Suffering from Sciatica? Physical Therapy Can Help

by Sarah Clough | 39 Comments

Pain, numbness, and tingling down the leg is both something I treat daily and something I myself have experienced. Feeling concerned that these symptoms are here to stay and there is little you can do about these symptoms is common. Fortunately, physical therapy can be very effective in treating these symptoms most of the time. I am pain free and many of you suffering with sciatica-type symptoms can be too.

What Is Sciatica?

What Does a Physical Therapist Do to Help Sciatica SymptomsSciatica is the symptom of pain down the leg that people may experience because of a low back  problem. The sciatic nerve starts at the low back and goes down the buttock and branches out through the back of the leg to the foot. Many reasons exist as to why the sciatic nerve may be symptomatic. Common problems resulting in sciatica may include a herniated disc, stenosis or narrowing of the nerve space, tightness in the hip, or misalignment of the pelvis. Sciatica symptoms may include pain, numbness, tingling, cramping, burning, and weakness in the muscles of the involved leg.

What Does a Physical Therapist Do to Help Sciatica Symptoms?

Physical therapists have many techniques/forms of treatment that may help. Treatment may include McKenzie-based mechanical diagnosis and therapy, muscle energy techniques, mobilizations, spinal stabilization and core strengthening exercises, nerve slides/glides, or traction. Often people will respond to moving in a certain direction. Some people with sciatica feel better with exercises moving in a backwards bending position, some in a bending forward position. Occasionally exercising in a neutral spine position is necessary. Sometimes we have a patient who responds best to rotating or shifting the hips sideways. The best therapy treatment for someone with sciatica varies greatly from person to person secondary to the many reasons the sciatica may be present. As a therapist, I cannot take a diagnosis of sciatica and know which exercises or manual therapy to provide someone immediately. I have to perform an evaluation to see how each individual will best respond to which treatment method. All patients are unique with their pain and presentation and each treatment should address each patient’s specific needs.

What Should You Do if You Have Sciatica Symptoms?

  • See a physical therapist to determine which exercises or manual therapies are best for your specific pain. All of our facilities perform complimentary injury screenings. Therefore, if someone needs to see a therapist to determine specifically what needs to be done for his or her pain, you can see a PT or athletic trainer free of cost for a half an hour. The therapist or athletic trainer can help guide or make suggestions for future care. The earlier you get into therapy, the better the outcome may be. Research recommends seeing a physical therapist within 16 days of onset to optimize outcomes.
  • Read “Treat Your Own Back Book” written by Robin McKenzie. All of our Athletico facilities either have the book in stock or can order this book for you. If you would like to see a therapist in your area who is McKenzie-certified or trained, please let me know which city you live in and I can help find a clinician that will best fit your needs.
  • Watch your posture. Use a lumbar support when you sit and perform bending activities at the hips instead of at the low back.
  • Keep moving. Many people with sciatica symptoms put themselves on bed rest or think sitting in the lazy boy chair to rest is beneficial. Often the opposite is true.

Sciatica Success Story

One of my favorite memories of treating a patient was from one who was suffering from sciatica and low back pain. She had pain for 15 years prior to attending therapy. We were quickly able to find an exercise in a direction that relieved her symptoms. In just a few treatment sessions she was pain free, something she had not 100% experienced for so many years. She bought me the EASY button from Staples that would say “That Was Easy” when you pushed it. Not all cases are “easy” to crack in the case of sciatica, but in most cases there is a solution! Share your sciatica success stories below!

39 Comments

  1. Steve Lockhart

    Hi Sarah, there is a great deal of happiness which comes with treating sufferers of sciatica. Physical therapy is a fantastic treatment and one I highly recommend. Great work.

  2. Erica

    I went to the physical therapist and they really helped me. They made some trigger point treatment on the piriforme muscle. Really painful but it helps.

  3. Al Hirschfield

    My wife has had a sciatic hip problem which has been reduced from physical therapy need those services near bonita springs florida

  4. Al Hirschfield

    Need a physical therapist for ciatitic problem for my 71 yr old wife near bonita springs Florida

  5. Sarah Clough

    Hi Al! I am going to send you an email now with a recommendation for a PT in Bonita Springs. If you don’t receive it, please let me know!

    Thank you!

  6. Lori Wills

    I’m recovering from second bout of sciatica. I now just have a “knot” in my back/hip area where the pain first started. My doctor advised physical therapy and indicated aquatic. Is this a good therapy for sciatica?

  7. Alfred Cucchiara

    I am a 66 year old American getting my doctorate in the Philippines. I was the natural body building champion for over 50 in 2005. I have had sciatca issues for years. The x rays showed anterior listing of L4 in relation to L5 with decrease in L4L5 joint space. Leftward deviation of lumbar spine and line of weight bearing falls anterior to the sacral promontory. Can you give me any advice for sleeping position to lessen this condition and any exercises that might help stabilize the spine?

  8. Sarah Clough

    Hi Lori!

    Aquatic therapy can definately be a good form of therapy for back/hip pain. Now that the sciatica has resolved and the pain has centralized to the one spot, its a great time to get stronger in the leg and core muscles. Aquatic therapy is a great way to loosen up that “knot” and get stronger, while also reducing pressure on the spine. I am glad to hear you are getting better!

    Thanks for the question!

  9. Md. Tabish khan

    Alfred Cucchiara sir, i am an aspiring bodybuilder too preparing for the third show of my life. The back pain which i was thinking to be be post deadlift soreness was diagnosed as sciatica. squats , deadlifts, bent over rows are out of theschedule. Can you recommend any other specific exercises to avoid. thanks.

  10. Sarah Clough

    Hi Alfred!

    Thank you for your questions! I have sent you an email with exercises that will help to stabilize the spine. As I mention in the email, these exercises may seem easy compared to traditional body building strength training, but target smaller muscles that lay beneath the larger 6-pack muscles and obliques. These deeper muscles directly attach to the spine and often need to be retrained after having back pain. I hope they help! I also provided a few sleeping positions for you in the email. I always tell patients that I am okay with them sleeping in whichever position obtains relief. Sometimes that is on the stomach, sometimes on the stomach with one leg bent up, sometimes on the back, sometimes on the side. Pillows between the knees or under the knees can help too. Hope the email helps! Let me know if the pictures don’t come through in the email!

    Thank you!

  11. Sarah Clough

    Md. Tabish Kahn:

    Thank you for your question! Those exercises you mentioned are the ones that I would back off on as well, as you are recovering. I would let pain be your guide. If an exercise hurts, back off on weight, repetition, or find a different spinal position to target the same muscles. If bending over increases your pain, then exercises that put you into that position ex) sit ups or bent over bicycling may need to be avoided for a time. Ideally the pain will get better and then those positions can be resumed. It is important during this time to always use good lifting mechanics and body positions and to work on your core muscles, so that you can contract the transverse abdominis when lifting to help stabilize/support your spine. If you would like me to email the exercises that I sent to Alfred to you, please let me know! Hope you feel better soon and good luck in your competition!

  12. Mike

    Hi,

    I’ve been dealing with sciatica for almost a year now. I spent a couple months getting chiropractic adjustments, stretching, icing regularly, and resting, which helped to an extent, but it just wasn’t doing the trick. I then spent a couple months (October-December) with a specialist who provided all sorts of therapy, from McKenzie extensions to acupuncture to breathing exercises to chiropractic adjustments. We did very intense McKenzie extensions for a short period to “push the bulging disc” into place, which was supposed to put me through excruciating pain for a short while but would ultimately fix me very quickly. It didn’t. I went through a good six weeks of intense pain which sort of subsided with a lot of rest and some anti-inflammatories (curcumin). At the end of December, I received an MRI to confirm that I did have a bulging disc (L3-L4), and I then received an epidural injection which relieved some pain.

    Bitter about the treatment I’d received and the money I’d wasted, I spent the next few months resting and exercising lightly (lot of core exercises). I went to another physiotherapist about a month and a half ago who determined that my body was not fixing itself because all my muscles are not working properly/are imbalanced. She loosened up my back with some massages and gave me some exercises to reactivate my glutes and hip flexors. Everything that she said seems to make sense, and I am working on the exercises, but I feel like I’ve come to a roadblock. Would you have any insight as to what I could do?

  13. Sarah Clough

    Hi Mike!

    I am sorry to hear you have been having this pain for so long. Prolonged pain can be very frustrating, especially when you have done so much to actively get rid of it. It is difficult for me to know exactly what to recommend for you personally without performing an evaluation with you in person. However, here are a few thoughts based on what you have told me:

    ~The McKenzie method is more than just extension exercises. It is a thought process of how to address pain with exercises that work to relieve pain. Sometimes pain will increase a bit in the middle of the back if leg pain is improving, but I would not want a patient to push through pain that was excruciating that leads to 6 weeks of intense pain. If pain was increasing in the leg with extension exercises, then I would investigate other directions of movement ex) moving sideways or combining sideways movements with extension. Exercises that are appropriate would not increase pain down the leg, but ideally lessen the pain in the leg and centralize more to the back.
    Therefore, I may recommend working with a McKenzie credentialed clinician to assist in thinking through this process with you. The therapist would have the credentials Cert. MDT.

    ~The core stabilization exercises that your therapist is having you do are beneficial, as research shows that these muscles shut down or don’t work as well after having a back problem. These exercises may also assist in supporting your spine with activities such as lifting in future situations. In addition, if this therapist took you through a McKenzie based assessment during your evaluation (investigated repetitive bending forwards, backwards, sideways, combined movements) and did not find a direction that helped relieve the pain, then this therapist may have decided that core stabilization was the next best thing which is appropriate. Remember that core stabilization may take 6-8 weeks to increase muscle strength.

    ~I highly encourage my patients to read the “Treat Your Own Back Book” written by Robin McKenzie. 100% of my patients report this book as being beneficial in their understanding of their disc problem and what to do about it.

    If you have any other questions please feel free to ask. I truly hope you feel better soon!

    Thank you for your post!

  14. Meera

    Hi,
    I m suffering from sciatica due to l4-l5 disc bulge . I have lot of pain while standing or walking. I went to a phy therapist for few months sand it didn’t resolve. She sent me back saying I need some intervention like cortisone injections of surgery. Could you suggest a good therapist in vernon hills, il who can help me? Thanks.

  15. Sarah Clough

    Hi Meera!

    I would recommend seeing Monika J. at our Vernon Hills location.
    Phone: 847-573-0051
    Address: 555 E Townline Dr. Suite: 24
    Vernon Hills, IL 60061

    Hope you feel better soon!!

  16. Sarah Clough

    Hi Meera!

    I would recommend seeing Monika J. at our Vernon Hills location.
    Phone: 847-573-0051
    Address: 555 E. Townline Dr. Suite 24
    Vernon Hills, IL 60061

    Hope you feel better soon!!

  17. Vicki

    Hi! Im sure that I am having sciatica pain in my right hip, but can’t decide which thing caused it…….. There are many. My pain goes away when i’m up and walking. Sitting and lying too many hrs increase the pain ALOT! Also do you know any good specialists for sciatica in the knoxville tn location? Any help would be very much appreciated!

  18. Arlene

    I have had the pain from sciatica for close to a year, the pain only comes when I sit up, it’s very bad only after a few minutes, so I spend my days lying on my bed with my legs on a wedge pillow. No pain when I walk or lay, only when I sir straight. When my husband and I go out I lay flat in the back seat of the car. I have been to a chiropractor for several months but it did not help. Do you have any advice. I am 81 years young lady and just lost 57 pounds in 2 years. I am also a liver transplant receipent 19 years.do you have the name of a physical therapist in the San Francisco area. Thank you in advance for any help or advice.

  19. Sarah Clough

    Vicki and Arlene:

    Thank you for your posts. I reached out to the company for both of you to find a recommended PT in your area. Here are some therapists that came highly recommended:

    Knoxville: Marino Physical Therapy in Knoxville

    San Francisco: Chris Daprato at UCSF and Presido Sports Medicine in San Francisco

    For both of you, I would recommend being seen by a PT in person versus me giving advice over the internet. A good in person evaluation is extremely valuable to a good prognosis!

    Hope this helps!

    Thank you!
    ~Sarah

  20. Chrissy

    Hi There,

    I would love to find a few suggestions for a McKenzie certified therapist in the St. Louis or surrounding area. Thank you!

  21. Patty Thomas

    I have been suffering from issues at L4L5 for two years. Originally diagnosed as MS but later determined to be irritation at L4L5 nerve and SI joint problems. I live in a small town..Luray Va 22835… and it is hard to find a good PT. Any suggestions ? thanks!

  22. diya

    Hello. I am not sure if I have sciatica or not but for a month I held a forward bending yoga postures for too long, say 10 mins continuously. After that I felt a slight tingling in front of my left thigh only when I am in that pose (forward bend in butterfly yoga pose in which you sit straight with hips abducted ,knees bent, ankles touching each other). Since then the pain kept increasing and then it affected my entire left leg, back and front, including foot. whenever I sit or lie down or stand I feel pain. In short, I am stable then I feel tingling needle pain. And now it has started in both legs. What should I do? Please suggest some aqua exercise also

  23. Sarah Clough

    Patty and Camila:

    Thank you for your posts and for reading the blog! I am emailing each of you individually with a recommendation for a therapist in your area.

    Thank you!

  24. Sarah Clough

    Hi Diya!

    It definitely sounds like you are having some nerve irritation going down the leg(s). My recommendation would be to get in to see a PT as soon as possible, as the sooner you address the issue, the more likely you are to recover quickly. First, do you live in the area? We now have clinics in 8 states. If so, I would recommend you take advantage of our complimentary injury screen. The therapist or athletic trainer can then do a quick screen to see what exercises or course of action would be best for you next, including the aqua exercises you requested. The clinician may recommend you see a physician, do a course of physical therapy, and or continue with a certain set of exercises. Please let me know if you would like a recommendation of a clinic close to you. There are many things that may be causing your symptoms and it is best to be checked out personally, as treatment will be different for each individual. Thank you and I hope you feel better soon!

  25. rettie

    Do you have a clinc in Oregon by any chance. Me and my hubby.has issues with sciatica. I can deal with mine. My L-1-L5 has effected me. I can. Just move wrong and shoot pain down my leg it could last hrs or weeks.
    Hubby can hardly walk because of the paim in his butt down his back and front legs. I tried to tell him he needs to move them. But he says it hurts too much.
    Lost in Oregon Coast

  26. Angie Padilla

    Hi Sarah!

    I’ve been suffering from sciatic since December. I am an avid runner, but have not been able to run in more than 2 months now. At first I thought my hamstring was extremely tight, but was told that my sciatic nerve is irritated. It has gotten to the point that about 10 minutes in to a run my leg gets so tight that I am not able to extend it. The discomfort/tightness begins behind the inner part of my knee and within minutes my entire leg begins to get pretty tense. What types of exercises would I be best going to as a substitute for running? Also, what strength training and stretching exercises are best for this?

    Thank you for sharing with us! :)

  27. Sarah Clough

    Hi Angie!

    Taking into consideration your pain and inability to run for 2 months now, I would definitely recommend getting into see a physical therapist. Athletico offers complimentary injury screens and can set you up with one of our running specialists. We also do video gait analysis for runners, assessing the run via video to best understand where the running may need to be addressed with flexibility and strengthening issues. If you need a recommendation for a running specialist, please let me know. If you are in a state that Athletico is currently not present in, I can also ask around for a good recommendation for you in your area. Please let me know if you are interested in getting information about a good therapist for your needs.

    Running in a pool or riding a bike in the mean time may be more tolerable. When you run, the sciatic nerve is placed on stretch and can be agitated. Left untreated, however, that nerve may bother you for a while. Nerves heal slowly. Every pain and reason for pain is different so finding out what is best for your specific needs from an in-person evaluation would be best. You may benefit from nerve sliding exercises, or it may be too early for those. Sometimes we need to stretch the nerves and other times it is best to keep it in a shortened position. There is a lot to take into consideration.

    I definitely recommend you get this treated so you can get back to your running! Let me know if you want that recommendation and I can send you a private message to get your location details.

    Thanks for the post!!

  28. Sarah Clough

    Hi Steve! I am going to send you the name of a clinician to your email. Thanks!

  29. therese

    I have a herniated disc pressing on the nerve, i have tingling and numbness to the point i think my leg is going to give out on me. So walking is out of the question for now. I do strectch but tingling and a burning sensation continues. Going for a steroid shot, hoping that will help. been to the Athletico on Michigan, in Chicago.

  30. Daman

    First of all I would like to tell you my
    symptoms as last year I started pain in my low back ,right leg,. I went to
    see Dr he prescribed me Meloxicam .It did not help me than he sent me to
    spine specialist .He ordered MRI and I got bulging disk at L5-S1 with
    annular tear.Spine specialist send me to physiotherapist and within two
    month pain gone almost. From December last year till February I lived
    without pain. This year in March pain started again.My Physiotherapist
    started doing accupuncture but did not help much even pain exceeded till my
    ankle.I went to Neurosurgeon he ordered other MRI .It showed one more
    bulging disc at L4-L5 and L5-S1 Disc DESSICATION with annular tear and
    S2nerve root involvement.He prescribed me Methylprednisone 4mg which helped
    me alot .My pain has gone again .I am doing physio exsercises at home and
    walking daily 2 miles.I go to Chiropractor 3 times in a week.My weight is
    140 lb and i am 5’3” tall. My neurosurgeon suggested me to go for surgery
    Laminoectomy / disectomy and fuse the vertebrae l5-s1 .
    Presently my pain is at 0 .My neurosurgeon said that eventually pain will
    come back. I appreciate you kind advice.
    Thanks

  31. Sarah Clough

    Hi Daman!

    I’m so glad your treatment has helped your pain! I would ask your neurosurgeon if surgery is necessary right now and why. For instance, what does the doctor anticipate happening if you do not have surgery right now? Can it wait until you have the pain again? Even then, if you have the pain, is it okay to follow up with the non-surgical route and see if you can obtain this pain free status again? As long as the doctor feels you are safe to not have surgery (usually the case) and you are satisfied with the treatment and relief you receive with each episode of pain, then its okay to not have surgery. However, sometimes the doctor may see something on imaging or in the exam that may lead them to feel surgery is the safest route. Is surgery indicated to help just with pain (which you don’t have at the moment), or is it to avoid further complications? I would ask some further questions such as these to help you make your decision. Also, a second opinion is sometimes helpful when it comes to surgery, providing peace of mind that your decision is what is best for you.

    Since I am unable to examine you personally, I recommend you follow up with your doctor to discuss further. I am so glad you feel good now though! Thanks for your question!

  32. Annie Wright

    Hello Sarah, this is my story. I clean houses part time, there is no heavy lifting of any kind,usually just vacuuming, dusting, cleaning bathrooms and doing laundry. There are numerous trips to the basements. I went to bed on Saturday night feeling fine. When I woke up Sunday morning,I could barely get out of bed. The pain I’m experiencing does not affect my leg. The pain I’m feeling starts on my lower back and radiates to my left hip. I am unable to walk without wincing, it hurts to stand up straight and I can not find a comfortable position to sleep in. Getting up and out of bed is a real work out. Does this sound like sciatica to you? I have had problems with sciatica before, but never like this. It always involved either my lower back, butt and either the front or back of my thigh and most of my lower leg. Thank you for any info you can give me.

  33. Alicia Chavez

    Hi can you recommend PT ‘s in Montebello CA area I have constant pain in my right buttocks with pain goiny down to the back of my legs. Please help :)

  34. Sarah Clough

    Hi Annie!

    Sorry you are in pain! This pain sounds like it could be your back or your hip. If it is groin pain that hurts when you walk it is probably hip related. In order to truly discover the source of your pain you would need to be evaluated. There are several ways your doctor or therapist can move your back and hip to help find the source of the problem. Do you have a doctor or therapist near you that you can go see? These types of pain can often be treated quickly if addressed early. If you are near an Athletico I would recommend going for a complimentary injury screen to see whats going on.

    Sorry, it is difficult to know what is going on or to give advice without truly looking at your back/hip. It could be a lot of differet thngs. Go get it checked out!

    Hope you feel better soon! ~Sarah

  35. Jaya

    Hi Sarah,

    I have the lower back pain since 2009 and used to get better with physio therapy. In January this year was chipping the ice from my drive when the pain started again. I visited a chiropractor in my area. It was getting better when my chiro moved to another location. I was taken over by another chiro. Meanwhile in May my school involved a lot of sitting to study. I started pain in my left leg as hamstring pull. I kept on visiting my chiro but it did not help with pain. I went back to my physio who tried spinal decompression but did not help much. My pain kept on increasing now with tingling in my left leg and pain in buttock and thigh. I switched to another chiro who wanted an MRI done. I am scheduled for MRI in couple of months time. The diagnosis from symptoms is L5S1 disc herniation however the spinal adjustments and inversion therapy has not helped with pain. In the last 3 months I have tried physio, 2 chiros and acupuncture. Nothing has helped. Now it seems my pain is getting to my right side as well. Is there anyway to get rid of this pain. I am on naproxen for the last 2 weeks.

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