How to treat sciatica: better rest or moderate activity?

By Cristiano Antonino On Dec 7, 2022

When one has sciatica, the question often arises as to whether absolute rest is better or whether, on the other hand, doing some movement and physical activity would be beneficial

Is walking with sciatica good or bad for you?

Sciatica, sciatica or lumbosciatica refers to a painful condition caused by inflammation and/or compression of the sciatic (ischiatic) nerve, the longest nerve in the human body that runs from the lower back down the buttock and the right (right sciatic nerve) and left (left sciatic nerve) hind thigh.

It is a problem, usually unilateral, originating from a variety of conditions (herniated disc, infection, spinal injury, vertebral slippage, pregnancy, etc.) and afflicting many people.

What is best to do when one has an episode of sciatica to facilitate its recovery: to stay at absolute rest or to walk?

The answer to this question is simply to listen to your body: if the pain experienced is very intense, with walking difficulties, it is best to rest at this stage.

If, on the other hand, the pain symptomatology is not so strong, moderate walking is useful to keep moving and strengthen the back muscles.

Activities to relieve sciatica

The first therapeutic approach against sciatica is pharmacological, with a therapy prescribed by the doctor that may include

anti-inflammatories (NSAIDs or, if the symptoms persist, steroids);
painkillers;
muscle relaxants (i.e. muscle relaxants).

Moderate physical activity can also help relieve painful symptoms.

Let’s see what types.

Which sports may be indicated

There is an old myth that sporting activity is not good for the back, but this depends on the type of sport and the pathology.

As far as sciatica is concerned, some sports activities such as running and weightlifting may be unsuitable, while others can help alleviate the pain symptoms.

Among these, for example, are:

walking-walk: allows you to stimulate blood circulation and muscles, without an excessive impact on the musculoskeletal system. To walk well it is important to land first with the heel and not on the toes, and then unroll the whole foot towards the front of the toes;
yoga and/or pilates: bodyweight sports such as yoga and pilates allow you to strengthen and stretch your muscles and spine;
bicycle: if cycling is an activity that tends to stress the sciatic nerve, moderate pedaling can help strengthen the muscles and improve the posture of the spine. In particular, pedaling represents a valid option for overweight subjects as it does not exert pressure on the vertebral discs and joints;
swimming: moderate activity in the water allows you to move in an unloaded position and without putting pressure on your back.

Postural gymnastics

For those suffering from sciatica, postural gymnastics can also be a valid therapeutic tool which, as the word itself indicates, acts on the posture, allowing a rebalancing at the musculoskeletal level.

A sedentary lifestyle in incorrect positions such as, for example, spending many hours in front of the computer with the neck stretched forward can cause back discomfort.

One of the causes of sciatica, in fact, is precisely an incorrect posture (postural sciatica) with excessive curvature in the lower back (lordotic posture) or in the upper part (kyphotic posture).

8 exercises for sciatica to do at home

To relieve the pain caused by the disease, some do-it-yourself exercises can be useful which, if your conditions allow it, can also be performed in series.

Exercise 1: lying on the floor on a mat, in supine position, bring the right knee to the chest with both hands, while the left leg remains stretched on the floor or with the knee bent. Hold the position for a few seconds and repeat the sequence with the opposite leg.

Exercise 2: in quadrupedia, close the abdomen, consequently arching the back towards the ceiling and vice versa, reopen and stretch the abdomen, thus arching the back towards the floor.

Exercise 3: supine with back on the ground and legs raised at 90°, use an elastic band or scarf to pull the toe of the right leg towards you, while the left leg is bent and resting on the ground. Repeat on the opposite side.

Exercise 4: Lie on your back and bring both knees to your chest, rocking left and right.

Exercise 5: sit on your heels, bring your forehead to the ground and stretch your arms forward, sliding on the mat.

Exercise 6: Lie face down on your stomach. Lift yourself up with your hands shoulder-width apart and maintain the plank position, perpendicular to the floor, with your back straight and buttocks and abdomen contracted.

Exercise 7: lying on the mat on your stomach, lift your pelvis upwards with your legs bent and your shoulders resting on the ground.

Exercise 8: supine on your stomach, stretch your arms on the floor. Bend both knees, bring them together and rotate them left and right towards the floor

What not to do with sciatica

The physiatrist concludes by indicating a series of activities and situations from which, however, if you suffer from sciatica it would be advisable to abstain:

abrupt movements and jerks;
intense sporting activity;
activities involving the lifting of weights and loads;
cold snaps and sudden changes in temperature;
emotional and/or particularly stressful situations that can further stimulate the nervous system.

What to do if sciatica does not go away

In the event that the painful symptomatology does not subside after a week or, on the contrary, tends to progress, it is advisable, even in this case, to consult your doctor.

Sciatica, in fact, is a condition of variable duration which, depending on the triggering cause, can be:

acute: if it occurs for a few days/weeks;
chronic: if it has persisted for more than 8 weeks.

Instead, it is necessary to go to the Emergency Department if the symptoms encountered are attributable to:

sudden, stabbing pain in the lower back and thigh;
pain in this area after an injury such as an accident;
you cannot control your bladder and/or bowel;
there is numbness and weakness in the leg and/or foot, which give way to weight.

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