Sciatica Exercises to Avoid

Sciatica is a painful condition that may be relieved by specific stretches and exercises that target the lower back and lumbar spine. Doing so can reduce pain in the back, hip, and outer leg caused by compression of the sciatic nerve. This includes sciatic pain commonly experienced by older adults, people with pregnancy, or those with obesity.

With that said, some exercises can help, and those that can make sciatica symptoms worse. Squatting, twisting, high-impact activities like running, and specific core exercises should be avoided if you have sciatica.

This article will help you understand the causes of sciatica and some sciatica stretches and exercises that are safe and effective. It will also list some exercises to avoid while recovering from a condition that may affect up to 40% of people at some point in their life.

What Is Sciatica?

Sciatica occurs when there is compression along the sciatic nerve, resulting in pain and/or various symptoms in the lower back that may radiate down the leg. These symptoms typically occur from the narrowing of the spinal canal (which houses the spinal cord). This may be due to a slipped disc, bone spurs, piriformis syndrome, or a lower back injury.

The sciatic nerve is the longest nerve in the body. It runs from the lumbar spine of the lower back and branches off in the lower leg and to the foot. When it is compressed, irritated, or inflamed, it can cause symptoms like:

• Sharp burning pain in the upper buttock
• Shooting pain in the back, hip, and outer side of the leg
• Tingling or pins-and-needles sensations

Sciatica is treated with physical therapy, over-the-counter anti-inflammatory medications, and cortisone injections. In some cases, surgery is needed.

Physical therapy or physiotherapy involves different modalities to treat the root cause of sciatica and relieve symptoms. Treatments may include:

• Electric muscle stimulation
• Hands-on therapies, like massage, trigger point therapy, and other techniques
• Hydrotherapy with ice or moist heat
• Muscle strengthening exercises focusing on the core
• Specific stretches 

Should You Exercise if You Have Sciatica? 

People with sciatica generally benefit from exercise but need to take care not to overdo it. Keeping active can relieve inflammation, loosen tight muscles, and help you feel better long term.

During a flare-up, light exercise and gentle stretching can help to relieve discomfort. While some rest can be helpful, too much inactivity can worsen your pain.

Once you start feeling better, taking short walks, physical therapy exercises, and keeping active can help keep pain at bay. Too much exercise or the wrong moves, however, can aggravate the sciatic nerve and should be avoided.

Exactly how much exercise and the right exercises for you will vary from person to person. Core stability, extension exercises, and isometric exercises are commonly recommended for sciatica. A 2023 review of studies on physiotherapy interventions for sciatica, however, found there is not enough evidence to say which is best. 

Exercises to Avoid if You Have Sciatica

Some activities and movements can put pressure on the lower back, hips, and/or thighs and make sciatica worse.

As a general rule, you should avoid squatting, twisting, running, jumping, or any high-impact activity if you have sciatica. Keep in mind that bending forward with straight legs (or any seated or lying exercise that requires you to lift both legs off the ground at the same time) may be aggravating to some people.

Here are specific exercises to avoid (or be careful about) if you have sciatic nerve pain:

• Bent over row: This is a weightlifting exercise that strengthens muscles in the back. It can place extreme stress on the sciatic nerve, particularly if your back is rounded.
• Hamstring stretch: A hamstring stretch in any position can lead to pain and other symptoms if the lumbar spine is not supported and nerves are compressed.
• Forward bends: Exercises like the downward dog used in yoga mean you'll have to bend at the waist. Be aware that the motion flexes the back and may compress the sciatic nerve.
• Double leg lifts: Exercises that require you to lift both legs at the same time while lying can aggravate the sciatic nerve because the lower back takes on the weight of your legs.
• Squats: Full-body squats and weighted squats put pressure on the lower back, aggravating sciatic pain. Squats also put pressure on the thighs and legs, worsening the sciatic pain in the leg as well.
• Deadlifts: Straight leg deadlifts (or Romanian deadlifts) stretch on the hamstrings and lower back with powerful force, placing undue stress on the sciatic nerve.
• Leg circles: Exercises that involve swinging your leg in a full circle can wrench the hamstrings suddenly, which can make sciatica symptoms worse.
• HIgh-impact exercise: Exercises that put stress on the hips and pelvis can also aggravate sciatica. You should avoid running, jumping, high-impact aerobics, burpees, and horseback riding.

What Are the Best Exercises for Sciatica?

Gentle exercises that can further help ease sciatica pain. These same exercises can be used to help prevent sciatica in the future by keeping your lower back strong and flexible.

Exercises for sciatica are really no different than for any other training program. It should involve both aerobic activities to improve endurance and strength training to activate core muscles that provide lower back stability.

Low-Impact Aerobics

Low-impact aerobic activity increases circulation and helps to loosen stiff muscles. Start by warming up with 10 to 15 minutes of low-impact aerobic activity, such as:

• Riding a stationary bike
• Swimming
• Walking
• Water exercises

Your lower back, legs, or hips may feel stiff or a little achy when you start your warm-up. This is normal. The muscles should loosen up after a few minutes.

You should do a low-impact aerobic activity at least five times a week and slowly increase how long you do it. As long as you are not feeling pain, you can do this type of exercise daily.

Strength Training

For sciatica, strength training does not mean resistance training or weight training. Rather, it means using focused movements against gravity to build the muscles that support the spinal column.

The trick is to add activity gradually and to slow down if any pain or discomfort is felt. This approach is known as symptom-guided exercise.

After stretching and warming up with aerobics, move on to exercises that strengthen core muscles. All of the recommended exercises are done on the floor.

Pelvic Tilt

The pelvic tilt is one of the most effective ways to strengthen the muscles of the lumbar spine. It is also very safe to do even if you are pregnant.

To do the basic pelvic tilt:

1. Lie on your back with your knees bent and your feet flat on the floor.
2. Place your arms alongside your torso, palms facing down.
3. Gently tilt your tailbone toward the ceiling, tightening your stomach muscles.
4. Hold for three to five seconds.
5. Lower your tailbone.
6. Repeat for a total of eight to 12 reps.

The Bridge

The bridge requires a bit more strength and is something you may need to ease into. If you have trouble, start with one or two only and add another rep every day.

To do the bridge:

1. Lie on your back with your knees bent and your feet flat on the floor.
2. Place your arms alongside your torso, palms facing down.
3. Gently lift your buttocks and back, arching your back as far as it can comfortably go.
4. Hold for several seconds.
5. Lower your buttocks and back.
6. Repeat for a total of eight to 12 reps.

Modified Plank

The modified plank is a holding exercise that strengthens the abdominal muscles and, in turn, the back, obliques, and pelvic floor muscles.

To do the modified plank:

• Lie on your stomach.
• Raise yourself up so that you're resting on your forearms and knees.
• Position your elbows directly under your shoulders, and keep your head and neck aligned with your spine
• Tighten your abdominal muscles.
• Hold for five to 10 seconds.
• Relax and return to the start position
• Repeat for a total of eight to 12 reps.

As you get stronger, you can do two or more sets of these and add other core-strengthening exercises to the routine.

What Are the Best Stretches for Sciatica?

Sciatica often gets better on its own with time, but some stretches may help speed up the process. Gentle stretching can help loosen lower back muscles that tend to "seize" following an injury. They can also help if you've been sitting for a long period and are overweight (or are carrying extra weight during pregnancy).

There are certain rules you should follow to reap the benefits of gentle stretching for sciatica:

• Always warm up with light aerobic activity before stretching.
• Be careful with bending forward or rotating at the torso.
• Do not force a stretch. If you feel resistance, don't push yourself.
  
• If you feel the muscle tense up, stop, relax the muscle, then try again.
• Never stretch cold muscles. If you can't do warm-up exercises, apply moist heat for 15 to 20 minutes before stretching.
• If you experience pain doing a particular stretch, stop doing it.

Talk with your healthcare provider before beginning an exercise and stretching program to ensure that recommended stretches used to relieve sciatica are safe for you to do.

Some of the commonly recommended stretches include the following. They all are done on the floor, lying on your back. The only equipment you would need is a belt.

Single Knee-to-Chest Stretch

The single knee-to-chest stretch is done on the side of the body with sciatica as well as the side of the body without.

To do the single knee-to-chest stretch:

1. Lie flat on your back.
2. Wrap your hands around one knee and gently pull to your chest as close to your chest as possible until you feel a stretch in your lower back.
3. Keep the opposite leg relaxed in a comfortable position, either with your knee bent or your leg extended.
4. Hold for 15 to 30 seconds.
5. Lower the leg and repeat on the opposite side.

Double Knee-to-Chest Stretch

This is a variation of the single knee-to-chest stretch. For this stretch, you need to focus on keeping your back flat on the floor.

To do the double knee-to-chest stretch:

1. Lie flat on your back with your knees bent and your feet flat on the floor.
   
2. Wrap your hands around both knees and gently pull to your chest as close to your chest as possible until you feel a stretch in your lower back. Do not force the stretch.
3. Keep your back flat on the floor. Avoid curling up into a ball. This helps center the stretch on the lower back muscles.
4. Hold for 15 to 30 seconds.
5. Lower your legs and relax.
   

Side-to-Side Knee Stretch

This stretch is particularly useful for people with a pinched spinal nerve as it gently rotates the lumbar spine.

To do the side-to-side knee stretch:

1. Lie flat on your back with your knees bent and your feet flat on the floor.
   
2. Extend your right arm level with your shoulder.
3. Gently bring both knees to the left as far as you can go without pushing.
4. Hold for 15 to 30 seconds.
5. Return your knees to a central, neutral position.
6. Repeat with the opposite, extending your left and twisting to the right.

Supine Hamstring Stretch

The supine hamstring stretch activates the lower back and hamstring muscles with the aid of a belt.

To do the supine hamstring stretch:

1. Lie flat on your back.
2. Lift your right foot and wrap either a belt or towel under the arch of the foot. (The belt would need to be long enough so that you can hold the ends and keep your leg straight.)
3. Bend the left knee and rest that foot comfortably on the floor.
4. Holding both ends of the belt, gently pull and lift your right foot toward the ceiling, keeping the leg straight.
5. Keep your back flat on the floor. Avoid twisting to the side or pulling too hard. You should feel a stretch without any pain or discomfort.
6. Hold for 15 to 30 seconds.
7. Lower the leg and repeat on the opposite side.
   

Sciatic Nerve Flossing

Nerve flossing is a technique that uses a series of gentle movements to mobilize the sciatic nerve. It involves performing gentle stretches in opposite directions to pull the nerve back and forth, freeing it from compression or entrapment in the process. 

Also known as nerve gliding, the simple movements help to calm nerve irritation and improve hip range of motion. There are a few different techniques for sciatic nerve flossing.

To do a seated sciatic nerve floss:

1. Sit upright in a chair with your knees shoulder width apart and feet flat on the floor.
2. Extend one leg straight, flex the foot toward the body, and tilt your head backward.
3. Next, bring your head forward and down so your chin is near your chest and point your foot.
4. Repeat this motion 10 times, then switch legs.
5. Perform this exercise two to three times a day.

When used as part of a traditional physiotherapy program, research shows nerve flossing can reduce acute sciatica pain and improve hip range of motion.

Cobra Pose

The cobra pose from yoga practice stretches the back by arching it. A modified version may be the better option for people with sciatica or other conditions causing back pain. You can:

1. Lie prone (on your stomach) with legs together and the floor for support
2. Put your forearms on the floor to help with stability, with elbows under your shoulders
3. Drop your shoulder blades down your back, keeping your hips on the floor
4. Extend the spine in an arching motion

Hold the cobra pose for several breaths and return to the starting position, repeating the steps for the exercise pose.

Cat-Cow Pose

The cat-cow pose used in yoga can stretch and strengthen your back, hips, and abdominal muscles.

1. Start on your hands and knees with your chin up, your back flat, and your eyes forward.
2. Slowly arch your back up as you draw your chin towards your chest. Hold for two to five seconds.
3. Slowly bring your chin away from your chest and return your eyes forward as you arch your back down. Hold for two to five seconds.

Repeat these steps eight to 10 times. If you feel any pain or weakness, stop the exercise.

Tips for Managing Sciatica

If you are experiencing symptoms of sciatica for the first time, see your healthcare provider for an evaluation and referral to physical therapy. Sciatica can take some time to resolve, but you should see an improvement within three months.

The following tips can help you manage sciatica at home:

• Apply ice to your lower back for 20 minutes several times a day to relieve inflammation.
• For muscle stiffness, use moist heat—a hot shower, soak in a hot tub, or use a damp heating pad.
• Keep active and avoid lying down or sitting in one position for too long.
• Take OTC pain relievers like Advil (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen)

Listen to your body, and if you have any questions or concerns, talk to your physical therapist or other healthcare provider.

Summary

Sciatica often goes away on its own over time, but some kinds of exercise can help the pain and some can make it worse. Exercises that relieve sciatica include low-impact aerobic activities like walking, certain strengthening exercises, and gentle stretching.

Exercises that can make sciatica worse include high-impact activities like running and aerobics, hamstring stretches, and some core-strengthening exercises.

The most important thing to remember about exercise and sciatica is not to overdo it. Once the sciatic nerve is already irritated, it doesn't take much to trigger symptoms. Listen to your body and stop or slow down if you experience any pain.

If you aren't sure how to do exercises on your own, talk to your healthcare provider. They may refer you to a physical therapist who can design an exercise program that's best for you.