Herniated Disc and Sciatica: How to Find Pain Relief

Question: I have terrible sciatica. Shoots down my right leg, and sometimes, it's so bad that I can hardly walk. The doctor says I have a herniated disc pushing on the sciatic nerve, and he also says I don't need surgery now. Are there exercises I can do every day that will help me? Keep in mind that I'm 71 years old, and while I'm in good shape, I can't do anything too excessive. I just need some easy exercises.
— Buffalo City, WI
Older man awake in bed holding his low back Answer: I hesitate to give you exercises without having had a chance to evaluate you and your particular pain. As you probably know, your pain isn't exactly the same as someone else's pain. In fact, even if someone else has a herniated disc causing sciatica (as you do), the intensity, location, and frequency of pain is most likely different.

Since you want to get the best treatment for your pain and other symptoms, you should get a personalized exercise plan from a physical therapist. That may not be the quick, easy answer that you're looking for, but in the long-term, the personalized program should provide the most pain relief.

In the meantime, I encourage you to remain as active as possible. I know it may be painful to walk, but take advantage of your good days and take short walks. Remain active within your pain limits.

I would recommend you see a physical therapist, who will work with you to develop a good exercise program. Taking into account your age, physical abilities, pain level, and goals, the physical therapist will help you deal with this sciatica and herniated disc.

You probably have one main goal: to get rid of your pain. Exercises for a herniated disc causing sciatica also have one main goal: to get your pain to move out of your leg. This is called "centralizing" the pain. As you do these exercises, you'll know that you're doing them correctly if the pain moves up your leg and into your lower back. The ultimate goal is to return to normal function without pain.

This idea of "centralizing" the pain is very central to the McKenzie Method. I don't know if you've heard of that, but it's a method of evaluating and treating spinal disorders. I am a physical therapist who's also a McKenzie practitioner. If you were my patient, the first thing I'd do would be to take a thorough history and evaluation.

In the evaluation, I'd have you move in various ways that would put different stresses on your spine. You'd tell me about your pain as you go through those movements: Does it get better, remain the same, or get worse? Does the sciatic pain start to move up or down your leg? For more details on this process, you can read this article.

The history and evaluation would help me determine the best treatment plan for you. I repeat my hesitation to give you exercises because your exercise program depends on the findings of the history and evaluation and should be tailored towards your specific condition. I strongly encourage you to make an appointment as soon as possible with a physical therapist.