How to Relieve Sciatica Pain

Muscle tension or incorrect movements can irritate the sciatic nerve in the back. What helps acutely, what exercises you can use to prevent

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Quickly carry the water tank into the apartment. But suddenly ... When bending down, severe pain pulls from the back over the buttocks to the back of the thigh and foot. "Sciatica pain is really hard to bear," says Professor Andrea Meurer.

They occur when pressure is applied to the sciatic nerve. This is made up of various nerve fibers that emerge in the lower lumbar region of the spine.

Several possible causes

The causes can be very different, explains Professor Meurer, Medical Director, Senior Surgeon and Center Manager of the Orthopedic University Clinic Friedrichsheim. Often it is muscle tension in the buttocks area in people who sit a lot. The nerve comes under pressure and sends pain signals.

Incorrect movement, for example when lifting a water tank, can also trigger the problems - up to and including a herniated disc. The sciatic nerve is then pinched.

What helps with acute pain?

The hip muscle (musculus piriformis), which lies directly under the gluteus muscle, is often tense. "In about 20 percent of all people, the sciatic nerve even runs directly through this muscle," explains physiotherapist Michael Preibsch. Those affected should try to stretch it with specific exercises. This relieves the sciatic nerve, says the former deputy chairman of the German Association for Physiotherapy.

Exercises for sciatica pain

© Jump Photo Agency / Kristiane Vey


© Jump Photo Agency / Kristiane Vey

1. Stretching

Lie on your back, bend your right leg. With your left hand, grasp the outside of your right knee, pull gently to your left and lay it down. The left leg is stretched out.

Extend your right arm away from your body and gently twist your upper body to the right towards the floor. Both shoulders stay on the ground all the time. So linger, breathe calmly. Then switch sides.

© Jump Photo Agency / Kristiane Vey

2. Relax

Lie flat on your back, bend your legs, lumbar spine is in contact with the floor. Grasp your shins and gently pull both knees towards your chest.

Keep your upper back, head and shoulders on the floor.

Hold this position for about half a minute and continue to breathe calmly.


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Many patients also find warmth to be beneficial. You can try to loosen the hardened muscles with heat patches from the pharmacy or a heated cherry stone bag. "Or you can go to the sauna," advises orthopedist Meurer.

Often the so-called step bed position also alleviates acute pain. The person concerned lies on the floor and places the lower legs on a chair at a right angle to the thighs (see picture below).

Step bed positioning

© W & B / Astrid Zacharias

It would be wrong to simply lie down in bed for a long time to cure the symptoms, explains Meurer. Moderate movements are definitely helpful to relax the muscles again.

When is it an emergency?

If, in addition to the pain, numbness occurs in the leg, on the inside of the thigh or in the pubic area, a doctor should be consulted immediately. This also applies to paralysis of the leg muscles or sudden incontinence.

"That would be an absolute emergency, since a herniated disc can be the cause," warns expert Andrea Meurer. A visit to the doctor is also advisable if the pain patient has recently had an accident, is taking cortisone supplements or suffers from osteoporosis.

Do you need an operation?

Even if it is a herniated disc, surgery is not absolutely necessary. The problem can also heal on its own if the prolapsed tissue retreats into the intervertebral disc space over time, explains physician Meurer.

Physiotherapists can support this process with certain techniques. According to Preibsch, the treatment is always adapted to the latest test results and discussed with the attending physician.

On the other hand, an operation must be performed immediately if there is numbness in the pubic area or incontinence. Otherwise there is a risk of permanent damage to the sciatic nerve.

Do medication help?

In the acute phase, patients can take pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) for one to two days. If the symptoms are very severe, the doctor may prescribe higher-dose opiates.

"If these have to be used, however, diagnostics with magnetic resonance tomography (MRT examination) and X-rays should also be carried out," advises Meurer. This allows the doctor to assess changes in the intervertebral discs and the condition of the vertebral bones.

What is the point of physiotherapy?

If sciatica symptoms keep recurring, a physiotherapist can use manual techniques to relieve tension and movement restrictions. He also shows those affected exercises to strengthen the back and abdominal muscles. Well trained, the muscles act like a corset that supports and stabilizes the spine.

According to Preibsch, the workplace of the person concerned is also important: "When someone sits down for a long time, their posture is extremely important.