A shooting pain with a clear pathway.
Some people experience a shooting pain, most commonly down the leg, that somehow radiates to the lower back. This is sciatica: pain that radiates along the path of the sciatic nerve, which branches from the lower back through the hips and buttocks and down each leg. Sciatica typically affects only one side of the body, and medication and surgery are not the only ways to treat it. Physical therapy is one of the most recommended remedies.
Physical therapy and exercise are typically first-line treatments for relieving, treating, and preventing sciatica symptoms, which can include lower back, hip, and leg pain, numbness, tingling, and weakness in the buttock, thigh, leg, or foot. Underlying conditions such as a herniated or degenerated disc, or nerve root compression in the lumbar spine, can trigger sciatica. A physical exam, checking muscle strength and reflexes, is standard, and severe cases may involve imaging such as X-rays, MRI, CT scan, or EMG. After a thorough assessment, your doctor or physical therapist can design a rehabilitation program to correct posture, strengthen the muscles supporting your back, and improve flexibility.
Targeted movement for sciatic pain relief.
A physical therapy program for sciatica often includes stretches such as the pigeon pose, done reclining or seated once reclining feels comfortable, to open the hips and stretch the back. Knees to opposite shoulder offers sciatica pain relief by stretching and loosening the piriformis and gluteal muscles. A sitting spinal stretch helps relieve back pain and decompress the spine, while a standing hamstring stretch eases the hamstring tightness that sciatica often causes.
Each of these poses targets a specific muscle, so it is worth doing them with a therapist rather than relying on instructions found online, since the wrong execution can affect the results of your therapy.
What helps between sessions.
For most people, sciatica responds to self-care measures alongside therapy. Resting for a day or so can provide some relief, though prolonged inactivity tends to make symptoms worse. A cold pack placed on the painful area for up to 20 minutes at a time, several times a day, can help initially; after two to three days, switching to heat, such as a heat pad on a low setting, often helps more, and alternating warm and cold packs can be useful if pain continues.
Gentle stretching for the low back can also relieve nerve root compression; avoid jerking, bouncing, or twisting, and hold each stretch for at least 30 seconds. Over-the-counter pain relievers such as ibuprofen or naproxen sodium are sometimes helpful as well, always in consultation with your physician.
A safer starting point than surgery.
Many people are unsure whether to pursue physical therapy for sciatica, but patients who have gone through it often recommend it over surgery, and doctors typically suggest physical therapy first since it carries far less risk. Every therapist may use a somewhat different set of stretching exercises, and your individualized plan will depend on your specific presentation and any limitations your provider identifies. If you want to know more about how physical therapy can help with sciatica, talk to one of our doctors.