Modifying postures and activities may help control sciatica pain by relieving pressure on nerves and soft tissues in the lower back. These modifications may also help prevent the recurrence of pain.
Essential techniques to help relieve sciatica pain—as well as prevent the likelihood and severity of potential future episodes of pain—include the following.
In This Article:
- Sciatica First Aid
- Cold and Heat Therapy for Sciatica
- Everyday Activities to Relieve Sciatica
- Sciatica Treatment Video
Postural Changes
Good posture creates a normal balance, relieving tension in the body. Sciatica may result when incorrect posture is used for long periods.1Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/,2Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia. 2007;99(4):461-473. doi:10.1093/bja/aem238 Consistently maintaining good posture can help prevent sciatic nerve irritation, relieve tense muscles, and improve the functioning of the lower body.
Good postural techniques for everyday activities are discussed below.
Standing
Standing is an active process. It is important to distribute weight equally between both feet, which should be hip-distance apart. The knees must be minimally rounded to engage the thigh muscles and prevent locking of the knee. The spine must be naturally curved with the head balanced on top.
Walking
A regular walking routine is typically recommended as part of any sciatica pain relief program. It is important to walk by landing on the heel of the foot and then rolling through the foot toward the big toe to push off. This process allows the weight to be distributed evenly through the foot while taking a step. With each step, the spine must be naturally curved, and a gentle spinal rotation must be achieved by reaching the opposite arm forward. The shoulders must be relaxed, with the head balanced on top of the spine.3Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
Bending and lifting
A proper lifting technique can prevent a muscle, joint, and/or a disc injury in the lower back. While lifting an object from the ground, it is recommended to squat down in front of the object by bending the knees, without bending the back. The object must be kept close to the chest after lifting while straightening the knees to stand up. It is important to inhale and exhale during the process to engage the core muscles. A proper lifting technique can prevent muscle, joint, and/or disc injury.3Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
See Manual Material Handling to Prevent Back Injury
Sitting
A sitting position places a small forward bend on the spine compared to standing. Over time, this forward bend may place a load on the lower spinal discs, causing herniation.4Alamin TF, Agarwal V, Zagel A, Qeli A. The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects. J Spine Surg. 2018;4(3):509–515. doi:10.21037/jss.2018.08.03
To minimize stress to the sciatic nerve while sitting, it is recommended to sit straight with the shoulders rolled back and shoulder blades down. The legs must be hip-distance apart with feet flat on the floor. The spine must follow its natural curve and a small pillow or rolled-up towel can be used to support the lower back.3Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
See Office Chair: How to Reduce Back Pain?
‘Wallet sciatica’ or sciatic pain that occurs while sitting on a wallet can be prevented by keeping wallets or other objects out of the back pocket of a trouser.
Sleeping
A good sleeping posture can help prevent twisting of the spine or tucking in of the pelvis. While sleeping on the side, a pillow placed between the knees helps relieve tension in the hip. While sleeping on the back, placing a pillow under the knees helps relieve tension in the lower back.3Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
Watch Pillow Tips for Sciatica Video
It typically takes less effort to maintain correct posture than an incorrect posture.3Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016. Changing from a habitual incorrect posture may take time and constant awareness.
Watch 3 Tips for Sleeping with Sciatica Video
Staying Active Helps Prevent Recurrence of Sciatica
When sciatica pain occurs, it is recommended to stay active and continue daily activities as tolerated.1Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/ While bed rest may provide temporary relief from symptoms, it usually does not aid in faster or long-term recovery.5Peul WC, van den Hout WB, Brand R, Thomeer RT, Koes BW; Leiden-The Hague Spine Intervention Prognostic Study Group. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. BMJ. 2008;336(7657):1355–1358. doi:10.1136/bmj.a143 Performing simple stretches and joint movements for the pelvis and the lower back can also help relieve sciatic nerve pain by loosening tight tissues and improving blood flow to the region.
Typically, sciatica symptoms may be well managed with nonsurgical treatment. For any concerning symptoms, it is best to consult a physician for a diagnosis and treatment plan that addresses the underlying cause of the symptoms.
If the sciatica symptoms worsen, or if there is reduced bowel and/or bladder control, severe muscle weakness, or weakness while lifting the foot (foot drop), it is important to promptly consult a doctor. Such symptoms may indicate serious medical conditions, such as cauda equina syndrome or spinal tumors that require immediate treatment.
- 1 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
- 2 Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia. 2007;99(4):461-473. doi:10.1093/bja/aem238
- 3 Pavilack, L., Alstedter, N. & Wisniewski, E. Pain-free posture handbook : 40 dynamic easy exercises to look and feel your best. Berkeley, CA: Althea Press; 2016.
- 4 Alamin TF, Agarwal V, Zagel A, Qeli A. The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects. J Spine Surg. 2018;4(3):509–515. doi:10.21037/jss.2018.08.03
- 5 Peul WC, van den Hout WB, Brand R, Thomeer RT, Koes BW; Leiden-The Hague Spine Intervention Prognostic Study Group. Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial. BMJ. 2008;336(7657):1355–1358. doi:10.1136/bmj.a143