Is Swimming Good for Sciatica (and why)? Evidence Review

Light exercise is recommended for most types of back pain, but is swimming particularly good for sciatica? If you are looking for ways to alleviate the shooting pain in your leg, buttock and lower back caused by your trapped sciatic nerve, you need to find the kind of exercise which can provide you with immediate sciatica pain relief without causing any further nerve compression.

Since swimming was long recommended for correcting posture and exercising without pressure on your spine [1], it seems like one of the best exercise options for sciatica. However, very few studies have been conducted to prove the pain-reducing effect of swimming on lower back pain in general and in sciatica in particular. While there are some promising aquatic therapy results in animal studies [2] [3], it seems that swimming may be just as good for you as any other form of exercise, with no specific added benefits.

In order to determine the best type of exercise for your sciatica, it would be best to see a physiotherapist. However, it can take over 18 weeks to be seen by a specialist when referred through the NHS for sciatica treatment [4]. Fortunately, if you are self-paying or privately insured, you can often get a same-day appointment for private physiotherapy or a consultation with one of our experienced pain management consultants at the Harley Street Specialist Hospital.

Keep reading this article to find out all you need to know about:

The benefits of swimming for sciatica
The risks swimming can pose for sciatica patients
Easy and safe swimming exercises for sciatica
Alternative ways to relieve your sciatica pain

Is swimming good for sciatica?

Swimming is normally recommended for sciatica, among other types of light exercise, such as walking, jogging, cycling, yoga, tai chi or pilates. That is because exercise is generally known to reduce pain, increase physical and psychological function and improve overall quality of life in chronic pain [5].

However, there are very few clinical trials that study the specific effects of swimming on sciatica and most of them are performed on animals, such as rats. The findings in rats are promising, as swimming has been shown to relieve animals’ sciatica pain, to promote nerve fibre regeneration, motor function recovery and walking stability [6][2][7][8].

However, since people move on two legs, while rats move on four, there are significant differences between the human arrangement of spinal bones and muscles and that of a rodent. That is why its findings made on animals can’t be directly transferred to humans.

Some human trials have been conducted to study the relationship between swimming and lower back pain (not necessarily sciatica). But a scientific review of 25 such clinical trials didn’t find enough evidence to recommend swimming in particular for this type of chronic pain [15].

Another meta-analysis performed on 18 clinical trials took a comparative look at the effect of walking, cycling, and swimming for relieving lower back pain. The authors found that while swimming yielded much better results than no treatment at all, its outcomes were comparable to those of the other investigated forms of exercise and inferior to alternate therapies, such as massage [9].

What this means is that while swimming may help improve your sciatica pain and increase your overall sense of well-being, it will likely do so to a similar extent as other forms of exercise.

Some physiotherapists recommend swimming for sciatica due to the fact that floating in water takes the pressure of your body weight off your spine and makes it easier for you to move without discomfort. So if you enjoy this sport and your level of pain allows it, it will likely be much better for you than getting no exercise at all.

Does the NHS recommend swimming for sciatica?

The NHS recommends light exercise for sciatica, including swimming. However they highlight the fact that there is no best exercise for sciatica pain relief. What is important is to find the type of exercise that you can perform comfortably (or at least at a tolerable pain level) several times a week [10]. This can vary according to your condition and preferences.

The best swimming exercises for sciatica

While there are no aquatic exercises developed specifically for sciatica, here are some gentle stretching exercises you can do in the swimming pool to help alleviate your pain:

Simply walking in the pool: Slowly walk in waist-level water – a few steps forwards, then a few steps backwards, then a few steps to the side – for 5-10 minutes at a time.

Leg lifts – Stand straight, with your spine well aligned, in the pool and hold on to the edge. Then gently lift your affected leg back, forth, then to the side (as high as feels comfortable), without bending from your torso. Repeat several times.

Frontal knee extensions: While standing in the pool, rest your hands on the pool edge and lift the knee of the affected leg, with the foot pointed toward the pool wall. Then slowly extend the knee forward. Return to the original position. Repeat 8-10 times. If stretching your knee is too painful, move closer to the pool wall or make your extensions shorter.

Right and left knee extensions: Starting from the same position as for the previous exercise, lift your knee up once more, but this time, extend it diagonally, to one side. Then return and extend it to the other side. Repeat 8-10 times.

Right to left knee rotations: Starting from the same position as before, rotate your raised knee gently, in wide motions, from one side to the other. Repeat 8-10 times.

Pool squats – gently squat (or slightly bend your legs) with your back resting against the pool wall. Then press your back against the wall and hold the position for 10 seconds before relaxing. Get back up slowly, then repeat 8-10 times.

Sitting leg lifts – Carefully sit on a step in the pool, then put your legs together and gently lift them up and lower them again about 8-10 times. Then slowly get back up and repeat several times.

If you would rather exercise in a group, a beginner water aerobics class may also be a fun way to get sciatica relief and make new friends. However, make sure you don’t overexert yourself, so you don’t accidentally make your condition worse. If you feel pain during certain exercises, it is best to sit them out.

Will swimming help a pinched nerve?

While there is no evidence that swimming will help a trapped nerve, not having to support the weight of your body in water can make your spine less compressed. Considering that 90% of sciatica cases happen due to a herniated disc which pinches or presses against your sciatic nerve [11], floating may feel less painful than standing.

However, it is unlikely that swimming will immediately resolve your pinched nerve. In 85% of cases, a herniated disc will heal over time, with home care, in 8-12 weeks [12]. And while exercise can help to some extent, it is not likely that it will heal your sciatica overnight.

Is swimming good for sciatica in pregnancy?

As pregnancy advances, your spine has to support the added weight of your growing belly and your centre of balance shifts to accommodate this. In the later stages, it can sometimes be difficult to walk, let alone exercise. So swimming might be better than other exercises for sciatica in pregnancy, because the water will support your weight and allow you to move more freely.

Moreover, aquatic therapy also has other benefits in pregnancy, such as regulating your heart rate and glucose levels, preventing postpartum depression and increasing your quality of life [13].

However, be sure to only swim in pools which are up to health codes and avoid wading in natural bodies of water, which may contain harmful bacteria or parasites.

What are the risks of swimming with sciatica?

Swimming with sciatica is generally considered safe. While there were some studies which found associations between swimming and increased lower back pain [14], they were conducted on athletes who spend a significant amount of time in the pool and it is not believed that this effect would also be seen in people who only swim therapeutically [15].

However, certain styles of swimming can put a higher stress on your spine than others. So while more evidence is needed for this, you may want to avoid breaststroke, backstroke or butterfly strokes [16], as they can overextend your spine and make your sciatica symptoms worse. Using a sidestroke can be easier on your back.

One more thing you need to make sure of when swimming with sciatica (and with pain in general) is that you stay in shallow water or that there is a lifeguard on duty who can quickly intervene if you need help.

While swimming itself is not likely to aggravate your sciatica pain, making a wrong move can do so and you may suddenly become unable to swim. If that happens, you need to be able to get out of the water safely and without risk of drowning. That is why it is best to avoid swimming in the sea or ocean, where currents can carry you far away from the shore.

Other ways to relieve sciatica pain at home

If swimming is not your cup of tea, there are many other things you can do at home to get some sciatica relief:

Other good types of exercise for sciatica

Any kind of gentle exercise can help your sciatica, such as:

Simple yoga (e.g. cat-cow pose, pigeon pose)
Pilates (e.g. the bridge)
Light jogging
Light cycling
Tai chi

Even a slow walk can be good for you if your pain is too great for anything else. What is important is that you keep moving. It can alleviate your pain, increase your mobility and release endorphins which make you feel better [17]. Learn more about why walking is good for sciatica.

Getting massage therapy to ease your sciatica pain

Getting a professional deep-tissue massage can help provide sciatica pain relief [18][19]. However, if you don’t have this option, no need to worry. You can simply ask a friend or a member of your household to apply these simple and effective massage techniques for sciatica pain relief.

In a pinch, you can even rub your own lower back, using a special massage belt or gun. If you don’t have any on hand, a smooth, rounded object, such as a tennis ball can work as well.

Applying heat or cold to reduce inflammation

A warm bath or a hot water bottle can feel great for an aching back and they can help your muscles relax. But an ice pack can also be effective in reducing inflammation and relieving your sciatica pain [20].

Just be careful to always have a protective layer between your skin and the hot/cold object you apply, as sciatica can sometimes alter your temperature sensitivity and you may get scalded or frostbitten without realising it.

Sleeping in the right position, on a supportive mattress

The most useful tips to help you sleep better with sciatica and wake up with lower pain are related to your sleeping position and the kind of surface you choose to nap on.

Sleeping on your back, with a pillow under your head and another under your knees is recommended in order to sleep better with sciatica. Science has shown that a medium-firm mattress is the best for keeping your spine supported and well-aligned [21].

Making lifestyle changes that can help your sciatica

There are several kinds of life changes you can make that can improve your sciatica. Here are some of the most effective:

Avoid wearing high heels and try comfortable shoes instead.
Avoid prolonged sitting or standing.
Use an ergonomic chair when you sit.
Don’t carry bulky objects in your back pockets when sitting.
Try a low-calorie diet if you are overweight [22].

What to do if swimming and home care do not relieve your sciatica

If you have had home care and exercise and do not see any signs that your sciatica is improving, it may be time to see a back and spine specialist. This is especially true if it has been longer than 6 weeks since the onset of your symptoms or if your sciatica pain is getting so bad you can’t walk anymore.

However, since there are such long waiting times for a specialist referral, there are times when the NHS can’t help you with your lower back pain. But if you are self-paying or privately ensured, our team of specialists can welcome you in the shortest time possible. They will use state-of-the-art diagnostic imaging tools to get to the root of your condition and recommend the best-personalised treatment. That may involve steroid injections (or other types of injections for back pain), physiotherapy, or back surgery using the most experienced surgeons and modern equipment.

So book an appointment with us now and take the first step towards curing your sciatica permanently.