Sciatica Notes

I’m not a medical professional but I did take copious notes during my rehab from my terrible sciatica in 2020. It was during quarantine, so I didn’t get an MRI, but I’m pretty sure I had slipped a disc. Recovery took months and had some setbacks but learning how to rehabilitate my body actually taught me how to avoid injury. Recently, I’ve had several friends reach out and ask what was helpful, so I thought I’d just post it here for easy sharing. I hope it is helpful. I am now 6 years free from sciatica and I struggled with it for 15 years before I started the following.

Healing phases:

• injured: extreme pain, serious rest required.

  • Ice and Ibuprofen were very helpful. I would lay on a large ice pad and alternate with heat when really intense. My doc told me that ice was to help with inflammation and heat was to help with circulation. When in pain, I would use ice; when stiff, I would use heat.

  • During this time, I started my physical therapy routine (details and video below) but only did what was not further aggravating. Take is slow in this phase. Avoid sitting and forward folds; anything that opens up the back of the spine again.

  • Tiny walks focusing on keeping core very strong. In the very early days, I even had to wear a corset to help me keep my spine erect and supported. It took me about 10 minutes to walk around our short block and I would be exhausted and need to ice by the time I got home.

  • To avoid triggering my back each time I got out of bed, I used this technique. (I had to keep doing this until I started weight-lifting regularly!)

• healing: noticeable improvement, able to walk and stand

  • continued my physical therapy routine 2-3 times per day and any time that I started to feel symptoms.

    • I started to get a real feeling of just what my quads and core felt like when I wasn’t too tight. I also started to notice strength in lifting my legs to step up stairs. I could tell that my form was improving from the standing hip lifts. I believe that this was the key to avoiding injury so long after this. I was able to catch tightness and stretch before injury could occur.

• full health: no symptoms

  • I paid close attention, and still do, to how tight my quads and hip-flexors are. I do stretches for these regularly and still feel quite a deep stretch in the very simplest quad stretch from the early days of physical therapy. Sometimes, I do this one now in a lunge but am very careful to focus on the pelvic tuck.

  • I also started weight lifting about a year after symptoms finished which I think has helped me stay symptom-free. I do comprehensive full-body training but the following are exercises that I think have helped me gain strength and avoid excessive tightness in my hips. I do not recommend these until you are way out of the symptom phase and make sure you are careful about form. I started with a trainer and had his guidance for 2 years.

    • hip flexor lifts: stand on a raised surface (stair, block, etc.), loop active foot under a 2 lb kettle ball and raise knee to 90 degrees. 8-12 reps, 2x per side. If too heavy, start without weights. I moved up to 4 and 6 lbs after a few weeks.

    • hip thrusts and single leg hip thrusts

    • core…so much core. Mostly roman chair, planks, TRX…all of it is helpful.

Physical Therapy Routine from Kaiser PT:

- kneeling thigh/hip stretch 4 sets 20 seconds
- standing hip lifting alternating legs 4 sets
- kneeling/elbo plank accordion 3 sets 30 seconds

I’m not a doctor. This is not medical advice. These are just some stretches and exercises which helped me heal my sciatica.