03/15/2003 - Questions and Answers

Sciatica and exercise

By: Mark Castleden

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Question

I enjoy physical activities such as weight lifting, walking and swimming, but I have sciatica. How much exercise should I do?

Answer

The first thing is to be sure that you have got sciatica, which is due to pressure on the nerve roots in the areas of the spine known to doctors as the lower lumbar and upper sacral spine. It is caused by spinal disc protrusion. The pressure on the nerve root gives rise to pain and neurological (nervous system) signs on the same side in the thigh and calf. The same pain may well come from joint or ligament disease but of course there will be no neurological symptoms. It is also true that any pressure on the nerve root will cause sciatica-like pain; so perhaps in certain people other things that may be squeezing the nerve need to be excluded.

What to do: In most cases a few days in bed is all that is required and after that activity is encouraged. This activity of course is progressive depending on pain and may require analgesics, such as paracetamol (acetaminophen), to allow the exercises to take place. With more severe prolapse, continuous bed rest and traction (with weights and pulleys) may be needed for 2 weeks and this will reduce the herniation (i.e. disc protrusion) in over 90% of cases. If symptoms and signs have not improved, then maybe an injection of steroids and a local anaesthetic will do the trick. Very occasionally it is necessary to surgically operate on the disc.

So, how much can you do with sciatica: The answer depends on whether the condition is acute or chronic, and how much pain you have. Exercises within the limits of your pain do not seem to produce any adverse effect. It is wise to avoid heaving and lifting tasks altogether, including weight training.

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Created on: 03/30/2000
Reviewed on: 03/15/2003

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