A combination of controlled exercise and rehabilitation is a good treatment for severe sciatica. If your pain is severe enough to prevent you from continuing with your exercise program, you may need to have medication or an injection of lumbar epidural steroids.
Targeted exercises for sciatica relief from lumbar herniated Discs usually have two main goals.
- Reduces severe sciatica discomfort
- Rehabilitation is an option for those who need to heal over the long-term.
Lumbar herniated Disc exercises activate, strengthen abdominal, deep and gluteal muscle. To determine the level of physical therapy and exercise needed to heal a lumbar herniated spinal canal, it will depend on the severity of the pain and how long the symptoms have been present.
What is the McKenzie Method and what can it do for you?
Robin McKenzie (a New Zealand physical therapy) created the McKenzie Method. McKenzie’s McKenzie method was designed to ease symptoms associated with herniated or bulging discs. He devised a series of progressive exercises that would reduce the pain radiating into your arms and legs.
The McKenzie Method
Robin McKenzie is a Physical Therapist. He discovered that stretching the spine could give significant pain relief to patients. He developed a series of exercises and maneuvers which allow patients to have a greater impact on their overall health.
The McKenzie Method has a long-term goal: to help patients with neck or back pain learn how to properly care for themselves. Other goals include
- Reduce pain quickly
- You can go back to your normal daily functioning
- Reduce the likelihood of repeated painful situations by eliminating painful movements and postures.
- Reduce the number of visits to your spine specialist
McKenzie provides a range of positions that can be used to treat back pain. The severity of your back pain might make it difficult to complete each stage. If this is the case, you should continue working until your pain subsides. McKenzie suggests four stages for you to go through: prone lie; prone lying while your elbows rest on your elbows; and prone push-ups. There are also progressive extensions with pillows or standing extensions. Depending upon your perspective of McKenzie’s original exercise sequence there are many variations.
What is a herniated bulging disc?
Imagine holding a disk that is a part of our spine and feeling like it was a jelly. It’s like holding a jelly sandwich with thick ligaments. Continue to squeeze the jelly with your palms on both sides. The jelly will eventually push on to the opposite side. It’s basically the same as what happens in our spine.
This can happen due to sudden injury, pressure from above and beneath, or wear and tears over time. This bulge or as it is known, “bubbling” can cause some movements to be restricted and press on nearby nerves. It’s crucial to restore the disc’s center. The McKenzie Method works the opposite way to injury.
Centralizing the Disc
If there is a bulge pressing posteriorly on the spine, then bending forward or sitting while trying to get to the next place will cause more pain. When we stand, or walk, our lumbar spine naturally moves forward. It decreases disc bulge as the lower spine extends in a different way than being bent over or hunched. It increases disc pressure, creating suction. It can also draw the disc material in the disc.
Depending on how severe your condition is, we can help you select the right exercises to start and move to. These exercises will not only strengthen the surrounding muscles, but they will also help to center the disc. Patients can choose which direction is most comfortable for them and minimizes their leg symptoms. During the acute stage (the first 7-10 days after a new injured), we recommend moving in the direction that your body prefers. You should do 20 reps every hour. In other words, gentle cobra extension of 20 reps per hour is recommended for anterior lumbar disk herniations. You can start slowly and increase in difficulty as the pain subsides.
Exercises to reduce sciatic nerve pressure due to a herniated disc
There are many strengthening and stretching options to help with sciatica due an herniated spine. The following types of exercises can be used:
- McKenzie method
- Exercises to increase your abdominal strength and back muscle tone
- Exercises of Abdominal and Back Stabilization
- Nerve mobilization exercise
Nerve mobilization treats nerves with adhesions. These are fibrous, soft tissue bands that have become stiffened because of inflammation. The adhesions can eventually cause pain from the spinal root and can travel down the leg as sciatica.
Exercises to strengthen the abdominal muscles
If you’re lying on your stomach, it is possible to do abdominal exercises that increase stability and strength.
Curl ups are for the upper stomach muscles
- Start by lying flat on your back and bringing your feet to the floor.
- Cross your arms and place your pelvis on a flat surface.
- Gently raise the shoulders and lift your head off of the floor.
- You should hold this position for between 2 – 4 seconds. Now slowly return back to your original position.
- You will gain strength and you will be capable of doing two sets (10 curls). Your head should not be lifted too high. For neck pain relief, place your hands behind your head.
Single leg lifts are good for your lower abdominal muscles
- Start by lying on your stomach, and then tighten your stomach muscles.
- Slowly raise one’s foot 8-12 inches above the ground, but don’t bend your knee.
- Place the opposite leg against a flat surface and lower your back. Slowly lower the leg so that it is in line with the ground. Keep it up for between 8-10 seconds.
- Your strength will increase, and you can complete two sets (10 lifts).
Water therapy can also be used in cases where the exercises are too difficult. The buoyancy water offers assistance and can reduce the pain. Water exercises can be particularly beneficial in strengthening the hips or lower abdomen muscles.
Sciatic Nerve Glide Exercise
Nerve mobilization or nerve stretching (nerve mobilization), is intended to loosen nerve tension and make nerves less rigid. These steps are necessary to mobilize sciatic nerves.
- To straighten your knees, place the other leg on a stool. The other leg must be flat on the ground.
- Slowly bend your ankle to point your toes up.
- Keep your ankle bent in the back, and keep your toes pointed up.
- You can increase tension by tilting your head forward and gliding with your head up. Your chin should be towards your chest.
- Move the other leg.
- Each leg should at most be completed 3 times per hour.