Sciatica, also known as radiculopathy, is usually caused by compression of a spinal nerve secondary to a bulging/protruding disc in the spine causing irritation of the sciatic nerve. However there are other causes. Spinal stenosis (narrowing of the spinal canal), bone spurs, and even trauma can cause sciatica. In a few individuals, injury or tightness in the Piriformis muscle in the buttock region can irritate the sciatic nerve.

Physical therapy intervention usually starts with trying to identify the cause(s) of the pain. If a pain source can be determined then treatments are directed at trying to reduce nerve irritation/inflammation, stretching tight muscles/connective tissue, strengthening weakened leg or trunk muscles, and addressing any postural deviations or habits that contribute to the pain. Most cases of sciatica improve in a few weeks. Longer lasting symptoms may require other treatments such as steroids or injections.

Individuals dealing with acute sciatica are encouraged to avoid prolonged sitting, to use ice or heat as needed, and maintain mobility by alternating between lying down and walking. Although there is no strong evidence supporting the use of heat or ice, some patients do report temporary relief. Ask your physician for a physical therapy referral and start getting relief from your sciatica!  
 

The exercises shown below can be effective for some individuals with sciatica. Consult with your physical therapist or physician before starting these exercises. 

 

Piriformis Stretch 

 

Start with painful leg crossed over uninvolved leg. Pull uninvolved leg toward chest as shown below. You will feel a stretch in your posterior hip and buttock. Hold position shown below for up to 30 seconds. Repeat 6-8 times per session. Try to do 2-3 sessions a day.

 

 

 

 

 Extension in Lying

 

Lay on your stomach and slowly push chest and shoulders away from floor while keeping your hips down. Start slowly because your extension range of motion may be limited at first. Try to push a little further with each repetition. Pause at the end point and return to start position. Do 10 repetitions 3-4 times per day.