Pilates for Sciatica Pain: Top 3 Exercises

Sciatica refers to the pain that originates in the lower back and radiates to the buttocks then down the back of the thighs, legs and occasionally, the foot. The pain follows the course of the sciatica nerve, the largest and longest nerve in the human body. It provides most of the sensory and motor activity of the lower extremities. In majority of cases, sciatica only affects one side of the body.

 About 1 in every 50 people suffers from sciatica as a result of a herniated disc. Of these, about 10 to 25% have symptoms that last more than 6 weeks. While sciatic pain can be severe, roughly 80 to 90% percent of people with sciatica get better over time. You are most likely to get sciatica between the age of 30 and 50.

Aside from a herniated disc, sciatica may also be caused by a bone spur on the spine, facet joint injuries or spinal stenosis (i.e. narrowing of the spine) which compresses a section of the nerve. This results in inflammation, pain and often some numbness in the affected leg. Those with sciatica that is associated with muscle weakness or bladder or bowel changes may be candidates for surgery.

What are the Symptoms of Sciatica?

Sciatic nerve pain can vary between dull, aching or burning sensations and sharp, shooting or excruciating pain. Sciatica may also cause numbness and tingling in the affected leg. It is important to see a doctor in these situations because long-term nerve compression can cause permanent damage to the sciatic nerve. In such cases, the symptoms can become permanent.

Sciatica may trigger one or more of the following sensations: 

  • Pain in the lower back, buttocks or back of the leg that is worse when sitting
  • A shooting pain that makes it difficult to stand up
  • Pain that is worsened by coughing or sneezing
  • Burning or tingling sensation in the leg
  • A constant, nagging pain in the rear calf
  • Numbness, weakness or difficulty moving the leg or foot

What are the Risk Factors?

Risk factors for developing sciatica include the following:

  • Age – degenerativechanges in the spine like bone spurs and herniated disks are by far the most common causes of sciatica.
  • Occupation – A job that requires twisting your back, carrying heavy loads or driving a vehicle for long periods may play a significant role in sciatica. However, there is no conclusive evidence of these correlations.
  • Prolonged sitting – It has been shown that people who sit for extended periods or have a sedentary lifestyle are more susceptible to develop sciatica.
  • Diabetes – This disease, which affects the way the body utilizes blood glucose, increases the risk of damage to the sciatic nerve.
  • Obesity – Being obese or overweight increases the stress on your spine. Excess weight can cause spinal changes that ultimately trigger sciatica.

Pilates and Its Role in Managing Sciatica

Let’s be clear and straightforward about this, Pilates exercises will not cure sciatica or the conditions that caused it. However, they can go a long way in helping alleviate the symptoms.

It is highly unlikely that Pilates will trigger sciatica, but it is true that there are certain exercises that can aggravate the condition. If you are afflicted with sciatica, refrain from engaging in any form of exercise that will have you rolling back and forth on your spine. In addition, avoid extreme stretches like the saw, spine twist, and spine stretch. The goal is to do gentle movements that will not overstretch the sciatic nerve.

In addition, try to avoid over-recruiting muscles. For instance, doing traditional Pilates where you tuck your buttocks a little and squeeze the hip extensors may be inappropriate if you have sciatica. The reason behind this is that the movement can increase the pressure on the nerve and decrease the space around it. The solution is to exercise wherein the spine is in a more neutral position. This is when all three spinal curvatures – the cervical (neck) lordosis, thoracic (middle) kyphosis, and lumbar (lower) lordosis – are in good alignment.

Exercise Form

Meticulous form always plays a crucial role in any Pilates exercise, and it is even more important for those dealing with sciatica. Although the classical Pilates method entails keeping your lower back firmly planted on the mat when you are lying supine, the modified method maintains the neutral spine. This is very important if you have sciatica because forcing your back into the floor, tilting your pelvis and squeezing your glutes will cause your spinal and gluteal muscles to compensate for your abs. 

1Equipment Exercises (Pilates chair)

Some Pilates rehab experts use the Pilates chair for their clients with sciatica. If herniated or degenerated disc causes the condition, clients are instructed to lie face down on the chair with their hands against the pedal. As they extend their backs, they push down against the pedals. Clients with spinal stenosis use the chair from the standing position by slowly bending at the hip, rounding their lower backs and pushing down against the pedals. 

2Mat Exercises

Some exercises like the basic cat, which will have you kneeling on all fours and rounding your lower back, may help ease sciatica symptoms, specifically those caused by spinal stenosis. The cat is one of the simplest and gentlest Pilates exercises to stretch out the spine.

For people with herniated discs, the swan preparation is the recommended exercise. It is basically an extension exercise and considered as one of the best in counteracting the forward flexion exercises in Pilates mat work. It expands the chest and stretches the abs, the hip flexors and the quadriceps. 

To do the swan, lie prone, with your elbows and forearms on the mat and your fingers directly under your shoulders. Lift your head, neck and chest while extending your upper spine. Return to the starting position and do five repetitions. 

3Home Pilates Exercises for Sciatica

Whenever pain is involved, it is important to get in touch with a qualified Pilates instructor in order to determine which exercises are safe for you to do at home.

Majority of these pre-Pilates exercises are basic moves from which other exercises are built upon. They are simple and easy, so you can do them on your own.

Quadruped Exercises – these include movements such as the cat/cow and the arm/leg reach where both hands and knees are in contact with the ground.

  • The cat-cow goes between a back stretch and a back extension. It is effective in decreasing low back pain and is a great Pilates workout to help find neutral spine. Start in the four-point kneeling position with your back flat. Do the following:
  1. Engage your abs by lifting your belly button to support your spine.
  2. Roll your back slowly towards the ceiling while pulling your abs in and dropping your head and tailbone to go into cat stretch. Hold the position for 2 to 5 seconds.
  3. Reverse the curvature of the spine by lowering your belly button, raising your head up and sticking your butt back to go to the cow pose. Hold for 2 to 5 seconds.
  4. You can go from cat to cow as you wish. Remember that the mid range between the two will put your spine in neutral.
  • The kneeling arm and leg reach promotes core stability which is crucial for those with back pain and sciatica.
  1. Start in the four-point kneeling position. See to it that your legs and feet are parallel and hip distance apart. Your spine must be in neutral position and supported by your abdominals.
  2. Extend your right arm in front of you while simultaneously extending your left leg behind you. Your right arm and left leg should be parallel to the ground.
  3. Maintain your balance and hold the position for 1-3 breaths.
  4. Return to the starting position
  5. Repeat step 2 for your left arm and right leg.

Bridging Exercises – these are a great way to isolate and strengthen the glutes and the hamstrings. Do the bridge properly and you’ll see that it’s excellent for core stability and strengthening the abdominals, along with the muscles of the lower back and hip. 

  1. Start by lying on your back with your arms by your side, your knees flexed and your feet flat on the floor. Your feet must be directly under your knees.
  2. Tighten your abs and gluteal muscles.
  3. Slowly raise your hips to form a straight line from your knees to shoulders.
  4. Pull your belly button down toward your spine.
  5. Aim for 10 reps and 2 sets

Remember that the goal is to maintain a straight line from your knees to your shoulders and hold for a few seconds. As you build your strength, hold the bridge position for 20 to 30 seconds. Note that it’s always better to hold the proper position for a shorter time than to hold it longer but in the incorrect position.

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