Sciatica is a condition that can cause pain lower back and leg, tingling, and numbness in the legs. Physical therapy and exercise are often effective treatments for sciatica. Physical therapy may include exercises, stretches, mobilisation, manipulation and electrotherapy. Exercise can help improve flexibility and strength, and reduce pain. Medication also important part of treatment.

Why Physical Therapy and Exercise Need

The goals of physical therapy and exercise in treating sciatica are to relieve pain, improve function, and promote healing. Physical therapy may include exercises, stretches, and massage to help improve blood flow and reduce inflammation. Exercise may also include low-impact activities such as walking, biking, swimming, and elliptical training.

Some Techniques for treating sciatica with physical therapy and exercise

Extension and flexion back exercises

Extension and flexion back exercises can help to treat sciatica by stretching and strengthening the muscles in the back. These exercises can help to improve flexibility and range of motion in the spine, as well as alleviate pain and discomfort. Extension exercises involve stretching the spine backwards, while flexion exercises involve bending the spine forwards. Performing these exercises regularly can help to improve posture and reduce the risk of developing sciatica in the future.

The McKenzie Method (Mechanical diagnosis and therapy)

The McKenzie Method is a mechanical diagnosis and therapy to treat sciatica. The McKenzie Method is a treatment approach used by physical therapists to diagnose and treat patients with low back pain and/or sciatica. The McKenzie Method is a series of exercises designed to improve range of motion, strength, and endurance in the spine. The McKenzie Method is a conservative treatment approach that may help patients avoid surgery.

Read More: Sciatica During Pregnancy: How To Treat It Naturally.

Strengthening exercises

Sciatica is a condition that can cause pain, tingling, and numbness in the leg. Strengthening exercises may help to improve symptoms. These exercises work to improve the strength and endurance of the muscles around the sciatic nerve. This may help to reduce pressure on the nerve and improve symptoms. Some examples of strengthening exercises include squats, lunges, and bridges.

Functional retraining

Functional retraining is a treatment approach for sciatica that focuses on improving function and reducing pain. The goal of functional retraining is to help people return to their usual activities as soon as possible. Treatment may include exercises, stretches, and other interventions to help improve function and reduce pain.

Nerve glides (Nerve Mobilisation)

Nerve glides are a type of manual therapy used to treat sciatica. They are performed by mobilising the nerves in the affected area. This helps to improve blood flow and reduce inflammation. Glides can be performed with the hands or with tools like a roller or ball.

Joint Mobilisation

Joint mobilisation is a treatment for sciatica that involves manipulating the joints in the spine. This treatment is designed to relieve pressure on the sciatic nerve and improve blood flow to the area. Joint mobilisation is often performed in combination with other treatments, such as chiropractic manipulation or physical therapy.

Joint manipulation

Joint manipulation is a common treatment for sciatica. The goal of this treatment is to relieve pressure on the sciatic nerve by adjusting the position of the bones in the spine. This treatment may be performed by a chiropractor, physical therapist, or other healthcare professional.

Dry needling

Dry needling is a technique used by physical therapists and other healthcare professionals to treat musculoskeletal pain. The therapist inserts a thin, sterile needle into the muscle tissue. When the needle is inserted, the therapist may gently move it around or “walk” it up and down the length of the muscle. This stimulates the muscle and may help to relieve pain. Dry needling is often used to treat conditions such as sciatica, neck pain, and shoulder pain.

Read More: How Should I Sleep with Sciatica?

Muscle energy technique

The muscle energy technique is used to treat sciatica. The therapist uses their hands to apply pressure to the patient’s muscles. The therapist then asks the patient to contract their muscles for a short period of time. This technique is used to help release tension in the muscles and improve blood flow.

Myofascial release and soft tissue Mobilisation

Myofascial release is a type of massage that uses pressure and stretching to release tension in the fascia, the thin layer of connective tissue that surrounds muscles. This type of massage can help to relieve pain and stiffness, improve flexibility, and boost circulation. Soft tissue mobilisation is a similar technique that uses deep pressure and friction to loosen tight muscles and improve range of motion.

Gait training

Gait training is a physical therapy treatment for sciatica that aims to improve walking and reduce pain. The therapist will work with the patient to improve posture, strengthen muscles, and increase flexibility. This can help reduce stress on the sciatic nerve and improve symptoms.

Active assisted range of motion

Active assisted range of motion is a physical therapy treatment used to relieve pain and improve function in people with sciatica. During this treatment, the therapist helps the person move their joints through a range of motion. This helps to increase blood flow and reduce inflammation in the area. It also helps to improve flexibility and range of motion.

Lastly, if you are suffering from sciatica, there are many treatment options to help you get relief. Physical therapy and exercise may be the best option for you. Talk to your doctor about what treatments may work best for you.

References

  • 1.Pourahmadi MR, Taghipour M, Ebrahimi Takamjani I, Sanjari MA, Mohseni-Bandpei MA, Keshtkar AA. Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis. BMJ Open. 2016;6(9):e012426. Published 2016 Sep 27. doi:10.1136/bmjopen-2016-012426
  • 2.Slater J, Kolber MJ, Schellhase KC, et al. The Influence of Exercise on Perceived Pain and Disability in Patients With Lumbar Spinal Stenosis: A Systematic Review of Randomized Controlled Trials. Am J Lifestyle Med. 2015;10(2):136–147. Published 2015 Feb 16. doi:10.1177/1559827615571510
  • 3.Koes B. Moderate quality evidence that compared to advice to rest in bed, advice to remain active provides small improvements in pain and functional status in people with acute low back pain. Evidence-Based Medicine. 2010;15(6):171-172. doi:10.1136/ebm1132
  • Luijsterburg, Pim AJ, et al. “Physical therapy plus general practitioners’ care versus general practitioners’ care alone for sciatica: a randomised clinical trial with a 12-month follow-up.” European Spine Journal 17.4 (2008): 509-517.
  • Wheeler, A. H. “Diagnosis and management of low back pain and sciatica.” American family physician 52.5 (1995): 1333-41.
  • Valat, Jean-Pierre, et al. “Sciatica.” Best Practice & Research Clinical Rheumatology 24.2 (2010): 241-252.
Dr. M Shahadat Hossain
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Physiotherapist, Pain, Paralysis & Manipulative Therapy Specialist, Assistant Professor Dhaka College of Physiotherapy, Secretary-General(BPA), Secretary(CARD), Chief Consultant(ASPC), Conceptual Inventor(SDM), Faculty Member(CRP), Member-Bangladesh Rehabilitation Council

May 29, 2024

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