Exercise for Sciatica related to Herniated Disc

Sciatic Nerve
Sciatic Nerve. SEBASTIAN KAULITZKI/Science Photo Library/Getty Images

Exercise for Sciatica related to Herniated Disc

Research is next to mum about which - or if any, for that matter - back and core exercises are effective for treating symptoms of sciatica.  Just the same, many people, including physical therapists and doctors, report good results with a movement based approach.  In fact, a Work Group from the North American Spine Society recommends a limited course of exercise as an option in cases of mild and moderate herniated disc with radiculopathy symptoms.


One reason for the dearth of exercise recommendations for sciatica pain relief may be related to the term itself.  While telling a friend or family member you have sciatica may help you get understanding or empathy, in reality, it is not an accurate way to describe the changes occurring inside your spine that could be responsible for your symptoms.  In other words, "sciatica" is a pretty vague term. True, it is often used to describe pain and/or electrical symptoms that go down one leg.  But keep in mind that such symptoms could be caused by a number of things.  

One common cause of "sciatica" is radiculopathy due to a herniated disc in your lumbar spine.

Briefly, a herniated disc occurs when the outer fibers of your intervertebral disc fray or rupture, allowing the soft jelly-like substance located in the center to escape.  Quite often this substance, called the nucleus pulposus, lands on a spinal nerve root.

 Because the spinal nerve root is highly sensitive to pressure, when it comes into contact with the nucleus pulposus, radiculopathy symptoms may result.  Symptoms of lumbar radiculopathy can include radiating pain and/or other nerve related sensations going down one leg.  Many people who are not in the medical field refer to lumbar radicuopathy as sciatica, but as you now know from reading this short description, lumbar radiculopathy is a disease process in the spine - that may be due to a herniated disc or another condition.

Related:  Exercise For Stenosis Related Sciatica

Relationship between the Type of Sciatica and Type of Exercise 

The knowledge gleaned from getting "sciatica" symptoms diagnosed by your doctor may influence your therapeutic exercise selections.  

For example, according to Dr. Judith Glaser, an osteopathic physician, medical acupuncturist and director of  Restorative Medicine in New Hyde Park, New York says, "the flexed posture tends to aggravate herniated disc symptoms."

This means that herniated disc symptoms in general tend to get worse when you bend forward, and better when you arch your back.  If you've been diagnosed with herniated disc with radiculopathy, this correlation between symptoms and the spinal actions of bending or arching may help you and/or your physical therapist determine which movements to do and which to limit.

But Dr. Naomi Betish MD, physiatrist and acupuncturist at Union County Orthopedic Group in New Jersey informs me that selecting exercises for relief of sciatica and/or radiculopathy - regardless of the cause - can be prioritized based on positions that are not painful.

 In other words, she suggests, don't exercise while in pain, as this may be counterproductive in terms of managing or relieving your symptoms.  

Sciatica Exercises for Herniated Disc with Radiculopathy

So what's the objective of doing sciatica exercise, anyway?  Dr. Glaser says that herniated disc is often accompanied by weakness and loss of muscle control.  "Therefore," she says, "relieving symptoms may be a matter of choosing exercises that both strengthen your muscles and improve dynamic (dynamic refers to the body in motion) control.

Keeping these tips in mind, below are a few ideas for exercises that may help you manage sciatica and/or radiculopathy symptoms that are related to herniated disc.

 A word of warning:  As Betish suggests, don't work in pain.  If an exercise increases your symptoms, stop doing it and consult with your doctor or physical therapist.  In fact, it's a good idea to see a licensed physical therapist for a sciatica exercise program anyway.  If that's not possible, at the very least, show this list of exercises to your doctor, and let her guide you as to the most appropriate ones to do, given your condition.

List of Exercises for Sciatica due to Herniated Disc 

  • Abdominal Bracing strengthens the transverse and other ab muscles, which will likely help stabilize your low back.
  • Pelvic Tilts help strengthen back and hip muscles -  important for fully standing upright, Glaser comments.
  • Glute Bridge Similar to the pelvic tilt exercise, the glute bridge strengthens your hips, particularly your hamstring muscles at the back of the thigh and pelvis.  Hamstrings are one of the hip muscles that play an important role in healthy, upright standing posture.
  • Bird Dog. An exercise that takes place on "all 4s"  (i.e. your hands and knees), the bird dog strengthens the muscles that extend your spine, which may help avoid a habitually flexed spine (important for reducing symptoms as we've already discussed).  As with pelvic tilt and the bridge, bird dog may also contribute to your ability to stand fully upright.

    Modify Your Sciatica Exercise to Fit Your Condition

    Some therapists give modified side bridges  (also known as side planks) to their patients who have herniated disc with radiculopathy symptoms.  Side planks strengthens the quadratus lumborum muscle which is a flank muscle that, when strong, assists with spinal flexion (bending forward).  It also plays an important role side bending.  Note that the full side plank "proper" is a pretty challenging exercise - and not recommended for people who have back pain or conditions; this is why a modified version is generally used.

    Betish adds that, sit ups and exercises where you draw your knee to your chest can work against you.  "Most people have difficulty doing these kinds of exercises.  Plus, the risk of herniated a disc increases if you perform them incorrectly."

    Glaser also suggests maintaining a stretching and flexibility routine.  Muscles to target include your hip flexors (illiopsoas), your back muscles and your hamstring muscles.


    North American Spine Society. Diagnosis and treatment of lumbar disc herniation with radiculopathy.

    Email Interview. Betesh, N., MD, Pain Management and Physical Medicine/Rehabilitation specialist, Acupuncturist. Union County Orthopedic Group, New Jersey.  Feb. 2014.

    Email Interview.  Glaser, J., DO, Director Restorative Medicine, New Hyde Park, New York.  February 2014.

    Email Interview. Murphy, J.  DPT, Director, MotionWorks Physical Therapy.  Neenah, WI.

    Burr Ridge (IL): North American Spine Society; 2012. http://www.guideline.gov/content.aspx?id=46414">http://www.guideline.gov/content.aspx?id=46414">http://www.guideline.gov/content.aspx?id=46414

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