Exercise for Sciatica from Spinal Stenosis

Burning and numbing sciatica symptoms in the leg that are associated with choked or constricted spinal nerves may be effectively treated with targeted therapeutic exercises. Exercises for lumbar spinal stenosis aim to relieve neural compression by:

• Improving spinal posture through muscle strengthening techniques
• Reducing further compression of the spinal nerve roots in their bony canals
• Improving mobility in the leg(s) and the ability to walk without discomfort

If severe pain reduces the ability to perform the exercises as advised, pain management techniques that involve oral medication or spinal injections may be prescribed to control the pain and allow better exercise compliance.

Sciatica Exercises for Spinal Stenosis

Exercises to relieve and treat lumbar spinal stenosis pain are usually flexion-based (forward-bending). This position opens up the constricted bony canals, decompressing the nerve root(s) and enabling patients to perform the exercise more efficiently with lesser pain.

Flexion-based lumbar stabilization techniques to treat spinal stenosis involve¹Slater J, Kolber MJ, Schellhase KC, et al. The Influence of Exercise on Perceived Pain and Disability in Patients With Lumbar Spinal Stenosis: A Systematic Review of Randomized Controlled Trials. Am J Lifestyle Med. 2015;10(2):136–147. Published 2015 Feb 16. doi:10.1177/1559827615571510:

• Functional stretching of the hamstrings, quadriceps, and the deep lower back muscles
• Abdominal strengthening exercises to decrease pressure on the spine
• Hip mobilization to improve the mobility of the hip joint

These exercises typically aim at building stability of the lumbar spine, reducing pain, and improving leg function.

A combination of several exercises is necessary to achieve the desired stability and support of the lumbar spine.

Flexion-Based Stretching Exercises for Spinal Stenosis

These exercises help improve lumbar stability and maintain a correct spinal posture during everyday activities, such as walking or bending.

Back flexion while lying down

Start by lying on the back.

• Gently pull the knees to the chest with both hands until a comfortable stretch is felt.
• For a more advanced stretch, gently raise the upper back so that the forehead touches the knees.

Hold for 2 to 3 seconds and slowly return to the starting position. Aim to complete 4 to 6 repetitions of this stretch.

Back flexion while sitting

Start by sitting in a chair with the feet flat on the floor.

• Lean forward, bending at the waist and keeping the back straight.
• Reach both hands towards the floor between the knees.

Hold for 2 to 3 seconds and return to the starting position. Aim to complete 4 to 6 repetitions of this stretch.

Back flexion while standing

Start by standing with both feet about shoulder-width apart.

• Gently bend forward at the waist, without arching the back.
• Reach both hands down towards the floor until a comfortable stretch is felt.

Hold for 2 to 3 seconds and slowly return to the starting position. Aim to complete 4 to 6 repetitions of this stretch.

Child’s pose or four-point back flexion

Start by getting down on the hands and knees.

• Gently sit back on the heels.
• Spread the knees comfortably apart and bend forward so the head is resting on the floor and the arms are outstretched in front.

Hold for 2 to 3 seconds and slowly return to the starting position. Aim to complete 4 to 6 repetitions of this stretch.

See Physical Therapy Aids and Passive Techniques for Treating Sciatica

Flexion-Based Strengthening Exercises and Hip Mobilization

Strengthening back exercises in a forward-bent position are usually done with a pelvic tilt. A pelvic tilt exercise strengthens the abdominal muscles and stretches the muscles of the lower back. This exercise is performed by tightening the lower stomach muscles and pulling the navel in and toward the sternum. The pelvic tilt may be done in a lying down, seated, standing, or hands-and-knees (4-point) position.

Strengthening and hip mobilization exercises for spinal stenosis are discussed below.

Curl-ups

Start by lying on the back with knees bent.

• Gently fold both arms across the chest and hold a pelvic tilt.
• Slowly lift the head and shoulders from the floor.
• Hold for 2 to 4 seconds and slowly lower to the starting position.

As strength builds, aim to complete 2 sets of 10 curls. Do not attempt to lift the head up too high. If neck pain occurs, place the hands behind the head to support the neck.

Hook-lying march

Start by lying on the back.

• Tuck both arms into the side and hold a pelvic tilt.
• Slowly raise alternate legs 3 to 4 inches from the floor (similar to a marching motion).

Aim to march for 30 seconds. Repeat for 1 or 2 more sets, with 30-second breaks in between repetitions.

Read more about Back Strengthening Exercises

Flexion-based therapy may also include cycling and inclined walking, which can help reduce spinal stenosis pain and improve blood flow.