Sciatica is caused by compression of the sciatic nerve, a large nerve that starts outside the base of the spine near the pelvis and runs down the back of the leg from the buttock to the foot. Sciatica pain can occur anywhere along this path or radiate everywhere.
“People with sciatica may experience stabbing, throbbing, or burning pain in those areas,” says Abby Halpin, DPT, PT, physical therapist and owner of Forte Performance and Physical Therapy. They may have altered sensations such as numbness or tingling, explains Dr. Halpin. “Because the sciatic nerve contains motor input, the leg may feel heavy, weak, or difficult to move,” she says. “Symptoms can last only a few seconds or be constant and chronic.”
What causes sciatica?
Dr. Halpin says that sciatica can happen to anyone, but it’s most common in people in their 30s and 50s. Symptoms often appear gradually. “It can occur when someone remains in a position that compresses nerve tissue for a long period of time, such as sitting, standing, working in awkward positions, or moving repetitively for long periods of the day, especially bending or twisting,” explains Dr. Halpin.
“Imagine falling asleep on your arm and waking up tingling or numb,” she says. “That’s also a form of nerve compression, albeit a very temporary one, which is somewhat similar to how sciatica can start. Although in the case of sciatica, it’s not just one night of sleeping in an awkward position, it’s usually many weeks or months of being in these compressive positions that are problematic for sciatica sufferers.”
Dr. Halpin says that reduced physical activity is often the cause of acute or sudden sciatica because people who are less active may be less resistant to movements that compress the spine or leg. This, in turn, can cause pain and inflammation of the sciatic nerve. “A classic example is someone who is quite sedentary in her everyday life, but one day she bends down to pick up a heavy sofa,” she says. “The lower back joints and the soft tissues around the nerve are not used to that kind of weight and movement and will send a signal to the brain that something dangerous may be going on. The resulting pain is to get you out of the dangerous situation, but it can lead to ongoing sciatica until recovery occurs.”
How Strength Training Can Ease Sciatica Symptoms
Dr. Halpin says that strength training is the best way to build resilience against the kinds of loading and compression that might otherwise cause sciatica. “By practicing heavy lifting frequently, the muscles are better equipped to withstand compressive loads and can prevent the sciatic nerve from taking too much pressure,” she says.
Strength training also allows people to move, sit and stand in a variety of positions, adds Dr. Halpin. “By having a broad ‘vocabulary’ of movements, people can avoid using the same movements or positions all the time, which means spending less time putting pressure on their sciatic nerves in the same way,” he explains. “Resilience and variety are vital to staying healthy.”
7 strength exercises for sciatica pain
1. Hip lift 90-90
This exercise strengthens the glutes, hamstrings, and core. Begin by lying on your back on the floor with your feet on the seat of a chair or against the wall. Your hips and knees are bent at 90 degrees (hence the name) with your shins parallel to the floor, arms extended by your sides, palms pressing into the floor. From here, without physically moving your feet, press your heels down to engage the backs of your legs. Then tuck your tailbone in and lift it an inch or two off the floor, without lifting your lower back, before lowering it back down. You should feel the back of your thighs (hamstrings) working. Continue for 30 to 60 seconds.
This is a foundational exercise that strengthens your entire posterior chain (back of your body). You’ll also get a good stretch in your hamstrings and glutes, lengthening the sciatic nerve. Start by standing holding a weight or any household item, like a jar of laundry detergent, with both hands in front of your body with your arms straight. Maintain a slight bend in your knees as you rotate your hips, keeping your back flat but allowing your torso to bend forward at a 45-degree angle as you slide your weight across the front of your shins toward the floor. Press through your heels to come back up, squeezing your glutes at the top. Complete three games of 8–10 repetitions
Rockbacks are one of the best exercises for sciatica and lower back dysfunction because they increase the mind-body connection in your core muscles and strengthen your lower back and deep abdominal muscles. These muscles can help protect your spine and nerves. Start by getting down on your hands and knees. Keep your arms straight and press your hips back so they hang over your heels while keeping your back flat. Slowly return to your starting position. That is a repetition. Complete three sets of 8 to 10 repetitions.
4. Diagonal cutlets
This is a good strength training exercise for sciatica because it strengthens your entire core while mobilizing your spine. Start standing with your feet hip-width apart and your knees slightly bent. Hold a weight or household object such as a water bottle with both hands. Reach diagonally to the right and feel your trunk and left leg (heel level) to rotate to that side. Reverse to swing the weight (with control) down off the opposite hip, so you’re making a big diagonal sweep across your body. That is a repetition. Complete three sets of 8 to 10 repetitions per side.
5. Goblet squats
Dr. Halpin says that strengthening exercises like this one can help ensure your body is resilient and capable of handling functional movements during daily activities. Start standing with your feet slightly wider than your hips. Bring your hands together in front of your chest. (Optional: Hold the top of a dumbbell vertically with both hands.) Squat down by bending your knees and sitting your hips back and toward your heels. Go as low as you can while keeping your heels on the ground. Point your elbow towards or just inside your knees. Press through your heels to stand fully upright. That is a repetition. Complete three sets of 8 to 10 repetitions.
This is a good whole-body strengthening exercise. It also develops core strength and lower back stability. Dr. Halpin says that he can make this exercise more difficult by holding a dumbbell or other weighted object. Start standing with your feet slightly wider than your hips, elbows bent, and fists up at shoulder height. Squat down to a comfortable depth while keeping your heels on the ground. Stand back up, reaching your hands above your head as you do so. Lower your hands back to the starting position. That is a repetition. Complete three sets of 8 to 10 repetitions.
7. Rounded planks
This exercise is great for sciatica because it strengthens your core without putting as much pressure on your lower back. Get on your hands and knees. Exhale and round your back a bit as you feel your abs engage. Step each foot back into a plank, keeping your hips low and your back rounded. Hold the position for 4-5 breaths, focusing on exhaling slowly and completely with each breath. Repeat 3-4 more times.
How long does it usually take for sciatica pain to go away?
Dr. Halpin says that many people who have sciatica symptoms often worry that they will have sciatica forever, but recovery is definitely possible. “Symptoms can take up to a year to go away completely, but that doesn’t mean intense symptoms last that long,” he says. “The longest lasting symptoms are usually small areas of numbness in the leg or foot. Getting an evaluation from a physical therapist is the best way to find out how and why your symptoms started, as well as make a plan to make changes to reduce your pain and weakness.”
Remember, movement is medicine. Staying active can help prevent the nerve compression that often causes this type of pain, and if you’re already experiencing it, the strength training exercises for sciatica mentioned above can help relieve symptoms.