Sciatica exercises are extremely important to the long-term
relief and management of disc-related sciatica. Although a
number of different exercises for sciatica are recommended
by various experts and non-experts alike, only a few are
actually appropriate during an acute, severely painful
sciatica episode, and some of the most commonly-suggested
sciatica exercises may actually make things worse when used
during times of acute pain.
For example, while commonly recommended to people with
sciatica, exercises such as hamstring stretches and the
yoga position, "downward facing dog" can be beneficial as
part of managing one's condition once the pain is reduced,
these exercises can place tension on the sciatic nerve and
aggravate an already inflamed and sensitive condition. In
general, any exercise that causes pain to increase in the
leg and/or extend further down the leg should be completely
avoided during the acute phase of sciatica.
To alleviate sciatica pain during the acute phase, the
McKenzie exercises are among the safest and most effective
treatment options available (even more effective than
medication and even injections in many cases). Though
often associated with spinal extension and mistakenly
called the "McKenzie Extension Exercises", McKenzie method
may involve any number of spinal positions/movements. The
whole point of the McKenzie method is to evaluate different
positions/exercises to find what best produces
"centralization" of symptoms.
"Centralization" is a term used by McKenzie practitioners
that means that symptoms move out of the areas furthest
from the spine. For example, if you had sciatica that went
all the way to the foot, centralization would be if the
symptoms left the foot and perhaps only went as far down as
the knee. Or, if sciatica symptoms started out going as
far as the knee, centralization would be if the symptoms
left the thigh and only went as far as the hip area.
Any exercise/position that produces centralization is
considered beneficial, even if the symptoms increase in the
areas closer to the spine. For example, if you had
sciatica and low back pain and tried one of of the McKenzie
exercises and the sciatica completely went away but the
back pain got worse, the exercise would still be considered
beneficial and it would be recommended to continue using
it. In the long run, a sciatica exercise that produces
centralization will usually eventually result in
improvement in all symptoms, even if more central (closer
to the spine) symptoms get worse at first.
The simplest of the McKenzie exercises for alleviating
sciatica is done by simply lying on one's stomach on the
floor or a firm surface and propping one's chest up on the
elbows. This places the lower spine in a gentle extension,
which can help relieve sciatica by pushing bulging spinal
discs forward, and away from the nerve roots that form the
sciatic nerve, reducing pressure and irritation. This
position can be maintained for several minutes at a time
when helpful, but I suggest using it for one to two minutes
at a time with at least a few minutes' break in between.
The frequent breaks prevent the low back muscles from
tightening up as much, and yet still allows for good
overall results. For more complex sciatica exercises,
getting detailed instructions either through an illustrated
guide or an experienced health care practitioner is advised.
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Dr. George Best has been treating sciatica patients since
1991. For a free e-book on sciatica exercises and a free
online video series on sciatica and the treatment options
for it, visit http://www.SciaticaSelfCare.com .
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