Sciatica Exercises: What Does The NHS Recommend?

Sciatica treatment usually involves some kind of exercise. The NHS recommends regular, gentle exercise for sciatica [1] but this exercise can take many different forms.

Here, we’ll discuss which types of sciatica exercises the NHS recommends and provide some gentle exercises to get started. To ensure you’re doing the exercises that work best for you, we recommend seeing a physiotherapist, which is available on the NHS but can have long waiting lists [1].

If you’re struggling to access NHS physiotherapy due to long waiting lists, Harley Street Specialist Hospital has a leading private physiotherapy department that can provide a full assessment and tailored exercises for sciatica.

Table of Contents

Why does the NHS recommend sciatica exercises?
What are the principles of exercise for sciatica?
NHS-recommended exercises for sciatica pain
What are the alternatives to NHS exercises for sciatica?

Why does the NHS recommend sciatica exercises?

The NHS recommends exercise for sciatica because targeted exercises relieve sciatic pain better than daily activities or rest [2]. A short period of rest may be necessary when sciatica initially flares up, particularly if you find you can’t move with sudden, severe lower back pain or leg pain. If this is the case, you may need a short period of rest and painkillers, but you need to get moving again as soon as possible.

Targeted, prescribed exercise is different from just staying active because it is structured and repeated over a period of time to build strength, fitness and mobility progressively. Prescribed exercise from the NHS is usually given in the form of a leaflet or direction to an NHS website, physiotherapy sessions or group exercise classes.

Prescribed exercise can help sciatica by:

Mobilising your sciatic nerve

There are specific exercises to mobilise your sciatic nerve and stretch the surrounding muscles, which can often provide immediate relief for sciatica pain. Exercises that stretch the surrounding muscles and mobilise the nerve by pulling it back and forth are known as sciatic nerve flossing exercises. These exercises can improve the delivery of nutrients to your sciatic nerve [3] and improve flexibility, oxygenation and inflammation in the surrounding muscles, which can improve your symptoms.

Improving intervertebral disc health

Your intervertebral discs are the cushions that sit between the bones of your spine. They hold your vertebrae together, allow spinal movement and act as shock absorbers for your spine.

A normal, healthy disc swells with water, electrolytes and nutrients and squeezes them back out. During exercise, forces on your discs improve this process and make it more efficient, boosting the health of your discs and the delivery of nutrients to them [4].

Reducing muscle spasm

The muscles around your spine sometimes spasm in response to sciatic pain. This can create a pain-spasm-pain cycle, where pain causes spasm, and spasm causes pain [5]. Stretches can help to relieve both the pain and the muscle spasm, breaking the cycle.

Increasing muscle strength

Strengthening exercises for sciatica build strength in the muscles that support your spine. This provides more stability for your spine and can also reduce pain from muscle fatigue. Core stability exercises are better at reducing pain and increasing functional ability in people with lower back pain, which is a common symptom of sciatica [6].

Promoting healing

Exercise boosts blood flow (which supplies nutrients) to your spine’s nerves, muscles and other soft tissues. This increase in nutrient supply improves the healing process and can speed it up [7].

What are the principles of exercise for sciatica?

Before you start a new exercise programme for sciatica, we recommend consulting a healthcare professional. If your sciatica is so bad you can’t walk or you feel the pain level is unmanageable, speak to a doctor as soon as possible.

Even if your pain is milder, it’s vital to get the correct diagnosis for your pain before starting exercises. This will also help to rule out rare but serious problems that need urgent treatment, like cauda equina syndrome, infection, or tumours. Remember that for sciatica in pregnancy, you should avoid exercises lying on your back during the later stages of pregnancy.

Consult a physiotherapist

It can be challenging to get the correct form with sciatica exercises at first, which is why it’s essential that you learn the proper technique from a physiotherapist. Sometimes, even a tiny change in posture or position can make a big difference to the outcome of an exercise. To work well, these exercises must be done regularly and as prescribed.

Harley Street Specialist Hospital has a team of physiotherapists who specialise in treating sciatic pain through exercise. Book an appointment for a thorough assessment, diagnosis and exercise-based treatment programme today. Treatment can also include other modalities, such as massage techniques for sciatica, manual therapy and acupuncture for sciatica.

Be consistent

Sciatica exercises will only improve your symptoms if you do them consistently over a period of time, usually several weeks. Your physiotherapist will give you a graded programme of exercises and personalised goals to achieve within specific timeframes. If you do these as prescribed, within a few weeks you should see signs your sciatica is improving.

Watch your posture

Posture has a significant impact on the symptoms of sciatica, and you may need to modify certain activities while you’re recovering. These activities may be things that you usually don’t give a second thought to, like bending to pick up a laundry basket or twisting to put food in the oven.

Make sure to bend your knees to pick something up to avoid excessive pressure on your lower back. Be mindful when lifting and moving objects – splitting a large load into several smaller loads will help reduce pressure on your lower back and the risk of worsening your symptoms.

It’s best to avoid long periods of sitting or standing. Sitting puts pressure on the sciatic nerve, and standing for a long time could lead to muscle fatigue when you have sciatica.

A tip to help you sleep better with sciatica: placing a pillow between your knees when lying on your side can relieve pressure on your lower back and improve your symptoms. Try placing the pillow under your knees if you sleep on your back.

Stretch your hamstrings

Your hamstrings are the large group of muscles at the back of your thigh. Tight hamstrings put pressure on your lower back and can worsen or cause the conditions that lead to sciatica.

Most people with sciatica will benefit from regularly stretching their hamstrings. Over time, these stretches increase hamstring flexibility and reduce pressure on your sciatic nerve and lower back.

Build core strength

Your core muscles are made up of your back, pelvis and abdominal muscles. By doing regular core strengthening exercises, you build these muscles and benefit from better muscular support for your lower back. This can help you recover from flare-ups and prevent future episodes of sciatica.

Do aerobic exercise

Aerobic exercise increases blood flow and promotes healing – research shows aerobic exercise can speed wound healing by as much as 25% [8]. Aerobic exercise also releases endorphins, your body’s natural painkillers.

Simple activities like walking can provide all the benefits of aerobic exercise, and swimming is also good for sciatica. Your exercise of choice should be comfortable (or at least tolerable) and not worsen your symptoms.

Prevention is better than cure

So you’ve done your exercises and your symptoms have resolved – congratulations! If you can make these exercise principles a part of your life going forwards, you’ll greatly reduce the risk of sciatica flaring up again. Not only that, but you’ll also protect yourself from a host of other lower back conditions and cardiovascular diseases by staying active.

NHS-recommended exercises for sciatica pain

There are several conditions that can cause sciatica, including a herniated disc, piriformis syndrome, and spinal stenosis. Physiotherapists provide exercises tailored to treat the underlying cause of your sciatic pain.

The exercises prescribed vary depending on what underlying condition is causing your symptoms. They also vary per person – your usual activity level, age, daily activities, goals, and preferences will all play a role when a physiotherapist decides on the best exercises for your symptoms.

Herniated disc

90% of sciatica cases are caused by a herniated disc [9]. A herniated disc is when one of your spinal discs moves out of place, which can put pressure on the sciatic nerve and cause symptoms like shooting pains in your legs.

Exercises for a herniated disc focus on core strengthening exercises to build support for your lower back. A physiotherapist may use specific spinal exercise methods that can improve the symptoms of a herniated disc, such as the McKenzie method [10]. In this method, you perform targeted, repetitive movements that encourage leg pain from sciatica to travel back towards the spine so it can resolve.

These exercises may help you get sciatica relief in less than 8 minutes per day. Here are the NHS exercises for sciatica caused by a herniated disc:

Isthmic spondylolisthesis

This condition is where one of your spinal bones (vertebrae) slips forward on the vertebra below. It’s caused by a fracture of the part of your bone that connects your spinal joints together (the pars interarticularis).

Exercises for isthmic spondylolisthesis focus on strengthening your lower back muscles. This improves your spinal support and can help prevent your vertebrae from slipping forwards.

Piriformis syndrome

Your piriformis is a muscle in your buttock region that sits close to the sciatic nerve. If this muscle spasms, it can cause buttock pain and irritate your sciatic nerve – this is known as piriformis syndrome.

Exercises for piriformis syndrome focus on stretching and strengthening the piriformis and surrounding muscles that can also be affected. Your symptoms are likely to resolve completely within 1-3 weeks if you have a correct diagnosis of piriformis syndrome and do the targeted exercises correctly [11].

Here are some NHS exercises for sciatica caused by piriformis syndrome:

Spinal stenosis

Spinal stenosis causes spinal canal narrowing, which puts pressure on the spinal cord and leads to trapped nerves within it. This includes the sciatic nerve, so it can cause symptoms of sciatica.

Exercises for spinal stenosis focus on strengthening your core muscles through forward-bending postures and improving the stiffness of your back and hip muscles through flexibility exercises. Here are some NHS exercises for spinal stenosis:

Degenerative disc disease

Your spinal discs degenerate as you get older, causing spinal instability. This can cause symptoms of sciatica if your sciatic nerve becomes compressed.

Exercises for degenerative disc disease focus on strengthening your back and core muscles to improve stability in your spine. Here are some NHS exercises for degenerative disc disease:

What are the alternatives to NHS exercises for sciatica?

If you’re struggling to access physiotherapy on the NHS to get started with your exercises, book an appointment with Harley Street Specialist Hospital’s private physiotherapy department. Our expert physiotherapists can assess, diagnose and treat symptoms of sciatica and provide tailored exercises to cure your sciatica permanently.

If you’ve tried physiotherapy and exercises and your symptoms haven’t resolved, we can help. With a full diagnostic imaging suite and a highly specialised pain management unit, we can diagnose your symptoms and provide rapid treatment.