As a chiropractor, I see quite a few patients demonstrating the symptoms of sciatica. The sciatic nerve is the longest and thickest nerve in the human body and spans from the lower back to the foot on both sides of the body. Typically sciatica presents itself as pain in the low back, buttock, thigh, leg and foot on one side of the body (both sides can occur). Other symptoms can include weakness of the leg and foot muscles, a sensation of pins and needs, tingling and numbness.
Sciatica is not a diagnosis but rather a word which describes the symptoms described above. It is caused by irritation or compression of the nerve roots as they leave the spinal cord in the low back or of the sciatic nerve itself which is eventually formed from these nerve roots.
- There are many causes of sciatica which can all cause the same symptoms. Therefore, it is important to get a proper diagnosis of what is causing an individual’s sciatic symptoms because treatment will differ accordingly. A common cause of sciatic symptoms is a herniated disc but other causes include:
- A narrowing of the spinal canal or a narrowing of the holes where the nerve roots exit the spine which is referred to as stenosis.
- When one segment of the spine moves slightly forward on the underlying spinal segment (spondylolisthesis).
- A tumor affecting the spinal cord or the sciatic nerve itself.
- Direct trauma to the spine or sciatic nerve.
Piriformis syndrome can also affect the sciatic nerve when it is overly tight or in spasm. Piriformis syndrome will be discussed in detail in a later post.
The first exercise I want to discuss is a McKenzie Exercise which is beneficial when a patient is suffering from sciatic symptoms due to a disc herniation. By doing this exercise over time it can reposition the disc fragments taking pressure off of the involved nerve. This exercise begins with the patient lying face down on a solid surface. Next the patient will lift his chest off the ground and support himself on his forearms. The position can be kept as is or modified by moving the torso to the right or left by 45 degrees. The idea here is to find the most relieving position for the patient. Once this ideal position is found it should be maintained for a minute. This exercise should be repeated 5 times throughout the day. Over time the patient should notice the symptoms in his foot should begin to lessen, followed by the leg and so on which is a sign the treatment is working.
The second exercise is called nerve flossing. The purpose of nerve flossing is to pull from one end of a nerve while keeping the other end of the nerve relaxed. Nerve flossing pulls the nerve free from any entrapments or adhesions along its path. For this exercise the patient is seated on a chair that his feet can be brought under. This exercise is done with the affected leg(s). First, the patient will tuck their head and draw their chin to their chest while flexing one leg at the knee under the chair. The patient then slowly moves into the next position where their head is extended looking at the ceiling with their knee straight and toe pointed at the ceiling. The patient slowly moves from one position to the other for 10 repetitions of the full cycle.
I was inspired to write this blog post because my grandfather (Pepe) came in to see me for treatment at my office just over a week ago. He has bilateral sciatica. Along with in office chiropractic treatment, I prescribed the above two exercises for him to do at home. So far his symptoms have slightly improved and I expect to see further progress over time.
If you’ve had any relief from you sciatica symptoms doing these exercises share you experiences in the comments section.
To your health!
Jesse
My ER doc told me, before I even get out of bed, while on my back, pull right knee to left shoulder, 5 times, then left knee to right shoulder 5 times, breathing properly which is inhale through your nose as you start to pull and exhale through your mouth when knee is near shoulder.
Interesting Sharron… I’ve never heard of this exercise.
This wouldn’t be good for a patient with sciatica as it would flex the low back. Depending on your specific injury this exercise could be helpful 🙂
it sounds to be a kind of gluteus medius stretch / mobilisation. lumbar flexion allows opening of the space between the vertebrae.
I have had sciatica for 6 years and I’m 27. Due to horrible health insurance and sometimes none I have not had much relief. I have tried chiropractors and it has always made it worse as well as yoga. I’m just wondering since its been so long is it most likely spinal disc issues? I’m going to push real hard for X-ray and MRI next time I go in. Very sick of the pain and nothing has helped! Any advice would be great
Without a proper examination and imaging it is impossible to say what
is causing your symptoms. An MRI of your low back is a great place to
start – it will provide a lot of information.
Good luck and keep me updated!
Thank you for sharing this information. I had sciatica 15 years ago and these are the exercises they gave me. I had forgotten. til I saw your site. Is it possible that this sciatica is caused by muscles and not the discs? I am curious as the pain started the day after I was bending and lifting a child of 25 lbs for two days.
It was very painful to do the exercise but I am going to continue several times a day and hope for relief
Dee – You should seek a chiropractor in your area to get a proper diagnosis/explanation of what is causing your pain.
Piriformis syndrome can cause pain down the leg similar to sciatica. The sciatic nerve can run under, over or through the piriformis muscle depending on your individual anatomy. If this muscle becomes overly tight it can put pressure on the sciatic nerve and you get pain down the leg. This syndrome will not respond to the McKenzie exercise but the flossing may help. The best treatment for piriformis syndrome is Active Release Techniques (ART).
Best of luck to you!
I know I’m late in the game for commenting but I heard your podcast today so stopped by to check your site out. I don’t quite understand how to do the second move but hope it will help my husband and son who both suffer lower back pain. Is there somewhere I can see pictures of the move or a you tube video of it being demonstrated?
Hey Amy,
Here is a YouTube video demonstrating sciatic nerve flossing – http://www.youtube.com/watch?v=bzF9FAJ1LdA
Good luck to your family!
Hello, I experienced sciatica 2 month ago. First the pain was in my left calf muscle and then it shifted to my right side buttock, as well as the right calf muscle.
at the moment the pain occurs only when I walk or bend over. I would like to ask a few questions:
1) is it possible to heal after a couple of months?
2) is X-Ray an effective test to find out the underlying cause for the pain?
3) is rest/walking recommended?
4) in which case will a surgery be recommended and what is the risk?
Thank you very much!
Hey Ari,
First of all, you should seek the help of a health care professional in person. They can confirm this is truly sciatica and steer you down the right path/treat you.
1) Yes.
2) It can provide some baseline information especially if the cause is bone related.
3) Continue your regular activities without pushing to the point of pain is recommended.
4) Surgery is an option depending on the cause and the risks will vary case to case.
Good luck with this!
Thank you for the great information. I have a long history of a herniated L5 which I even had repaired via surgery only to have it re-herniate. No one from my neurologist to my chiropractor has mentioned either of there. I’m definitely going to start doing them. Is it normal that the first one the Mackenzie isn’t very comfortable?
Hey Laura,
A mild discomfort is normal but don’t push it beyond that. As you continue to do the exercise over a couple of weeks, you may be able to get deeper into it.
Good luck 🙂
Hi, I’m going on 61 days L5 herniation, and severe practically disabling sciatica. I’m a 30 yr old female, just curious if others are having pressure in the bum area with this problem as well? I’m willing to try anything for pain, my next hope is acupuncture, wondering what’s your suggestions on this?
Hey Jan,
Yes sciatica can cause pain/pressure in the buttock which can go all the way down into the toes.
Acupuncture is a great therapy for sciatica – there are specific points for these symptoms. Let us know how it works out.
Good luck!
Hi jan. Have things improved for u? I’ve been suffering for nearly 2 months now
Yes Jan, I would love to hear how you are doing as well.
Hey,
My mom had surgery to remove her disk that was pressing on the nerve.. Her pain has only gotten worse? But I’ve been googling, and told her to try walking sideways, and she has no pain… Also, when she has something heavy (like a heavy bag of groceries) on her left side (where the pain is) held by her shoulder, she feels no pain and is ecstatic! But the doctors are very discouraging. I will have her try these exercises.. Any other advice or explanation you can give for this side stepping/grocery bag holding to alleviate pain?
Thanks for sharing your Mom’s story, Natasza! Have her start incorporating these two exercises and share how she responds.
Hello Jesse,
Will issues of a sciatic nerve show up on xray ‘s and or ultra sounds?
Catherine,
Depending on the cause and xray or ultrasound can be helpful. Xrays are great at showing the bony changes and ultrasounds show the soft tissues. An MRI is best to see any disc bulges or herniations that may be pressing on the nerves.
I’m 33 weeks pregnant and the flossing technique did wonders for my sciatic nerve pain. Thank you for this post!!!
You are welcome Keri! Thanks for sharing!
Hi! I’ve suffered what I thought/think is piriformis syndrome for about 6 years. But my condition seems to be worse than ever now and I think it is more like sciatica with this “flare up”. I will be utilizing your two moves here but have a question on what you meant below regarding ART for piriformis syndrome. What should I do to get Active Release??
ART would release/loosen the piriformis in the case of piriformis syndrome, taking pressure off of the sciatic nerve. I would recommend doing a Google search for an ART chiropractor in your area.
You can read more about how I use ART in my practice here – https://drjessechappus.com/my-approach-to-chiropractic/
I was unable to find any exercise that would give me relief, then one day by
then one day when the pain was greater then usual i needed to ride a bike for work. after couple hours the pain was gone.
I’m glad you found something that works for you B! All the best!
That’s exactly how it is for me! Bike riding seems to give me relief. Jesse, why is this? Does it mean that it is muscle related and not disc related? Thanks!
Jade – Typically sciatica caused by a bulging/herniated disc will become worse when bending forward – this includes the hunched over biking position. Most likely the sciatic nerve is being compressed by the hip muscles – primarily the piriformis. The hip muscles are probably warming up/relaxing while you bike taking pressure off of the sciatic nerve. I would seek out a chiropractor who does ART. Releasing the muscles around the hip will most likely give you a more permanent solution. Good luck!
My husband had had great relief with the McKenzie exercise. Works great!
That’s awesome Linda – thanks for sharing!
I just found this article while doing some research for a class. I’m going to try these for my sciatica. Any other exercises you could recommend for sciatica due to unilateral sacralization of the L5?
Bryan – I don’t have any specific exercises for sacralization of L5 but give McKenzie and nerve flossing a try and let me know how it goes. Good luck!
Thank you so much for the sciatia exercises!
You’re welcome Marcia! I hope they helped 🙂
I have a disc fragment at L5-S1 as seen by an MRI. The fragment is on my nerve and causes pain in my butt area. I have no pain in my back. I see on your web page that you are a runner and very active. I also like to run, play golf and cross fit. This injury has slowed all of that to a halt. If I am feeling better with the epidural injections I received and want to get back to my activities, do you think I can do further damage. Or if I can tolerate the pain, can I exercise knowing the fragment can’t get any bigger?
Brian – You should slow your activities down until you get this disc injury under control. Listen to your body… pain is telling you that you are over stressing the injury. I recommend seeing a chiro in your area and start implementing the McKenzie exercise and nerve flossing. If not taken care of properly the disc can further protrude causing a more serious issue. Good luck and let me know how it goes!
I have pain going down my left leg. ..I need help! !
Jimmie – You should find an evidence based chiropractor in your area to have things checked out – one that does Active Release Technique. I would also try these exercises and see if you get any relief. Without getting more information and performing some tests this is all I can say. Good luck!
I Just had A MRI done on my spine so now I’ m just waiting on the results. I Still have pain going down my left leg and my primary Doctor will not give me any pain medicine I need to find another Doctor.
Jimmie – I’m happy to hear you got an MRI. While you wait for results, take my advice and seek out an ART chiro. Make sure and have him check for tightness around the left hip including the piriformis – I’ve helped so many patients using ART on these muscles. Keep me up-to-date on your progress.
I go in the morning for Mt results. And where can I find a ART CHIRO? I’m in Atlanta Georgia
Google search Active Release Techniques Chiropractor Atlanta Georgia and look for someone nearby with great reviews. Make sure they are spending at least 15 minutes with patients on subsequent visits. I’m happy to hear you have the results by now.
I got my results back. I don’t know what it means. Moderate to severe at L4-5 disc bulge and pinched nerve.
Jimmie – From what you have said it looks like the disc bulge in your low back is pushing on a nerve causing your pain in the leg. Follow my advice about seeing a local chiro and also try the McKenzie Exercise explained above. Keep me updated.
I got a epidural shot today. It helped when I got it and now I still feel pain. Why?
Jimmie – You need to work with a great health professional in your area. I don’t have enough information to properly guide you online. Keep me up to date. All the best!
7 months ago I had a full hip replacement which has given me the mobility I had lacked for many years. However, my thigh has this uncomfortable sensation that the bone is trying to come out. I have just been to my PA who had me take an x-ray of my thigh/hip area, showing a perfect alignment of the inserted stem and hip “ball”. He says that I more than likely have lumbar 4 and 5 problems (and I do) with pinched nerves and bone spurs that are causing this problem. He suggested checking the McKenzie root exercises to strengthen the stomach muscles and back. Also recommended an MRI. Am I going in the right direction?
Jeremy – An MRI sounds like a great idea!
The McKenzie Exercise isn’t used to strengthen the back and stomach – it helps draw a disc bulge forward and off of the nerve roots. So depending on the lumbar spine issue this is a useful technique.
It is hard to give any advice without knowing way more details. All I can say is go for the MRI and continue to see your PA or another health practitioner (chiro or physio) until you resolve the issue. Good luck and keep me updated.
Can’t quite picture the second excercise with the chair.
Check the video in the comments for a demonstration, Judy 🙂
I have bilateral sciatica only at night (last half) when lieing down…excessive belly fat causing pressure and possible disc herniation..now .attempting to juice (checkout Juice Lady Cherie Calbom and Joe Cross and http://www.juicerecipes.com)…also trying to change diet/lifestyle per Dr. Fuhrman latest diet plan book…I read in the past Rusty Hoge (www.cforyourself.com) and others…(Dr. Lorraine Day for ex.)…got rid of their herniated disc through taking large amounts of vitamin C and water…large amounts of C (ascorbic acid powder at @ 10-12g per day) toughens the disc shell and healing and water hydrates the spongey interior material of disc for cushioning. also check out http://www.vitamincfoundation.org . Hope this helps others.
Thanks for the info J! Just be sure to have a medical professional on board as well. I’m so happy you are trying some natural therapies to heal. Let us know how it goes.
I have had a Mri scan and it said I have L2 and L3 bulging disc what is the best treatment for this I have been suffering sciatica and back pain for about ten months doing physio acupuncture and chiropractic treatment have pain and anti inflammatory medication and pain relief but to no avail when pain kicks i
Hi Joyce!
I would try the nerve flossing and Mckenzie exercise as described in my article. I would do these under the care of a chiro who does ART. Have him/her check the glute med, piriformis and TFL for tightness which can affect the sciatica nerve. I find these muscles are often tight in people with pain down the leg and releasing them may provide you with some relief. Let me know how it goes. All the best!
I tried the first exercise and felt much relief 🙂
thank you for taking the time to write and share all of this information. I’m excited to see how I’m feeling in a week!
Thanks for sharing Ivy! So happy you are on the mend!
Let us know how it goes in the longterm.
All the best!
Jesse
Since my 20’s always had low back issues. Last 2 yrs. it has turned into sciatica alternating but worse in the right. I’ve try chiropracty, and it did get me up and walking from my first severe episode but now it is chroni. I just tried your xercises, Dr. Jesse and will let you know how I’m doing. My right rear thigh muscle is cramping when I hold it in the backward position. Anything I can do to stop that from occurring? I’m 70..like your grandpa. ha
Hey Joyce!
Your cramping may be due to dehydration. Have you been drinking enough water?
Also, a product you might want to try is called Natural Calm. It’s a magnesium powder you make into a hot beverage. Many of my patients solved issues with muscle cramps by including this drink into their daily routine.
A deep tissue massage of the involved muscle may help relieve the cramping as well.
Good luck and keep me updated!
I’ve been reading about magnesium so I will now shop for Natural Calm thanks to you Jesse. My back and sciatica doesn’t allow me to walk very far and sitting, weirdly, takes all the pain away!
Try the magnesium and make sure to get up periodically to get the muscles and blood moving. Keep me in the loop.
What if lying on my stomach sends a horrible unbearable pain down my left leg
Find a great chiro in your area. Look for one who does Active Release and has excellent reviews on Google. You need a proper assessment and most likely imaging to determine the issue. Good luck jmc!
Having bilateral sciatica I have tried sleeping in different ways and sleeping on my back works for me
It is the most excruciating pain to deal with.
I am under the back clinic and have resulted to having injections to try and help me
of which gave me temporary relief now I am back to square one again.
Sorry to hear you are struggling with pain. Find a great chiropractor in your area to work with. Keep strong and wishing you the best!
Sorry to hear you are struggling with pain. Work with a great chiro in your area that does ART. Good luck and wishing you all the best!
I have been suffering from sciatica for 7 months now, the McKenzie exercise you show was recommended during a physio session 4 months down the line, almost immediately after doing this exercise I began to suffer terrible spasms and intense pain in my buttock region, thigh and calf. Not realising that this was causing my symptoms to worsen I continued to see the physio and do this exercise along with other stretching exercises. As my pain got increasing worse I refused to do this exercise and was referred to a second opinion clinic where I was given an MRI. This shows a bulging disc in my lower spine however only affecting the left side, my pain is all in the right. While waiting for my MRI I was advised to stop all exercises which I did, slowly my pain eased to tolerable level with fewer of the spasms. I was then advised to restart the exercises, which I was terrified to do, however I did two days and have been sent spiralling into extreme pain again. It is important to find out what is causing your sciatica before embarking on any exercise. I believe mine is being caused by the piriformis muscle. I am going to start following the gentle exercises recommended for this syndrome and see if it I can do these without my pain getting worse and hopefully help to relieve this pain and get my life back
Anna I recommend seeing a chiro who specializes in Active Release. He can check to see if piriformis is the problem and use ART on the muscle, if warranted. Just make sure you are continuing to see a credible health professional while you are working through this. Wishing you all the best!
I can’t believe how much these exercises helps relief the pain almost an instead ! Thank you
My pleasure Jessica, glad they helped!
Nerve flossing is a godsend! I have been suffering from an irritated sciatic nerve for months until I started using this exercise. Some days I could barely walk, but the nerve flossing works wonders and I get my leg back free of pain and with returning strength. Never knew such a simple exercise could lead to so much relief!
So happy to hear it’s working for you, Claire! Keep us in the loop.
I have had sciatica for 10 months doing pt and still suffer extreme pain. What can I do ?
I would seek out a chiro who does Active Release Therapies. Make sure and have him check for tightness around the hips that could be affecting the sciatic nerve. Keep us in the loop, Shamika.
I am here to ask if anyone knows if it is common for the stretching exercise (laying on back pulling up your knee to opposite shoulder) should (typically) hurt like hell? I had pain in left now moved to right. Sipping Ginger tea all day help the pain big time
You really need to seek out the help of a chiro to diagnose your injury and give you proper stretches, you don’t want to cause any further damage. Good luck!
Dr. Jesse said that find out the cause before doing any of the excercises, you may be doing wrong one. Thanks for the info on the ginger tea. Will try it. This site is still active, isn’t it?
Yes this site is active Sue 🙂
I had sciatica nerve pain when I was pregnant with my 3 kids. Last Sunday it flared up and doctor gave me a shot and muscle relaxer. My back is better but still have a toothache pain at the back of my leg. went up to emergency room of hospital yesterday and they checked me and confirmed it was Sciatica nerve pain. They gave me shot and muscle relaxer and Ibprofen (Motrin) 800 mg. I will not take the motrin the paper said it was very high risked med. So am taking otc ibprofen. When I sit it doesn’t bother me and when I lay it doesn’t bother but when I start walking it will get achy. So which excercises should I do? Been rotating ice and heating pad on it.
Sorry to hear you’re in pain. You should see a chiropractor or a physio therapist for a proper assessment and recommendations. Good luck Sue!
I understand the first excercise but not quite sure how to do the nerve flossing I read it several times. Do you happen to have any videos of these excercises online?
Here is a video that demonstrates nerve flossing. BTW it’s not me in the video 😉
https://www.youtube.com/watch?v=bzF9FAJ1LdA
Just discovered your two recommended exercises. The first one, not easy for me to do but I gave the nerve flossing a try today whenever it hurts and it brings relief !!
I’ll spread the goods news. Thank you for sharing. I am tempted to add :and God bless
you !
So happy nerve flossing brought you relief, wishing you all the best Marie! Oh and thanks for sharing this info, much appreciated 😉