Physical Therapy for Sciatica
Physical therapy can be used to relieve sciatica pain? In this article, we review sciatica, what to do about sciatica pain, and a few great exercises for physical therapy.
What is Sciatica?
Sciatica is a common radiculopathy. A radiculopathy, commonly known as a pinched nerve, is irritation to a nerve from the surrounding tissue or structures. This can happen both on the upper part of our body (think neck and arm), and the lower part of the body (think low back, butt, and back of your thigh).
Pathways
One nerve that is most commonly impacted by entrapment sites and irritation is the sciatic nerve. Let’s take a look at the pathway of the sciatic nerve.
Where the Sciatic nerve is located:
Low back → glutes → down the back of our legs
Think: back of the lower body
Entrapment sites
Now that we know where each of these nerves run, let's think about each of the most common entrapment sites for the sciatic nerve.
As discussed previously, we know this nerve runs from our lower spine, through our glute muscles, and down the back of our leg. This route leaves a lot of places for potential areas of irritation that can cause nerve symptoms:
Low back: Stenosis (narrowing of the vertebrae)
Herniated discs
Hypomobile vertebrae
Glutes: Piriformis
Posterior leg: Hamstrings
How do I know if I have radiculopathy?
Who is at risk?
Anyone has the potential for developing a radiculopathy, but there are certain groups of people who are at a higher risk. In short, those who are sedentary and not getting much movement may be at a higher risk for developing radiculopathy.
How can it be presented?
The most common and expected symptom will be a shooting or radiating pain, paresthesia, or weakness that is exacerbated during some positions and alleviated during others.
Some more specific presentations are as followed:
Sciatic Nerve
Low back pain (radiating pain)
Shooting pain down one leg in bending forwards, twisting, coughing
Paresthesia and weakness down the back of the leg + glutes
Self tests
Each of these tests may put tension on the nerves and should be performed in search of familiar symptoms (i.e. the symptoms that have led you to continue to read this article).
Sciatic Nerve Assessment
** At each step, stop just short of any signs or symptoms to prevent injuring yourself **
Sit at the edge of a table with feet in the air, and rest hands on your lap
Put yourself into a slumped/rounded posture
Extend the knee
Point the toes to the sky
Tuck chin to your chest
→ A (+) test would be an increase in your familiar symptoms during any part of this test
What to do about Sciatica Pain?
Work environment
Symptoms can be aggravated by certain positions. Your sciatica nerve runs from the low back and down the leg. Due to this, sitting can often contribute to symptoms. If this is the case, setting up your work area where you are able to move between sitting and standing can be helpful. In addition, taking frequent standing/walking breaks throughout your day can help you to stay loose and mobile.
Physical Therapy Exercises for Sciatica Pain
While you wait on your physical therapy appointment, there are a few exercises you can do to alleviate some of the symptoms. Here are two of the best physical therapy exercises for sciatica pain.
Sciatic Nerve Glides
Begin seated at the edge of a table with a rounded posture. Keeping toes pointed towards the sky, extend the knee. As you extend the knee, lift your head up so that your eyes are looking at the ceiling. Slowly relax the knee and bring the head back down into a tucked position. Repeat these sets with 3 second holds in each position for 10 sets.
Side Lying Roll with Foam Roller
Begin lying on your side with the affected leg on top. Put a foam roller directly in front of your hips and legs. Flex the hip and knee up so that the knee and lower leg are resting comfortably on the foam roller. Keeping head relaxed and top hand on the ground for support, roll your hips forward onto the foam roll to a comfortable range. Bring the hips back to the starting position. Repeat these sets with 3 second holds in each position for 10 sets.
Other Pain Management Techniques
Another technique that has proven successful in managing sciatica pain is dry needling. Dry needling for sciatia nerve pain is offered to clients at Move Strong PT as an alternative or supplement to your physical therapy program.
Wrapping Up: Sciatica for Physical Therapy
These exercises should help you address sciatic pain, and strengthen your core, legs and lower back. If you have any questions, please reach out to our Hudson, MA physical therapists!
