Yoga for Sciatica

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Sciatica, Fitness and Back Pain

Published: 06 October 2017

So, Yoga for Sciatica? Is it very effective? I am sometimes asked this question in my Physiotherapy Practice.

The answer I give is - “sometimes it is and sometimes it’s not! It really depends!”

Let’s first look at the question: “When is Yoga good for sciatica?” Then we will flip it: “when is Yoga NOT good for Sciatica?” and finally I will aim to advise you on “How do I identify the best treatment for your sciatica?”

I am basing this on my experience in the treatment of sciatica over the past 20 years. Sciatica makes up approximately 40% of my working days at the moment!

When is Yoga good for sciatica?

It really comes back to the causes of sciatica - and there are a few. If the cause of your sciatica arises from a tightness in the muscles of your lower back and leg, the Yoga exercises can be of benefit. It is also of value if the cause of your sciatica is stress-related or contributory cause.

Correctly understanding and examining the underlying cause of your sciatic pain requires a thorough assessment from an experienced Spinal Physiotherapist, and may require x-rays and scans of your lower back and pelvis in some cases.

Sciatica is most commonly caused by a joint or a disc in your back being out of place. The most common causes of displaced discs that I see result from injury, tight muscles, postural stress, road traffic accidents, arthritis, osteoporosis and also pregnancy.

The most important aspect in the management of your sciatica is identifying the underlying cause. Frequently, sciatic patients have a joint out of place - as well as having tight muscles. If the muscles are treated before the joint alignment is addressed and restored, further damage and pain can result. This is the main reason why I insist on through examination before treatments (or exercise regimes such as Yoga) are started.

I frequently see patients in my practice who have carried out only sciatica home treatment and have found that their pain has worsened. They commonly report that they have read a book about sciatica and were following recipes for the “cure of sciatic pain”! Beware of following any “cure” without a full diagnosis from your physiotherapist.

The trouble is that there is no single recipe to cure all of sciatica. I see, on average, three sciatic pain sufferers each day - and rarely do these sciatic pain patients have the exact same findings in relation to the cause of their sciatica. If you are one of the lucky few - your recipe book might work, but I advise that you don’t risk your health!

However, if your spinal alignment is normal and you have no positive findings on examination other than tightness in your muscle tissue, yoga may prove very useful. But, I would insist on Yoga movements and positions specific to your tight muscles, and taught by a Physiotherapist with a qualification in Yoga. Inappropriate exercises may do more harm than good.

Let’s now move on:

When is yoga bad for sciatica?

It’s not that Yoga is bad for sciatica - certain yoga exercises can be bad for sciatica, particularly if the cause of your sciatica has not been firstly diagnosed and then treated. Performing Yoga with sciatic pain may worsen your condition if you are not careful. The important thing to do first is treat the underlying cause of the pain. Once the structure that is pressing or pinching your sciatic nerve has been corrected, then certain forms of yoga will help strengthen your core and mobilise the tightness efficiently. If you feel your sciatic pain increasing during or after yoga exercises, stop them immediately and seek professional help.

I have treated patients who have tried to exercise their way out of sciatic pain. Performing Yoga through pain is, in my opinion, crazy!

What is the best treatment and exercise for sciatica?

Again, I do not have a recipe for the answer to this question that I can simply give over the web. However, based on my many years of experience in the treatment of this condition, I would advise the following:

1. Get a thorough examination from a Chartered Physiotherapist and doctor specialising in back pain.
2. Use non-steroidal anti-inflammatory medication in the short term (see back pain medication), when inflammation is acute as advised by your doctor.
3. Get some manual therapy from a massage or physical therapist.

Once the pain has eased and the pressure on your sciatic nerve has been released, I then recommend Pilates or Yoga as the best form of exercise specific to sciatica (see the difference between Yoga and Pilates). Based on my own clinical experience, I would recommend Pilates as my overall exercise regime of choice in the treatment of sciatica. It should be taught by a chartered Physiotherapist with knowledge of the type of sciatica you have suffered from.

However, note that similar to yoga - Pilates that is taught or performed incorrectly can do more harm than good.