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Physical Therapy for Sciatica: Treatment and Exercises


Physical Therapy for Sciatica: Treatment and Exercises

Sciatica pain affects up to 40% of Americans and can be everything from uncomfortable to excruciating.


The pain flare-ups vary from person to person, but without a doubt, they negatively impact their everyday lives.


Many people don't seek help immediately because they're unsure what could relieve their suffering and whether it's at all possible. However, the sooner they receive treatment, the better the outcomes and the fewer complications.


Physical therapy for sciatica is one of the best ways to treat this condition and get back to a normal, pain-free life.


What is Sciatica?


In short, sciatica pain is pain people feel along the sciatic nerve, the longest and thickest nerve in the body. Sciatica is also known as lumbar radiculopathy.

What is Sciatica?

Usually, sciatic pain is felt only on one side - left or right - and goes from the hip, buttock, and leg. But sciatica on both sides is also possible.


The pain is caused by the nerve's inflammation and can be anything from stabbing, shooting, burning, or sharp.


Most of the time, sciatica pain comes and goes, but due to the regularity and intensity of the pain, patients' lives become disturbed nonetheless.


The good news is that reducing sedentary time, moving more, over-the-counter medications, and physical therapy for sciatica is enough to reduce or eliminate the pain.


What Causes Sciatica?


Generally, sciatica pain is caused by these factors:

  • A herniated disc

  • Degenerative disc disease

  • Spinal stenosis (narrowing of the spine)

  • Osteoarthritis (bone spurs on the spine)

  • Trauma and injury to the spine and/or sciatic nerve

  • A tumor that compresses the nerve (a rare occurrence)

What Causes Sciatica?

Sciatic pain can be categorized into acute (lasts 4-8 weeks), chronic (lasts more than 8 weeks), alternating (affects both legs alternately), and bilateral (affects both legs at the same time).


While anyone can be affected by sciatic pain, some risk factors increase the probability:

  • Weight - Overweight and obese people experience sciatica pain more often, as extra weight can increase pressure on the spine and trigger the nerve.

  • Age - Many spinal changes occur at an older age; that's why sciatica pain affects older people more often.

  • Job - Sedentary or physically demanding occupations can cause damage to the nerve.

  • Weak core - Weak muscles don't support the lower back properly, leading to back pain and sometimes sciatic pain.

  • Diabetes: Diabetes is associated with increased nerve damage, including sciatica.

  • Osteoarthritis: The disease damages the spine and can lead to sciatica pain.


For most people, changes in lifestyle, sciatica physical therapy exercises, and sciatica physical therapy are enough to manage or eliminate the pain.


Conditions such as herniated disk may require back surgery.


What are the Symptoms of Sciatica?


Sciatica pain that originates from the lumbar spine and affects hips, buttocks, and legs can vary from mild to moderate to intense and depends on the person and the cause.


The pain can come and go or be constant, but it's not the only symptom associated with sciatica.

Symptoms of Sciatica

Overall, sciatica symptoms include:

  • Pain in the lower back, buttocks, and legs

  • Tingling, numbness, and muscle weakness in the same areas

  • Heaviness, such as feeling like it's difficult to lift the leg or foot

  • "Needles and pins" sensations in legs and feet

  • Loss of bowel and bladder control


Based on patient reports, the leg pain is usually more severe than back pain and is the identifying symptom of sciatica.


These symptoms can worsen with prolonged periods of sitting, coughing, sneezing, twisting of the spine, or bending.


Many patients ask, "does physical therapy help sciatica" and the short answer is yes. Physical therapy stretches for sciatica and sciatica physical therapy exercises can be highly effective and help eliminate the pain.


Physical Therapy Exercises for Sciatica


Every person will respond differently to different exercises, so it's best to have a professional recommend a regiment.


It's important to remember that no movement should cause sharp pain; if it does or generally doesn't feel right, it's best to try other exercises.


Standing Hamstring Stretch

  • Stand straight and put your right foot on a stair or other slightly higher surface.

  • Straighten that leg, pointing the toes up.

  • Lean forward with your back straight (do this gently).

  • Hold for 30 seconds, breathing deeply.

  • Release. Stretch the other leg and do 2-3 repetitions on each side.

Standing Hamstring Stretch

Lower Back Rotation

  • Lie on your back and keep your feet flat on the floor with both knees bent.

  • Hold the knees together and rotate them to one side, stretching the opposite side of the back and hips. Hold for 5 seconds.

  • Repeat on the other side and do 5-10 repetitions on each side.

Lower Back Rotation

Knee to Opposite Shoulder

  • Lie on your back with legs straight and feet flexed upward.

  • Bend your right leg and clasp your hands around it.

  • Gently pull the knee toward the left shoulder and hold for 20-30 seconds.

  • Return the leg and repeat on the other side. Do 3 repetitions on each side.

Knee to Opposite Shoulder

Pelvic Tilt

  • Lie on your back and keep your feet flat on the floor with both knees bent.

  • Pull your abdominal muscles toward your spine, flattening the back and tilting the pelvis toward your chest.

  • Hold for 20-30 seconds, release and repeat 8-10 times.

Pelvic Tilt

Glute Bridges

  • Lie on your back and keep your feet flat, shoulder-width apart on the floor, with both knees bent. Keep the arms relaxed at the sides.

  • Push into your heels and lift your hips - you should form a straight line from knees to shoulders.

  • Hold for a few seconds, slowly release and repeat 8-10 times.

Glute Bridges

Why is Physical Therapy Beneficial for People with Sciatica?


We've already established that the answer to the question "is physical therapy good for sciatica" is a resounding yes.


Physical therapy for sciatica is beneficial for a few reasons. First of all, it helps reduce inflammation and pain. Besides that, it helps improve the patient's physical condition and ensures that the symptoms won't return.


Initially, physical therapy for lower back pain sciatica will start with an evaluation, after which the physical therapist (PT) will create a program depending on the patient's condition and the severity of the problem.


During this evaluation, the therapist checks the range of motion, reflexes, and posture and asks questions about the patient's lifestyle and symptoms.


How Do You Rehab a Sciatic Nerve?


Physical therapists use various treatment modalities to rehabilitate the sciatic nerve.


These include manual soft tissue mobilization, exercises, joint manipulation, TENS, and others.

How Do You Rehab a Sciatic Nerve

Generally, to fully rehab the nerve, a mix of different modalities and techniques are used during the course of treatment. Therapists also asses the progress and how well the patient responds to specific therapies and may adjust the treatment accordingly.


The PTs aim to reduce tension with massages and other soft tissue manipulation techniques to prepare the body for therapies that strengthen, reduce long-term pain and increase flexibility.


How Long Does Physical Therapy Take for Sciatica?


While physical therapy treatment for sciatica usually takes 4 to 12 months, every case is different and will depend on the patient's progress and condition.


It's important to remember that physical therapy takes time and will not solve the problem immediately. Patients should expect multiple therapist visits and need to incorporate at-home exercises into the treatment program.


Can Sciatica Physical Therapy Prevent Re-Injury?


One of the benefits of physical therapy for sciatica pain is that it not only helps manage, relieve and eliminate current pain but also helps prevent future re-injury.


To ensure that future injuries don't happen, the PTs recommend keeping up with at-home stretches and exercises and making lifestyle changes.


The key to staying pain-free is strengthening the body and increasing flexibility and range of motion.


Treatment for Sciatica Relief


Physical therapy for sciatica treatment includes multiple modalities.

Treatment for Sciatica Relief
  • The McKenzie Method redirects the radiating pain through exercise.

  • Extension and flexion back exercises relieve pain by increasing spine movement.

  • Nerve mobilization helps facilitate movement and reduce symptoms.

  • Joint mobilization applies pressure to a joint and provides relief.

  • Strengthening exercises strengthen the muscles of the abdomen, low back, hips, and legs.

  • Dry needling targets a trigger point in a muscle, relaxes the muscle tissue, and helps reduce pain.

  • Myofascial release and soft tissue mobilization help decrease muscle tension or spasms.

  • Deep tissue massage targets specific spinal muscles and muscular connective tissue in the low back, hips, and buttocks that compress the sciatic nerve and helps release tension.

  • TENS (transcutaneous electrical nerve stimulation) stimulates muscles through electrical current and helps reduce muscle spasms.

  • Ultrasound creates heat, increases circulation, and reduces muscle spasms, swelling, stiffness, and pain.


Final Thoughts


Sciatica pain is a common issue among the entire population. The shooting, burning pain, muscle weakness, and tingling create discomfort and disrupt lives.


Physical therapy for sciatica is one of the most effective ways to reduce and eliminate sciatic pain. It uses various modalities to decrease tension, swelling, and inflammation and increase flexibility, range of motion, and strength.

Physical therapy exercises for sciatica are an excellent way to achieve relief and prevent future injury.


Usually, physical therapy lasts 4-12 weeks, but general lifestyle changes are necessary for a full recovery. In rare cases, back surgery may be necessary. Contact us at Miracle Rehab Clinic, available in Farmington Hills and Warren.


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