This Is How You Manage Sciatica: Expert Tips from a Certified Personal Trainer
- Justin Roth
- Jun 22
- 6 min read
Sciatica is one of the most common complaints among adults dealing with lower back or leg pain—and it’s also one of the most misunderstood. If you've ever experienced a shooting pain that travels down your leg from your lower back, you may have had sciatica. The good news? Many cases can be managed or even prevented through targeted exercises and movement strategies.
In this blog post, we’ll explore what sciatica actually is, what causes it, treatment options (including when to see a professional), and the best evidence-based exercises to help you find relief.
What Is Sciatica?
Sciatica refers to pain that radiates along the sciatic nerve, the longest and thickest nerve in the human body. It starts from your lower spine (lumbar spine), travels through your hips and buttocks, and continues down each leg. The condition isn’t a diagnosis itself, but rather a set of symptoms that indicate irritation or compression of the sciatic nerve.
Key Symptoms of Sciatica:
Sharp, burning, or shooting pain down one leg
Numbness or tingling (pins and needles)
Muscle weakness in the affected leg
Pain that worsens with sitting, bending, or lifting
Sciatica typically affects only one side of the body and can range from mild to debilitating.
Causes of Sciatica
Sciatica is usually caused by mechanical compression or inflammation of the nerve roots that form the sciatic nerve. Here are the most common causes:
1. Herniated or Bulging Disc
The most frequent cause is a lumbar disc herniation—when the soft inner gel of a spinal disc leaks out and presses on a nerve root. According to a study in The New England Journal of Medicine, herniated discs account for about 90% of sciatica cases (Ropper & Zafonte, 2015).
2. Spinal Stenosis
Narrowing of the spinal canal (called lumbar spinal stenosis) can compress nerve roots. This is more common in adults over 60.
3. Piriformis Syndrome
Sometimes, the piriformis muscle, a small muscle deep in the buttock, can irritate the sciatic nerve. While this is less common, it's well-documented in cases where no spinal issue is found (Boyajian-O’Neill et al., 2008).
4. Spondylolisthesis
This is when one vertebra slips forward over another, narrowing the space where nerves exit the spine.
5. Degenerative Disc Disease
Age-related disc wear can also lead to nerve root compression and sciatica symptoms.
Risk Factors
Several factors can increase your likelihood of developing sciatica:
Sedentary lifestyle
Occupations involving heavy lifting or twisting
Obesity
Prolonged sitting
Diabetes (which can damage nerves)
Poor posture and core instability
When to See a Professional
Most sciatica cases improve with conservative care, but you should consult a doctor or physical therapist if:
You have sudden, severe pain or numbness
Symptoms last longer than a few weeks
You experience loss of bladder or bowel control
You have progressive weakness in the leg
These may indicate cauda equina syndrome, a rare but serious condition requiring immediate medical attention.
Treatment Options for Sciatica
The treatment path depends on the cause and severity, but research consistently supports non-surgical, movement-based approaches as a first step.
1. Physical Therapy
Physical therapy focuses on mobility, nerve gliding, and strengthening exercises. A 2020 randomized controlled trial in Spine showed that guided physical therapy was just as effective as surgery for many sciatica patients (Ostelo et al., 2020).
2. Medication
Over-the-counter NSAIDs (like ibuprofen) can help reduce inflammation. Muscle relaxants and prescription pain relievers may be used in more severe cases—but long-term use is discouraged.
3. Injections
Epidural steroid injections can provide short-term relief but are typically used only when conservative treatments fail.
4. Surgery
Surgery (such as microdiscectomy) is usually reserved for persistent or severe cases. About 5-10% of people with sciatica may eventually need surgical intervention (Peul et al., 2007).
The Role of Exercise in Managing Sciatica
Exercise is one of the most effective tools for reducing sciatic nerve pain, improving function, and preventing recurrence.
Let’s break down 7 science-backed exercises that help with sciatica, and exactly how to perform them safely.
1. Nerve Glides (Sciatic Nerve Flossing)
These help the sciatic nerve move more freely within its surrounding tissues.
How to Do It:
Sit upright in a chair.
Extend the affected leg straight in front of you while keeping your toes pointing up.
Simultaneously tilt your head backward as your leg rises, and bring your head forward as your leg lowers.
Perform 10–15 repetitions, 2–3 times daily.
📚 Coppieters & Butler (2008) found that nerve gliding can significantly reduce neural tension and improve mobility in sciatica patients.
2. Pelvic Tilts
Great for core stability and spinal mobility.
How to Do It:
Lie on your back with knees bent and feet flat.
Gently tilt your pelvis to press your lower back into the floor.
Hold for 5 seconds and release.
Repeat 10–15 times.
Pelvic tilts are supported by a 2016 Journal of Back and Musculoskeletal Rehabilitation study as a foundational core exercise for low back pain management.
3. Knee-to-Chest Stretch
This helps release tension in the lower back and glutes.
How to Do It:
Lie on your back.
Gently pull one knee toward your chest while keeping the other foot on the floor.
Hold for 20–30 seconds.
Repeat on both sides.
📚 Delitto et al. (2012) included this stretch in clinical guidelines for low back pain due to its positive effect on lumbar flexion and comfort.
4. Cat-Cow Stretch
Increases spinal flexibility and reduces stiffness.
How to Do It:
Start on all fours.
Inhale and arch your back, lifting your head and tailbone (Cow).
Exhale and round your spine, tucking your chin and pelvis (Cat).
Perform 10–15 reps slowly.
This is often included in yoga-based therapy for low back pain and is backed by studies like Sherman et al., 2011, which showed yoga as effective in reducing chronic low back pain.
5. Glute Bridges
Strengthens glutes and takes pressure off the lower back.
How to Do It:
Lie on your back with knees bent.
Squeeze your glutes and lift your hips toward the ceiling.
Hold for 2 seconds at the top.
Lower with control.
Repeat 10–15 times.
A study in Clinical Biomechanics (2015) highlighted that weak glutes can contribute to increased lumbar strain and sciatic pain.
6. Piriformis Stretch
Helpful if piriformis syndrome is contributing to sciatica.
How to Do It:
Lie on your back and cross your affected leg over the other, resting the ankle on the opposite knee.
Pull the uncrossed leg toward your chest.
Hold for 20–30 seconds.
📚 Fishman et al. (2002) found this stretch especially helpful in reducing piriformis muscle tension and sciatic nerve irritation.
7. Standing Hamstring Stretch
Tight hamstrings can exacerbate sciatica symptoms.
How to Do It:
Stand tall and place the heel of your affected leg on a low surface (like a step).
Keep your back straight and lean forward slightly from the hips.
Hold for 30 seconds.
Tight hamstrings can pull on the pelvis and irritate the sciatic nerve. A 2019 study in Physiotherapy Theory and Practice showed improved pain levels after a consistent stretching program.
Tips for Exercising With Sciatica
Start slowly. Pushing through intense pain can worsen your condition.
Avoid forward bending if it aggravates your symptoms.
Focus on form, not intensity.
Stay consistent. Daily movement is better than sporadic effort.
Stop if you feel sharp or radiating pain—mild discomfort is okay, but pain is a red flag.
Can You Prevent Sciatica?
You can’t eliminate all risk factors, but the following habits can drastically reduce your chances of developing sciatica:
Strengthen your core and glutes.
Practice good posture, especially when sitting or lifting.
Take movement breaks during long periods of sitting.
Lift with your legs, not your back.
Maintain a healthy weight to reduce spinal compression.
Final Thoughts
Sciatica can be painful, frustrating, and limiting—but it doesn't have to define your life. Most cases can be significantly improved through targeted exercise, consistent movement, and attention to body mechanics.
As a personal trainer, I often guide clients with sciatica through gentle mobility and strength routines tailored to their needs. If you're struggling with sciatic pain, start slowly and consider working with a certified professional to create a personalized plan. You don’t have to go it alone. Contact me HERE
Workouts & Fitness Tips @justinrothpt
References
Ropper, A. H., & Zafonte, R. D. (2015). Sciatica. New England Journal of Medicine, 372(13), 1240–1248.
Boyajian-O’Neill, L. A., et al. (2008). Piriformis syndrome: diagnosis and treatment. American Family Physician, 77(9), 1479–1485.
Ostelo, R. W. J. G., et al. (2020). Physical therapy or surgery for sciatica. Spine, 45(6), E327–E334.
Coppieters, M. W., & Butler, D. S. (2008). Do 'sliders' slide and 'tensioners' tension? Manual Therapy, 13(3), 213–221.
Delitto, A., et al. (2012). Low back pain clinical practice guidelines. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1–A57.
Sherman, K. J., et al. (2011). Yoga for chronic low back pain. Annals of Internal Medicine, 155(9), 569–578.
Fishman, L. M., et al. (2002). Piriformis syndrome: diagnosis, treatment, and outcomes. Muscle & Nerve, 26(6), 771–777.
van Tulder, M. W., et al. (2007). Surgical treatment of sciatica. Spine, 32(18), 1925–1931.
Andrade, R., et al. (2015). Gluteal muscle activation. Clinical Biomechanics, 30(9), 905–911.
Behm, D. G., et al. (2019). Effectiveness of hamstring stretching. Physiotherapy Theory and Practice, 35(12), 1092–1100.
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