg. It is a SYMPTOM, and not a CONDITION. An easy comparison that explains the difference is that sneezing is a symptom of a cold. So Sciatica is a symptom of a named condition (e.g. disc herniation, see more below). This is important to bear in mind because the causes of sciatica are numerous, and there are a few common conditions that are most often the culprits, not all of which respond equally to exercise.

So it’s January, you’ve eaten your body weight in mince pies and chocolate and drank enough to fill a bathtub several times over. You’re keen to exercise, but you’ve got that nagging leg pain… What should you do?

People Exercising in the park with sciatica

Considering joining that boot camp? Wondering if your sciatica will play up? (Photo by Paul Bence on Unsplash)

Common Causes of Sciatica

Exercises for Disc Herniation

Depending on your age group, there will be certain conditions which are most likely to cause sciatica. If you are fairly young, between the age of 25-50, the most common cause would be a disc herniation – aka “the slipped disc” (although discs don’t technically slip – they bulge or prolapse). Often if you have low back pain with radiating leg pain, which is made worse by bending forward, or that is causing you to stand in a very awkward posture (known as an antalgic list), then you may well have a disc problem on your hands. Exercises that involve flexion of the lumbar spine or bending forwards/curling up into a ball – such as sit-ups will make things worse.

Advice:

  • This type of injury is relieved mostly by low back extension, such as the McKenzie stretch. Exercises that promote extension would be advisable.
  • Avoid High impact exercises that involve jumping, such as aerobics or running. Stick to core strengthening, low impact movements.
  • Maintain a good low back lordosis throughout all movements. , this is the normal curvature or “small” of the back, as if sticking your bum out a little.
  • Swimming and Pilates are great exercises for disc problems, though make sure you discuss with your instructor if you have a disc problem.

Exercises for Degenerative Joint Disease

This is a not-so-pleasant way of saying “wear and tear” or the more vague term “arthritis” (again this is not a specific diagnosis as it does not indicate the type/location nor severity of the condition). More specific terms are Degenerative Disc Disease, Facet joint arthrosis or Facet joint hypertrophy. This normally occurs in the over-50 category, and although may sound depressing, the good news is that it is normally a more stable condition than the herniated disc, and so I would encourage anyone with “wear and tear” to get on with exercising and work within their pain threshold.

Advice:

  • Exercises that strengthen the back, such as core exercises, swimming or pilates.
  • If you are new to exercising, start with flexibility work, stretching the lower back to help alleviate some of the nerve compression.
  • Weight loss is essential for minimizing the compression as well, though high impact exercises are generally safe, I would stick to lower impact cardio work such as swimming, cycling or cross training/elliptical machine.
  • Discomfort will be normal during exercise and to be expected, but do not exercise through sharp pain.
  • Watch the following video for some simple and effective core exercises for degenerative joint disease.

Exercises for Piriformis Syndrome

Sounds pretty right? The piriformis muscle is in your buttock region and moves the hip. Normally the sciatic nerve travels underneath it, but in around 15% of the population, the Sciatic nerve pierces the belly of the piriformis muscle. This is not usually a problem, but if you develop tightness in the muscle, it can pinch the nerve and cause leg pain. The difference, however, will usually be that you do not have lower back pain as well. This is because the site of nerve entrapment is in the buttock, not in the spine like the above 2 examples.

Advice:

  • Exercising with this may be a little uncomfortable, but provided you include plenty of stretches for the piriformis such as the one below then you should be ok. Do them at the beginning of the session and at the end.
  • This is common in runners and so if you love running, don’t forget your stretches!
  • Work on the muscle with a tennis ball. Lie on your back on the floor, lift your painful side buttock up and place the tennis ball into the centre of the buttock. Roll your bodyweight onto the ball and move in small circles for around 30-45 seconds in each tender spot. Do this 3-4 times a day to help release the piriformis muscle.

 

How do I know if I have sciatica?

Knowing you have sciatica will be quite obvious, in that you will have leg pain and most often accompanying back pain. You may also have pins and needles or tingling or even numbness in the leg. However, knowing the cause is essential in order to ensure that you do not make things worse by exercising. Be sure to see a professional who can diagnose you with the right condition and recommend appropriate exercises for you

Check out some of our other articles on Sciatica: