Important Exercise for Sciatica - Copy

8/12/2019 Important Exercise for Sciatica - Copy

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Important exercise for sciatica

Exercise for sciatica resulting from slip disc, piriformis syndrome, spinal

stenosis, degenerative disc disease, spondylolisthesis, sacroiliac joint dysfunctionetc.

Although sciatica is a relatively common form of low back pain and leg pain, the true

meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than

a diagnosis for what is irritating the root of the nerve, causing the pain. This point is

important, because exercise for sciatica or treatment for sciatica will often be

different, depending upon the underlying cause of the symptoms.

Sciatica is a general term that refers to pain caused by compression or irritation of one

or more nerves exiting the lower spine that make up the sciatic nerve. There are a

number of different conditions that can cause sciatica pain. The medical term forsciatica is a radiculopathy, which means that a spinal disc has extended beyond its

normal position and is irritating the radicular nerve (nerve root) in the lower back,

which connects with the sciatic nerve. The sciatic nerve branches off as it travels

down the lower extremity through the back of the leg. Sciatic pain can be experienced

along this nerve route.

Causes for Sciatica

Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or sacral

nerves S1, S2 or S3, or by compression of the sciatic nerve itself. When sciatica is

caused by compression of a dorsal nerve root it is considered a lumbar radiculopathy

(or radiculitis when accompanied with an inflammatory response) from a spinal disc

bulge or spinal disc herniation (a herniated intervertebral disc in the spine), or from

roughening, enlarging, and/or misaligning of the vertebrae (spondylolisthesis), or

degenerated discs. The intervertebral discs consist of an annulus fibrosus which forms

a ring surrounding the inner nucleus pulposus. When there is a tear in the annulus

fibrosis, the nucleus pulposus (pulp) may protrude through and push against spinalnerves within the spinal cord or those exiting, causing numbness or excruciating pain.

Sciatica due to compression of a nerve root is one of the most common forms of

radiculopathy.

Pseudosciaticaor non-discogenic sciatica, which causes symptoms similar to spinal

nerve root compression, is most often referred pain from damage to facet joints in the

lower back and is felt as pain in the lower back and posterior upper legs.

Pseudosciatic pain can also be caused by compression of peripheral sections of the

nerve, usually from soft tissue tension in the piriformis or related muscles (piriformissyndrome and see below).


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Spinal Disc Herniation

One of the possible causes of sciatica is a spinal disc herniation pressing on one of the

sciatic nerve roots. The discs separate the vertebrae,thereby allowing room for the

nerve roots to properly exit through the spaces between the L4, L5 and sacral

vertebrae. The discs cushion the spine from compressive forces, but are weak to

pressure applied during rotational movements. That is why a person who bends to one

side,at a bad angle to pick something up, may more likely herniate a spinal disc than a

person jumping from a ladder and landing on his or her feet.

Herniation of a disc occurs when the liquid center of the disc bulges outwards, tearing

the external ring of fibers, extrudes into the spinal canal, and compresses a nerve root

against the lamina or pedicle of a vertebra, thus causing sciatica. This extruded liquidfrom the nucleus pulposus may cause inflammation and swelling of surrounding

tissue which may cause further compression of the nerve root in the confined space in

the spinal canal. Sciatica caused by pressure from a disc herniation and swelling of

surrounding tissue canspontaneously subside if the tear in the disc heals and pulposis

extrusion and inflammation cease. Sciatica can be caused by tumours impinging onthe spinal cord or the nerve roots. Severe back pain extending to the hips and feet, loss

of bladder or bowel control, or muscleweakness, may result from spinal tumours.

Trauma to the spine, such as from a car accident,may also lead to sciatica.

EXERCISE FOR SCIATICA FOR ACUTE OR SUBACUTE SLIP DISC

Exercise does not help acute back pain. In fact, overexertion may cause furtherharm. CONTROLLED REST- is recommended

MODALITIES TO REDUCE PAIN AND SPASM- cryotherapy, tens,ultrasound therapy, moist heat etc.

Back extension exercise for sciatica can be started. An incremental aerobic exercise program (such as walking, stationary biking,and swimming) may begin within 2 weeks of symptoms. Jogging is usually

not recommended, at least not until the pain is gone and muscles are stronger.

Beginning after 4 - 8 weeks of pain, however, a rehabilitation program may

benefit the patient.

Patients should avoid exercises that put the lower back under pressure until theback muscles are well toned. Such exercises include leg lifts done in a

facedown position, straight leg sit-ups, and leg curls using exercise equipment.


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EXERCISE FOR SCIATICA FOR CHRONIC SLIP DISC

Exercise for sciatica plays a very beneficial role in chronic back pain.Repetition is the key to increasing flexibility, building endurance, and

strengthening the specific muscles needed to support and neutralize the spine.

Exercises called lumbar extension strength training are proving to be effective.Generally, these exercises attempt to strengthen the abdomen, improve lower

back mobility, strength, and endurance, and enhance flexibility in the hip, the

hamstring muscles, and the tendons at the back of the thigh.

Pelvic Tilt. The pelvic tilt alleviates tight or fatigued lower back muscles. Lieon the back with the knees bent and feet flat on the floor. Tighten the buttocks

and abdomen so that they tip up slightly. Press the lower back to the floor,

hold for one second, and then relax. Be sure to breathe evenly.

Spine Stabilization and Strength Training. Low Impact Aerobic Exercises. Low-impact aerobic exercises, such as

swimming, bicycling, and walking can strengthen muscles in the abdomen and

back without over-straining the back. Programs that use strengtheningexercises while swimming may be a particularly beneficial approach for many

patients with back pain.

Flexibility Exercises. Flexibility exercises may help reduce pain. A stretchingprogram may work best when combined with strengthening exercises.

Piriformis syndrome

In 15% of the population, the sciatic nerve runs through the piriformis muscle rather

than beneath it. When the muscle shortens or spasms due to trauma or overuse, it can

compress or strangle the sciatic nerve beneath the muscle. Conditions of this type are

generally referred to as entrapment neuropathies; in the particular case of sciatica and

the piriformis muscle, this condition is known as piriformis syndrome. It has

colloquially been referred to as "wallet sciatica"since a wallet carried in a rear hip

pocket will compress the muscles of the buttocks and sciatic nerve when the bearer

sits down. Piriformis syndrome may be a cause of sciatica when the nerve root is

normal.

EXERCISE FOR SCIATICA FOR PIRIFORMIS SYNDROME

Treatment begins with rest, ice, compression, elevation and referral to theappropriate medical professional.

Stretching the piriformis can be used in both treatment and prevention ofpiriformis syndrome. One stretch involves sitting with one leg straight in front

of the body and holding the ankle of the opposite leg and pulling it to your

chest. An additional stretch involves laying face down with one leg bent under

your stomach. Once in this position, lean toward the ground for the stretch.This second stretch is known as the piriformis stretch.


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folding arms across chest, flattening the back by tightening lower abs, then

raising the head and shoulders from the floor. Hold for two to four seconds,

then slowly lower to starting position. As strength builds, aim to complete two

sets of ten curls.

These exercise for sciatica alone will not necessarily make the patient with sciatica

from spinal stenosis better, but they will allow the patient to more easily hold a

posterior pelvic tilt during activities, especially standing and walking. This posture

will allow the patient to perform more activities with less pain. The pelvic tilt is often

very difficult for patients to learn and can take a good deal of practice with the

guidance of a physical therapist before it is used effectively to treat sciatica resulting

from spinal stenosis.Degenerative Disc Disease

Disc degeneration is a natural part of aging and over time all people will exhibit

changes in their discs consistent with a greater or lesser degree of degeneration.However, not all people will develop symptoms. In fact, degenerative disc disease is

quite variable in its nature and severity. With symptomatic degenerative disc disease,

chronic low back pain sometimes radiates to the hips, or there is pain in the buttocks

or thighs while walking; sporadic tingling or weakness through the knees may also be

evident. Similar pain may be felt or may increase while sitting, bending, lifting, and

twisting. Chronic neck pain can also be caused in the upper spine, with pain radiating

to the shoulders, arms and hands. Neck pain may cause interrupted blood supply to

the brain resulting in headaches, vertigo and worsened cognitive abilities and

memory.

Exercise for Sciatica for Degenerative Disc Disease

A well-rounded rehabilitation program assists in calming pain and inflammation,

improving your mobility and strength, and helping you do your daily activities with

greater ease and ability.

Regular exercise for sciatica is the most basic way to combat back problems. Considerit part of long-term health management and risk reduction program. Exercise for

sciatica focus on improving strength and coordination of the low back and abdominal

muscles. The emphasis of therapy is to help you learn to take care of your back

through safe exercise for sciatica and self care when symptoms flare up. Therapy

sessions may be scheduled two to three times each week for up to six weeks.

The goals of physical therapy:

learn ways to manage condition and control symptoms maintain appropriate activity levels


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learn correct posture and body movements to reduce back strain maximize your flexibility and strength

Therapeutic Exercise for sciatica:

In some patients, the pain response may limit flexibility. Prescribed stretchingexercises can improve flexibility of the trunk muscles. Flexion exercises may

help to widen the intervertebral foramen. The intervertebral (between the

vertebrae) foramen are small canals through which the nerve roots exit the

spinal cord. The intervertebral foramen are located on the left and right sides

of the spinal column.

Extension exercises, such as the McKenzie Method, focuses on the musclesand ligaments. These exercise for sciatica help maintain the spines natural

lordotic curve, important to good posture.

Aerobics (no/low impact) offers many benefits including improved muscularendurance, coordination, strength, strong abdominal muscles, and weight loss.

Strong abdominal muscles work like a brace (or corset) to reduce the loads tothe lumbar spine. It is also known that aerobics help to combat anxiety and

depression. The loads on the discs during walking are only slightly greater

than when lying down. Walking, bicycling, and swimming are forms of

aerobic exercise a physician may suggest.

Hamstring stretchingSpondylolisthesis

Spondylolisthesis is a condition in which the affected vertebra slips on the adjacent

vertebra below it. It is very commonly seen at L5 and S1 vertebra level. Patient

complains of low backache, which is worst after some activity and is relieved by rest.

The pain may radiate down to one or both legs.

Exercise for Sciatica for Spondylolisthesis

Some heat modality like SWD(Short wave diatheramy) is given for pain relief. Exercises to induce relaxation are given. Strong abdominal exercises are given for abdominal muscles. Flexion exercises for the spine, for example: sitting on a chair with backresting, then gradually bending the trunk forward from the lumbar region. Active posterior tilting is tought to the patient to compensate the exaggerated

lumbar lordosis.

The patient is given guidelines for correction of posture and its maintenance. Stretching of hamstrings is done at regular intervals.

Sacroiliac Joint Dysfunction (SI Joint Pain)


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Dysfunction in the sacroiliac joint, or SI joint, is thought to cause low back and/or leg

pain. The leg pain can be particularly difficult, and may feel similar to sciatica or pain

caused by a lumbar disc herniation. While it is not clear how the pain is caused, it is

thought that an alteration in the normal joint motion may be the culprit that causes

sacroiliac pain. This source of pain can be caused by either:

Too much movementhypermobility or instability. The pain is typicallyfelt in the lower back and/or hip and may radiate into groin area.

Too little movementhypomobility or fixation. The pain is typically felt onone side of the low back or buttocks, and can radiate down the leg. The pain

usually remains above the knee, but at times pain can extend to the ankle or

foot. The pain is similar to sciatica, or pain that radiates down the sciatic nerve

and is caused by a radiculopathy.

Stretching Exercise for Sciatica Pain from Sacroiliac Joint Dysfunction

Performing range of motion exercises directed at the SI joint can often restore normal

movement and alleviate the irritation of the sciatic nerve. Three helpful exercises are

described below:

Single knee to chest stretch. Pull one knee up to the chest at a time, gentlypumping the knee three to four times at the top of the range of motion. Do 10

repetitions for each leg .

Press-up. From the prone position, press up on the hands while the pelvisremains in contact with the floor. Keep the lower back and buttocks relaxed

for a gentle stretch. Hold the press-up position initially for five seconds, and

gradually work up to 30 seconds per repetition. Aim to complete 10

repetitions.

Lumbar rotationnon-weight bearing. Starting by lying on the back withboth knees bent, keep the feet flat on the floor while rocking the knees from

side to side. The thighs should rub together and the knees will not move very

far. The lower spine should remain fairly still. Rock the knees for 30 seconds.

Pelvic stabilization exercise for sciatica should be performed to strengthen musclesthat support a joint that may be too loose. This is important because the extra motion

can cause wear and tear on the joint cartilage leading to degeneration and arthritis.

Pelvic Stabilization Exercises for Sacroiliac Joint Pain:

Wall squatsStanding in neutral against the wall with your feet the length of your

thighs away from the wall. Bend your knees no lower than a 90 degree angle keepingyour weight in the heels evenly for both feet. Kneecaps should line up with the second


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Important Exercise for Sciatica - Copy