Suffering from Sciatica? Physical Therapy Can Help

by Sarah Clough | 18 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!

18 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.

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