The spine is made up of 24 bones that work together to protect our spinal cord. But sometimes, one or more of these bones can move slightly out of place, causing discomfort, weakness, and pain.
Approximately 80% of adults will experience lower back pain at some point in their life, and it can make day-to-day activities unpleasant.
One of the most common—and intense—types of lower back pain is commonly called sciatica, which occurs when the body’s longest and widest nerve, the sciatic nerve, is pinched or irritated.
In this article, I will explain what sciatica is, and explore a number of ways to address sciatica discomfort, including exercises, other non-surgical options, and surgery.
In the end, you should better understand your treatment options for sciatica pain relief.
What is Sciatica?
This nerve is the largest, longest, and widest in the body, stretching from the top of the leg down to the foot.
Symptoms of sciatica include pain, numbness, a burning sensation, or mild weakness, typically affecting your lower back, buttocks, or one leg.
While there are a number of reasons you might experience sciatica nerve pain, a few common causes include: bone spurs, degenerative disc disease, and osteoarthritis.
There are also a number of factors that might put one at higher risk for experiencing sciatica pain, such as age, poor posture, being overweight, improper lifting techniques, or trauma, such as a car accident or a fall.
Sciatic nerve pain most commonly affects those between 30-50 years old.
Exercises to Relieve Sciatica Pain
If you’re experiencing lower back pain, certain stretches and exercise programs can help target pain and relieve your discomfort.
A knees-to-chest stretch can help restore flexibility to your lower back muscles and reduce the stiffness felt in your spine as a result of sciatica.
Begin by lying on your back. Use your hands to gently pull one bent knee toward your chest.
Hold for 10 seconds. Repeat the movement with the opposite knee.
Try this 3 to 5 times, holding the position for 10 seconds each time. When your muscles are ready, gently pull both knees toward your chest. Hold for 10 seconds, and repeat 3-5 times.
Sitting pigeon pose
This stretch works the glutes and lower back.
Sit on the floor with your legs stretched out straight in front of you.
Bend your right leg, putting your right ankle on top of the left knee, creating a shape that looks like a figure-four.
Gently lean forward and allow your upper body to reach toward your thigh. Hold for 15 to 30 seconds. Repeat on the other side.
Reclining pigeon pose
This pose helps support your lower back, reducing pressuring on your hips. Lie on your back with your knees bent, and feet flat on the floor.
Bring your left ankle up so that it’s resting on top of your right thigh, just below the knee—kind of like you’re crossing your leg in a chair.
Clasp both hands behind your right thigh, with your right hand outside the legs, and your left hand “threading the needle” through the hole you’ve created by crossing your legs.
Now gently pull the right thigh towards your chest. Hold the position for a moment, and then repeat on the other side.
Stretching your piriformis can work the upper buttocks area.
Lie on the back with both feet flat on the floor and both knees bent.
Pull the right knee up to the chest, grasp the knee with the left hand and pull it towards the left shoulder, stretching across your body.
Hold the stretch, then repeat on the opposite side.
Standing hamstring stretch
This stretch will help ease tightness in your hamstring.
To begin, stand in place and elevate your right foot on a surface at or below your hip level (try a chair, ottoman, or step on a staircase).
Flex your foot and straighten your leg, but try not to hyperextend your knee.
Fold over your body towards your foot. The further you go, the deeper the stretch. Hold for at least 30 seconds, then repeat on the other side.
Glute foam roll
To loosen your glutes and piriformis, you can also try foam rolling.
To roll on your piriformis, sit on the roller with bent knees and feet flat on the floor.
Support yourself by putting your left hand on the floor behind you, and then cross your left leg so that your ankle is just above your bent right knee.
Put your right hand on your left ankle, and lean a bit so the roller is directly beneath your left butt cheek.
Now slowly roll back and forth over this area of the buttocks for 30 to 60 seconds. Rest for 30 seconds, then repeat on the other side.
You can also use a roller on your quadriceps, IT band, and hamstrings.
Sometimes stretching is not enough to relieve sciatica pain. There are many other non-surgical options for targeted pain relief.
Hot and cold therapy
Research shows that applying a cold ice pack on your rear pelvic area can help reduce pain in the nerves and helps reduce inflammation and swelling.
Similarly, a heating pad over the rear pelvic area might promote tissue healing by improving the flow of blood and oxygen to the affected region.
Some over-the-counter pain relievers such as acetaminophen, aspirin, or NSAIDs (such as ibuprofen, ketoprofen, or naproxen) can help relieve back pain.
For localized, immediate pain relief, topical medications like ointments, gels, and creams, can be effective.
When your muscles are tense, they can put pressure on your nerves, including your sciatic nerve.
Massages help soothe tense muscles and reduce pressure on your sciatic nerve. There isn’t compelling evidence that one type is more beneficial for sciatica pain than another, so choose the type of massage you prefer.
If your back pain is more severe, a physician can prescribe a short course of high dose non-steroidal anti-inflammatory drugs (NSAIDs).
Consult a healthcare professional about how often you should be taking this medication, as the overuse of NSAIDs can result in side effects including stomach pain, ulcers, and, in rare cases, kidney damage.
Physical therapy can provide symptom relief and can promote the healing of underlying causes of sciatica, helping prevent recurrences and flare-ups.
Working with a physical therapist can help strengthen and mobilize muscles in the lower back, pelvis, abdomen, buttocks, and thighs.
Ultrasound therapy uses low-energy ultrasounds to stimulate living tissue cells working to speed up their recovery.
During the treatment, an ultrasound machine produces vibrations, aiming to deliver heat and energy to body parts under the skin in an attempt to reduce pain and speed up recovery.
Epidural injections can provide pain relief so one can return to everyday activities and continue to make progress in other forms of work, like physical therapy.
Acupuncture is widely used to relieve back pain. Using tiny needles, acupuncture can stimulate the nervous system and help provide pain relief.
It’s been demonstrated to be effective, safe, and well-tolerated.
Certain yoga poses—like child’s pose, downward dog, and cobra—can help reduce chronic lower back pain, improve limitations in activity, and reduce the need for pain medications.
Always use caution when starting a new yoga practice to avoid causing or exacerbating pre-existing injuries.
For some, surgery might be the best option to provide lasting, effective pain relief. There are a number of options depending on the cause and symptoms of your pain.
- Microdiscectomy: The goal of a microdiscectomy is to remove the disc material that is placing pressure on the nerves and provide space in the spinal column, thus stopping any pain caused by pinching on the nerve. During the procedure, the surgeon will make a small incision directly over the affected disc and carefully remove the damaged, herniated tissue, relieving pressure on the nerve.
- Laminectomy: During a laminectomy, the surgeon removes part or all of the vertebral bone. This procedure is commonly chosen for sciatica pain that is caused by lumbar spinal stenosis.
- Foraminotomy: A foraminotomy cuts bone from the sides of a vertebra to create space for the nerve roots.
- Facetectomy: This surgical procedure is used to relieve compression on pinched nerves caused by degenerated facet joints. In this procedure, the facet joints are typically trimmed, undercut, or removed to relieve nerve pressure.
Sciatica pain can affect your ability to live life to the fullest.
While for some it’s mildly uncomfortable, it can leave others immobilized or in persistent pain.
If sciatica pain is affecting your daily life, reach out to a healthcare professional for a consultation.
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Low Back Pain Fact Sheet. (2020). https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
Sciatica Home Remedies and Self-care. (2020). https://www.health.harvard.edu/pain/sciatica-home-remedies-and-self-care
The Effects of Altered Ultrasound Parameters on the Recovery of Sciatic Nerve Injury. (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600954/
Back Pain: What You Can Expect from Steroid Injections. (2020). https://www.health.harvard.edu/pain/back-pain-what-you-can-expect-from-steroid-injections
The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis. (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575738/
Laminectomy. (n.d.) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laminectomy
Foraminotomy. (n.d.) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/foraminotomy
The evolution of partial undercutting facetectomy in the treatment of lumbar spinal stenosis. (2018). https://pubmed.ncbi.nlm.nih.gov/30069541/